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インフルエンザと肺炎の関係と要注意な場合

インフルエンザの女性

 
肺炎は、日本人の死因の第3位となっています。他の疾患で亡くなった場合も、約7割に肺炎の症状がみられます。高齢者は免疫力が低下しているため、風邪をひきやすく、肺炎を併発することも少なくありません。特にインフルエンザの場合は、肺炎も重症化しやすくなります。

こちらでは、インフルエンザと肺炎の関係についてご紹介します。

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インフルエンザと肺炎

インフルエンザと肺炎の関係

風邪の女性

インフルエンザは、インフルエンザウイルスが起こす感染症です。気道にインフルエンザウイルスが感染して、高熱や全身の倦怠感、のどの痛みなどの症状を起こします。インフルエンザウイルスは、それ自身が肺炎を引き起こすことはあまり多くありませんが、インフルエンザの合併症の1つとして、肺炎が挙げられます。肺炎は、インフルエンザの合併症の中で、最も多い病気で、重症になると死亡する可能性もある怖い病気です。

インフルエンザからくる肺炎は、原発性のウイルス肺炎と、細菌の二次感染からくる細菌性肺炎がありますが、頻度としては、細菌性肺炎の方が多くみられます。インフルエンザを発症して、4~5日過ぎても発熱が治まらない場合、一度熱が下がっても、再び発熱し、咳が続いて呼吸が苦しくなる場合などは肺炎を疑ってみるべきです。おかしいと思ったら、早急に医療機関を受診しなければいけません。

インフルエンザウイルスによってのどや気道に炎症が起こると、気道の表面の細胞が壊れて、感染に対する防御機能が弱まり、細菌が感染しやすくなります。細菌性肺炎は、原発性として、細菌の感染が肺炎の直接の原因になっているものと、細菌の二次感染として、ウイルス性の上気道炎が原因になっている肺炎があります。細菌性肺炎の原因となる菌は、インフルエンザ菌(インフルエンザウイルスとは別)、肺炎球菌、黄色ブドウ球菌などがあります。

インフルエンザ菌b性肺炎
主に乳幼児に多く、生後半年から4歳くらいに多くみられ、5歳以降になるとほとんどみられなくなります。発症は冬に多く、細菌性肺炎の原因として1番多いものです。ヘモフィルインフルエンザ菌b型が最も強く、全身型感染症の95%を占めます。この全身型感染症はヘモフィルインフルエンザ菌b型が血流の中に鼻咽腔から入り、身体に広がって菌血症になります。こうしたことで、肺炎を起こしつつ、各臓器で炎症も起こります。このタイプの肺炎は、肺炎の症状の他に敗血症を同時に起こす可能性がありますので、かなり注意が必要です。程度としては重症の部類に入り、神経系の後遺症も多く、気管の入り口が腫れて炎症を起こし、ふさがれてしまうことによって起こる重篤な呼吸困難もあります。これは集中治療を必要としますので、早めに治療を行うことが重要になります。

この型の肺炎には、全身形感染症の他に、粘膜型の感染症もあり、中耳炎や副鼻腔炎、気管支炎なども起こします。

肺炎球菌性肺炎
新生児を除く、全年齢にみられる肺炎です。成人では細菌性肺炎で一番多いタイプの肺炎です。高熱と激しい咳が出て、最初は乾いた咳が1~2日あり、次に膿のような痰が出る咳に変ります。腹痛、中耳炎、髄膜炎、副鼻腔炎、心内膜炎を起こす肺炎菌です。

インフルエンザの二次感染による肺炎を合併しやすい場合

体力のない子供や高齢者では注意が必要ですが、特に、呼吸器系や心臓に持病のある人は注意が必要です。肺炎は死亡することもありますので、体力のない人は注意が必要です。75歳を過ぎると肺炎での死亡率が急激に高くなります。高齢者になると、唾液の分泌量も減り、細菌の増殖を招きます。細菌を含んだ口腔内の分泌物を誤嚥することにより、肺での細菌処理が追いつかなくなり、肺炎を引き起こします。とくに下記の場合に、インフルエンザに伴って肺炎を合併しやすいといわれています。

  • 心臓や呼吸器に慢性の病気を持っている
  • 糖尿病、腎臓病、免疫不全などを持っている
  • 養護老人ホームなどの長期療養施設に入所している
  • 50歳以上の方

インフルエンザの二次感染による肺炎の対策方法

インフルエンザは必ず病院へ

大人の人だと、恐らくインフルエンザだと思っても自宅で安静にして、病院に行かない人もいるようです。インフルエンザは合併症が怖い病気ですので、必ず病院を受診し、薬を処方してもらいましょう。特に小さな子供や高齢者の場合、様子を見るなどと悠長なことを言っている場合ではありません。医師の診察を受けるべきです。合併症が出てからでは手遅れになる場合もあります。

肺炎の予防方法

二次感染による肺炎を予防するには、インフルエンザにかかった時は十分に休養をとり、また処方された薬は指示通りに飲み、インフルエンザを早く治すことが最も重要です。二次感染を起こす危険性が高い方にはあらかじめ細菌に有効な抗菌薬が処方されることがあります。インフルエンザの症状が出てから5~7日たっても熱が下がらなかったり、咳などが悪くなってきた場合は、肺炎を合併した可能性もありますので、早めに医師に伝え、適切な治療を受けましょう。

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まとめ:インフルエンザと肺炎の関係を知ろう

インフルエンザの合併症の1つとして、肺炎が挙げられます。肺炎は、インフルエンザの合併症の中で、最も多い病気で、重症になると死亡する可能性もある怖い病気です。おさらいしておきましょう。

特に気を付けたい場合

  • 心臓や呼吸器に慢性の病気を持っている
  • 糖尿病、腎臓病、免疫不全などを持っている
  • 養護老人ホームなどの長期療養施設に入所している
  • 50歳以上の方

熱が下がらなかったり、症状の悪化が見られる場合は、肺炎を合併した可能性もありますので、早めに医師に伝え、適切な治療を受けましょう。

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Check Also

考える

症状が似ているインフルエンザと扁桃腺炎を見分けるポイント

  インフルエンザと症状のよく …

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