Preface

**Section 3 Idiopathic and Viral Etiologies of Pneumonia 143**

Akira Takeda and Yoshiki Ishii

Al Johani Sameera and Akhter Javed

Chapter 8 **Pneumonia of Viral Etiologies 191**

**VI** Contents

Chapter 7 **Interstitial Pneumonia Associated with Connective Tissue Disease: An Overview and an Insight 145**

> Pneumonia is a life-threatening inflammation of the air sacs, small airways, and surround‐ ing connective tissue. Pneumonia is caused by bacterial and viral organisms or by immune system–related interstitial disease of idiopathic origin. Infectious pneumonia afflicts millions of people worldwide across age groups. The highest mortality rates occur in children under 5 years of age, the elderly, and critically ill patients in hospitals. Environmental and socioe‐ conomic factors and access to health care underlie differences in morbidity and mortality rates from pneumonia in different parts of the world. The increasing incidence of antibiotic resistance and limitations in existing therapies are major public health concerns in the clini‐ cal management of pneumonias.

> The book *Contemporary Topics of Pneumonia* consists of eight chapters that combine systemat‐ ic reviews and investigations; global and clinical perspectives on bacterial, viral, and inter‐ stitial pneumonias; drug resistance; and natural remedies to eradicate carbapenem-resistant Enterobacteriaceae. In Section I, chapters examine the influence of environmental pollution, gender and hormonal influences, and the prospect of climate change on epidemiology and susceptibility to infectious and inflammatory lung disease. In Section II, chapters cover clini‐ cal, epidemiologic, diagnostic, bacteriological, multidrug resistance, and ecological aspects of community and health care–associated bacterial infections that devastate the efforts of medical practitioners in critical care facilities. Two chapters in Section II appraise the in‐ creasing prevalence, acquisition, and ecological aspects of carbapenem resistance in the mi‐ crobiome and evaluate the use of essential oils and nonantibiotic adjuvant chemotherapy as complementary approaches for the treatment of drug-resistant infection. Section III includes a comprehensive chapter on interstitial pneumonia as an autoimmune connective tissue dis‐ ease and a chapter that reviews viral etiologies of pneumonia.

> Written by clinical and research scientists who are directly involved in patient care and re‐ search on pneumonia, the compilation of topics in this book brings together reference, edu‐ cational, and research materials that meet the investigational interests of specialists, researchers, and students and informational needs of patients and general public. I would like to thank the authors for their contributions and diligent efforts in preparing the chapters and Romina Rovan at InTechOpen for facilitating the editorial process.

#### **Zissis C. Chroneos, PhD**

Associate Professor of Pediatrics, Microbiology and Immunology, Pennsylvania State University College of Medicine, USA

**Section 1**

**Intersection of Environment and Pneumonia**

**Intersection of Environment and Pneumonia**

**Chapter 1**

**Provisional chapter**

**Understanding the Intersection of Environmental**

**Understanding the Intersection of Environmental** 

Patricia Silveyra, Nathalie Fuentes and Lidys Rivera

community-acquired pneumonia, environmental exposures

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

Patricia Silveyra, Nathalie Fuentes and

http://dx.doi.org/10.5772/intechopen.69627

**Play a Role?**

**Abstract**

**1. Introduction**

Lidys Rivera

**Play a Role?**

**Pollution, Pneumonia, and Inflammation: Does Gender**

Accumulating evidence indicates that exposure to air pollution is associated with increased mortality from respiratory disease. Exposure to ambient pollutants, such as ozone, particulate matter, sulfur dioxide, nitrogen dioxide, and other agents has been associated with decrease in lung function and immunity, and with increased rates of hospitalization for lung disease, including pneumonia. Furthermore, sex differences in frequency and severity of pulmonary disease and infection have been reported, suggesting a role of sex hormones in mediating these differences. Pneumonia, which is commonly caused by bacterial infection and subsequent lung inflammation leading to hospitalization and death, occurs at different rates in men and women. In this context, male and female hormones can have direct effects on the immunity system by binding to receptors in immune cells, and these responses can be modulated by environmental exposures. This chapter summarizes clinical, animal, and epidemiological studies linking exposure to air pollution and pneumonia in both males and females. Understanding sex-specific mechanisms in pneumonia pathogenesis and environmental responses can help in the development of more effective therapeutics and treatment options to reduce negative health outcomes in men and women. **Keywords:** sex differences, ozone, particulate matter, air pollution, sex hormones,

**Pollution, Pneumonia, and Inflammation: Does Gender** 

DOI: 10.5772/intechopen.69627

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Regulation of the lung inflammatory response is critical to the successful resolution of pneumonia. Exposure to air pollutants has been linked to negative lung health outcomes, and both male

**Provisional chapter**
