Description

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Pneumonia can range in severity from mild to life-threatening. It is most serious for infants and young children, people over 65 years of age, and people with health problems or a weakened immune system.

Symptoms

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and general health. Mild signs and symptoms often are similar to those of a cold or the flu, but they last longer.

The signs and symptoms of pneumonia may include:

  • Chest pain when you breathe or cough
  • Confusion or changes in mental awareness (in adults age 65 and older)
  • Cough, which may produce phlegm
  • Fatigue
  • Fever, sweating and chills
  • Lower than normal body temperature (in adults older than 65 years of age and people with weak immune systems)
  • Nausea, vomiting, or diarrhea
  • Shortness of breath

Newborns and infants may not show any sign of infection. Or may be vomiting, fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

When to see a doctor

Consult your doctor if you have shortness of breath, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you are coughing with pus.

It is especially important that people in these high-risk groups to see a doctor:

  • Adults older than 65 years of age
  • Children under 2 years of age with signs and symptoms
  • People with an underlying health problem. or a weakened immune system
  • People undergoing chemotherapy or taking a medication that suppresses the immune system

For some older adults and people with chronic heart failure, or lung problems, pneumonia can quickly become a life-threatening condition.

Causes

Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs of infection of the lungs. But sometimes these germs can overpower the immune system, even if their health is generally good.

Pneumonia is classified according to the types of germs that cause it and where you have the infection.

Community-acquired pneumonia

Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. It can be caused by:

  • Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur spontaneously or after having a cold or the flu. It may affect one part (lobe) of the lung, a condition called lobar pneumonia.
  • Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. Usually causes milder symptoms than other types of pneumonia. Wandering is an informal name given to this type of pneumonia, which is not usually serious enough to require bed rest.
  • Fungi. This type of pneumonia is most common in people with chronic health problems or a weakened immune system, and in people who have inhaled large doses of the organisms. The fungi that cause can be found in soil or bird droppings and vary depending on geographic location.
  • The virus, includingCOVID-19. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children under 5 years of age. Viral pneumonia is usually mild. But in some cases can become very serious. Coronavirus 2019 (COVID-19) can cause pneumonia, which can become severe.

Hospital acquired pneumonia

Some people get pneumonia during a hospital stay for another illness. Hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. The people who are on breathing machines (ventilators), is often used in intensive care units, are at greater risk of this type of pneumonia.

Health care-acquired pneumonia

Health care-acquired pneumonia is a bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers. As the hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.

Aspiration pneumonia

Aspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Risk factors

Pneumonia can affect anyone. But the two age groups at highest risk are:

  • Children of 2 years or less
  • People who are 65 years of age or older

Other risk factors include:

  • To be hospitalized. You are at greater risk of pneumonia if you're in a hospital intensive care unit, especially if you're on a machine that helps you breathe (a fan).
  • Chronic disease. You're more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease ( COPD ) or heart disease.
  • The habit of smoking. Smoking damages the body's natural defenses against bacteria and viruses that cause pneumonia.
  • Weakened or suppressed immune system. People who have HIV / AIDS , who have had an organ transplant, or who are receiving chemotherapy or long-term steroids are at risk.

Complications

Even with treatment, some people with pneumonia, especially those in high-risk groups, may experience complications, including:

  • The bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, which can lead to organ failure.
  • Difficulty breathing. If the pneumonia is severe or chronic underlying lung disease, you may have trouble breathing in enough oxygen. You may require hospitalization and the use of a breathing machine (ventilator), while the lung heals.
  • The accumulation of fluid around the lungs (pleural effusion). Pneumonia can cause accumulation of fluid in the thin space between the layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to drain through a tube in the chest or removed with surgery.
  • Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed in the abscess, it is necessary to remove the pus.

Prevention

To help prevent pneumonia:

  • Get vaccinated. There are vaccines available to prevent some types of pneumonia and the flu. Talk with your doctor about these vaccines. The vaccination guidelines have changed over time, so make sure to check your state of vaccination with your doctor, even if you remember to have received a vaccine against pneumonia.
  • Make sure that the children are vaccinated. Doctors recommend different vaccine against pneumonia in children under 2 years of age and for children 2 to 5 years who are at particular risk of pneumococcal disease. The children who attend group child care center should also receive the vaccine. Doctors also recommend flu shots for children older than 6 months.
  • Practice good hygiene. To protect against respiratory tract infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.
  • Do not smoke. Smoking damages your lungs ' natural defenses against respiratory infections.
  • Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.

Diagnosis

Your doctor will start by asking about your medical history and perform a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia.

If pneumonia is suspected, your doctor may recommend the following tests:

  • Blood tests. Blood tests are used to confirm an infection and to try to identify the type of organism causing the infection. However, the precise identification is not always possible.
  • X-ray of the chest. This helps your doctor diagnose pneumonia and determine the extent and location of the infection. However, you can't tell your doctor what kind of germ is causing the pneumonia.
  • Pulse oximetry. This measures the level of oxygen in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
  • Sputum test. A sample of fluid from the lungs (sputum) is taken after a deep cough and analyzed to help identify the cause of the infection.

Your doctor may order additional tests if you are over 65 years of age, is in the hospital, or have severe symptoms or health conditions. These may include:

  • CTscan. If the pneumonia is not clear as quickly as expected, your doctor may recommend a ct scan of the chest to obtain a more detailed picture of your lungs.
  • The Pleural fluid culture. A fluid sample is taken by placing a needle between the ribs of the pleural area and analyzed to help determine the type of infection.

Treatment

The treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more.

Specific treatments depend on the type and severity of the pneumonia, your age, and your health in general. The options include:

  • Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing the pneumonia and choose the best antibiotic to treat it. If your symptoms do not improve, your doctor may recommend a different antibiotic.
  • Cough medicine. This medicine can be used to calm your cough so that you can rest. Because coughing helps to loosen and move the fluid from your lungs, it is a good idea not to eliminate the cough completely. In addition, you should know that very few studies have examined the possibility of over-the-counter cough medicines to reduce the coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest.
  • Fever reducers/pain relievers. You may take these as needed for fever and discomfort. These include medications such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).

Hospitalization

You need to be in the hospital if you:

  • You are older than 65 years of age
  • You are confused about time, people, or places
  • Her kidney function has declined
  • Your systolic blood pressure is less than 90 millimeters of mercury (mm Hg) or diastolic blood pressure is 60 mm Hg or below
  • Your breathing is rapid (30 breaths or more per minute)
  • You need respiratory assistance
  • Your temperature is below normal
  • Your heart rate is lower than 50 or over 100

You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe.

Children can be admitted to the hospital if:

  • They are younger than the age of 2 months
  • They are apathetic or excessively sleepy
  • Have difficulty breathing
  • Have low levels of oxygen in the blood
  • Appear dehydrated

Lifestyle and home remedies

These tips can help you to recover more quickly, and reduce your risk of complications:

  • Get enough rest. Do not return to school or work until after the temperature returns to normal and stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Because pneumonia can re-occur, it is best not to jump back into your routine until you're fully recovered. Ask your doctor if you are not sure.
  • Stay hydrated. Drink plenty of fluids, especially water, to help loosen the mucus in the lungs.
  • Take your medicine as prescribed. Take the full course of any medication that your doctor prescribed. If you stop taking the medication too soon, your lungs can continue to harbor bacteria that can multiply and cause pneumonia to be repeated.

Preparing for your appointment

You can start by seeing a primary care physician or emergency medical care, or you may be referred to a doctor who specializes in infectious diseases or lung disease (pulmonologist).

Here's some information to help you prepare for your appointment and know what to expect.

What you can do

  • Keep a record of symptoms, including its temperature.
  • Write down your key medical information, including the recent hospitalizations, and any medical condition that you have.
  • Write down key personal information, including exposure to chemicals or toxins, or any recent travel.
  • Make a list of all the medicines, vitamins, and supplements you are taking, especially left over from a previous infection, as this can lead to a drug-resistant pneumonia.
  • Bring a family member or friend along, if possible, to help you remember the questions and what your doctor told you.
  • Write down questions to ask the doctor.

Some basic questions to ask the doctor include:

  • What is likely causing my symptoms?
  • What kinds of tests do I need?
  • What treatment do you recommend it?
  • I know that I have to be hospitalized?
  • I have other health conditions. How will my pneumonia affects them?
  • Are there any restrictions that I need to follow?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer the questions your doctor may ask:

  • When did you first start having symptoms?
  • He has had pneumonia before? If so, in which lung?
  • The symptoms been continuous or occasional? How serious are they?
  • What, if anything, seems to improve or worsen your symptoms?
  • You've traveled or been exposed to chemicals or toxic substances?
  • Have you been exposed to sick people in the home, school, or work?
  • Do you smoke? Or have you ever smoked?
  • How much alcohol do you consume in a week?
  • Has had the flu or pneumonia vaccines?

What you can do in the meantime

To avoid making your condition worse:

  • Do not smoke or be around smoke
  • Drink plenty of fluids and get plenty of rest
Symptoms and treatment of Pneumonia