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What is pneumonia?

Pneumonia is an infection in one or both lungs. It can be caused by bacteria, viruses, or fungi. Bacterial pneumonia is the most common type in adults.

Pneumonia causes inflammation in the air sacs in your lungs, which are called alveoli. The alveoli fill with fluid or pus, making it difficult to breathe.

What are the symptoms of pneumonia?

Pneumonia symptoms can be mild to life-threatening. The most common symptoms of pneumonia can include:

  • coughing that may produce phlegm (mucus)
  • fever, sweating, and chills
  • shortness of breath
  • chest pain

Other symptoms can vary according to the cause and severity of the infection, as well as the age and general health of the individual.

Symptoms by cause

  • Viral pneumonia may start with flu-like symptoms, such as wheezing. A high fever may occur after 12–36 hours.
  • Bacterial pneumonia may cause a fever as high as 105°F along with profuse sweating, bluish lips and nails, and confusion.

Symptoms by age

  • Children under 5 years of age may have fast breathing.
  • Infants may vomit, lack energy, or have trouble drinking or eating.
  • Older people may have a lower-than-normal body temperature.

What are the types and causes of pneumonia?

The major types of pneumonia are classified by the cause of the infection, where the infection was transmitted, and how the infection was acquired.

Types by germ

Pneumonia can be classified according to the organism that caused the infection.

Bacterial pneumonia: The most common cause of bacterial pneumonia is Streptococcus pneumoniaeChlamydophila pneumonia and Legionella pneumophila can also cause bacterial pneumonia.

Viral pneumonia: Respiratory viruses are often the cause of pneumonia, especially in young children and older people. Viral pneumonia is usually not serious and lasts for a shorter time than bacterial pneumonia.

Mycoplasma pneumonia: Mycoplasma organisms are not viruses or bacteria, but they have traits common to both. Mycoplasmas generally cause mild cases of pneumonia, most often in older children and young adults.

Fungal pneumonia: Fungi from soil or bird droppings can cause pneumonia in people who inhale large amounts of the organisms. They can also cause pneumonia in people with chronic diseases or weakened immune systems.

One kind of fungal pneumonia is called Pneumocystis jirovecii pneumonia (PCP). This condition generally affects people with weakened immune systems, such as those with AIDS. In fact, PCP can be one of the first signs of infection with AIDS.

Is pneumonia contagious?

Most kinds of pneumonia are contagious.

Both viral and bacterial pneumonia can spread to others through inhalation of airborne droplets from a sneeze or cough. But while you can become infected with fungal pneumonia from the environment, it doesn’t spread from person to person.

Who is at risk of pneumonia?

Anyone can get pneumonia, but certain people are at higher risk:

  • infants from birth to age 2 years, and individuals ages 65 years or older
  • people who have had a stroke, have problems swallowing, or are bedridden
  • people with weakened immune systems because of disease or use of medications such as steroids or certain cancer drugs
  • people who smoke, misuse certain types of illicit drugs, or drink excessive amounts of alcohol
  • people with certain chronic medical conditions such as asthma, cystic fibrosis, diabetes, or heart failure

How is pneumonia diagnosed?

Your doctor will start by asking you questions about when your symptoms first appeared and about your medical history. They’ll also give you a physical exam. This will include listening to your lungs with a stethoscope for any abnormal sounds, such as crackling.

Your doctor will also likely order a chest X-ray. Typically, pneumonia can be diagnosed with the physical exam and the chest X-ray. But depending on the severity of your symptoms and your risk of complications, your doctor may also order one or more of these tests:

  • A blood test. This test can confirm an infection, but it may not be able to identify what’s causing it.
  • A sputum test. This test can provide a sample from your lungs that may identify the cause of the infection.
  • Pulse oximetry. An oxygen sensor placed on one of your fingers can indicate whether your lungs are moving enough oxygen through your bloodstream.
  • A urine test. This test can identify the bacteria Streptococcus pneumoniae and Legionella pneumophila.
  • A CT scan. This test provides a clearer and more detailed picture of your lungs.
  • A fluid sample. If your doctor suspects there is fluid in the pleural space of your chest, they may take fluid using a needle placed between your ribs. This test can help identify the cause of your infection.
  • A bronchoscopy. This test looks into the airways in your lungs. It does this using a camera on the end of a flexible tube that’s gently guided down your throat and into your lungs. Your doctor may do this test if your initial symptoms are severe, or if you’re hospitalized and your body is not responding well to antibiotics.

How is pneumonia treated?

Your treatment will depend on the type of pneumonia you have, how severe it is, and your general health.

Prescribed treatment

Antibiotic, antiviral, and antifungal drugs are used to treat pneumonia, depending on the specific cause of the condition. Most cases of bacterial pneumonia can be treated at home with oral antibiotics, and most people respond to the antibiotics in one to three days.

Your doctor may also recommend cough medicine to calm your cough so you can rest. However, coughing helps remove fluid from your lungs, so you don’t want to eliminate it entirely.

Home treatment

You can help your recovery and prevent a recurrence by:

  • taking your drugs as prescribed
  • getting a lot of rest
  • drinking plenty of fluids
  • not overdoing it by going back to school or work too soon

Hospitalization

If your symptoms are very severe or you have other health problems, you may need to be hospitalized. At the hospital, doctors can keep track of your heart rate, temperature, and breathing. Treatment may include:

  • Intravenous antibiotics. These are injected into your vein.
  • Respiratory therapy. This therapy uses a variety of techniques, including delivering specific medications directly into the lungs. The respiratory therapist may also teach you or help you to perform breathing exercises to maximize your oxygenation.
  • Oxygen therapy. This treatment helps maintain the oxygen level in your bloodstream. You may receive oxygen through a nasal tube or a face mask. If your case is extreme, you may need a ventilator (a machine that supports breathing).

Worsened chronic conditions

If you have certain health problems already, pneumonia could make them worse. These conditions include congestive heart failure and emphysema.

For certain people, pneumonia increases their risk of having a heart attack.

Potential complications

Pneumonia may cause complications, especially in people with weakened immune systems or chronic diseases such as diabetes. Complications can include:

  • Bacteremia. Bacteria from the pneumonia infection may spread to your bloodstream. This can lead to dangerously low blood pressure, septic shock, and in some cases, organ failure.
  • Lung abscesses. These are cavities in the lungs that contain pus.
  • Impaired breathing. You may have trouble getting enough oxygen when you breathe. You may need to use a ventilator.
  • Acute respiratory distress syndrome. This is a severe form of respiratory failure. It’s a medical emergency.
  • Pleural effusion. If your pneumonia is not treated, you may develop fluid around your lungs in your pleura. The pleura are thin membranes that line the outside of your lungs and the inside of your rib cage. The fluid may become infected and need to be drained.
  • Death. In some cases, pneumonia can be fatal.

Prevention tips

  • If you smoke, try to quit. Smoking makes you more susceptible to respiratory infections, especially pneumonia.
  • Wash your hands regularly with soap and water.
  • Cover your coughs and sneezes, and dispose of used tissues promptly.
  • Maintain a healthy lifestyle to strengthen your immune system. Get enough rest, eat a healthy diet, and get regular exercise.