Pneumonia is a general term for a range of acute infections that attack the tissues lining the air spaces—the alveoli—of one or both lungs. The tissues become inflamed, making it difficult for oxygen to reach the bloodstream, impairing breathing. The inflammation may be limited to a single lobe of the lung (lobar pneumonia) or may occur in patches throughout the lungs (pneumonia). If the inflammation also involves the bronchi (airways), it’s called bronchopneumonia.
Pneumonia can strike people from infancy through old age, though those over 65 are at higher risk. Until the development of antibiotics, pneumonia caused by bacterial infections was the leading cause of death in the United States. Pneumonia, along with the flu, is now the eighth most frequent cause of death, but in developing countries the mortality rate from bacterial pneumonia can be much higher, particularly among young children. Symptoms of pneumonia can range from very mild to severe—in fact, the illness can be so mild that some people may not know they have it. Infants and elderly people are at the greatest risk of developing serious complications from pneumonia. Healthy adults usually can be cured within two weeks, though aggressive medical treatment may be required.
One of the more serious forms of lung infections is hospital-acquired pneumonia, which strikes a patient who has been hospitalized for some other condition. It occurs most frequently in patients who are in intensive care units. Though less common than pneumonia that develops outside a hospital (called community-acquired pneumonia), hospital-acquired pneumonia is the most deadly of any hospital acquired infection, with mortality rates of up to 33 percent.
Symptoms of pneumonia
- Fever (over 100?F, may reach 105?F)
- Cough, sometimes with bloody sputum; this cough may last as long as six weeks after the initial infection has cleared.
- Chest pain on inhalation and shortness of breath
- Rapid pulse, rapid breathing
- Weakness and fatigue
- Muscle pain, sore throat, and headache
- In severe cases extreme breathing difficulty; blue tinge to fingernails, lips, or other skin areas; mental confusion
What causes pneumonia?
Pneumonia has many causes, but viral or bacterial infections (particularly with the bacterium Streptococcus pneumonia in older people) are the most common—often as a complication of a lingering cold, or a bout with the flu or bronchitis. Mycoplasma pneumoniae (another type of bacteria) is more likely to cause pneumonia in younger people. There are many other bacteria and viruses that cause pneumonia.
Streptococcus pneumoniae, responsible for a type of bacterial pneumonia called pneumococcal pneumonia, is found in the throats of many healthy people. When body defenses are weakened—by illness, old age, a recent bout of influenza, or impaired immunity, for example—the bacteria can work their way into the lungs and multiply. It’s estimated that about 900,000 Americans get pneumococcal pneumonia each year, and about 5 to 7 percent die from it. Fortunately, a vaccine is available to help prevent pneumococcal pneumonia, though only about 60 percent of older adults have received it.
Who Should Get the Pneumonia Vaccine?
Many people are surprised to hear that a vaccine is available to protect adults and young children against many strains of pneumococcal bacteria, which are responsible for most cases of bacterial pneumonia in this country.
Both bacterial and viral pneumonia can strike year-round, but the autumn and winter months, when colds and influenza proliferate, are major times for the disease. Other risk factors for developing community-acquired pneumonia include smoking, recent surgery, and the use of chemotherapy or other immunosuppressive medications. Living in a nursing home or other long-term care facility can also put you at higher risk.
Medical conditions that can increase the risk for developing pneumonia include sickle-cell anemia, heart disease, asthma or other chronic lung diseases such as chronic obstructive pulmonary disease (COPD), poorly controlled type 2 diabetes, alcoholism, chronic kidney disease, HIV infection, and many types of malignancies. In many people with untreated HIV/AIDS, less common lung pathogens such as Pneumocystis carinii, a fungal organism, may cause pneumonia.
What if you do nothing?
Most cases of viral pneumonia are relatively mild and clear up within one to two weeks. In fact, if the infection develops slowly, you may be unaware that you have pneumonia—a condition known as walking pneumonia.
Bacterial pneumonia, on the other hand, is often more serious. Left untreated, it can lead to scarring of lung tissue or the infection can spread to other vital organs. The earlier a diagnosis is made and treatment started, the less damage will be done to the lungs. Recovery may take anywhere from 10 days to three weeks.
Home remedies for pneumonia
Pneumonia, whether bacterial or viral, should be diagnosed and treated by a physician. In either case, though, you can do certain things to help ease symptoms and speed your recovery.
- Get plenty of rest. Rest is necessary until the fever and shortness of breath subside.
- Lower your fever. Over-the-counter medications—aspirin, ibuprofen, naproxen, or acetaminophen—will help when taken according to label directions. Children should not be given aspirin. A safer bet is acetaminophen; children ages 6 and older can also take ibuprofen.
- Loosen lung secretions. Inhale steam, use a humidifier, take hot showers, and remain well hydrated with water or other nonalcoholic, fluids to make lung secretions easier to cough up and expel.
How to prevent pneumonia
- Get a flu shot. An annual flu vaccination may reduce your risk since pneumonia is a common complication of influenza, especially among those in higher-risk groups.
- Don’t smoke. Tobacco byproducts make you more susceptible to pneumonia and weaken your ability to battle the infection.
- If you’re at higher risk, get immunized. Two different vaccines are now used to prevent pneumococcal pneumonia: the pneumococcal conjugate vaccine (PCV13, or Prevnar 13) and the pneumococcal polysaccharide vaccine (PPSV23, or Pneumovax 23). The CDC recommends that people 65 and older be vaccinated with both vaccines: Prevnar 13 first, followed by Pneumovax 23 at least one year later. Medicare pays for both vaccines if they’re given at least a year apart. All children younger than 2 should also receive the pneumococcal vaccine, as should people ages 2 to 64 who are at elevated risk (due to a medical condition or smoking, for example) and have not previously received the vaccine.
When to call your doctor
Contact your physician whenever you have symptoms of pneumonia.
Call for an ambulance if you experience severe difficulty in breathing or if you develop a blue tinge to your skin.
What your doctor will do
After reviewing your symptoms and examining you, your physician may take a chest x-ray to confirm the diagnosis. If the pneumonia is believed to be bacterial, antibiotics will be prescribed. Cases of viral pneumonia are not treated with antibiotics. Depending on the severity of your pneumonia and your age, hospitalization may be recommended.
Published December 29, 2016