Pneumonia

Overview

What is pneumonia?

Pneumonia is an infection of the lungs. Your lungs have 2main parts: airways (also called bronchial tubes) and alveoli (also called airsacs). When you breathe, the air moves down through your airways and into youralveoli (say: “al-vee-oh-lie”). From the alveoli, oxygen goes intoyour blood while carbon dioxide moves out of your blood. When you havepneumonia, your alveoli get inflamed (irritated and swollen) and fill withfluid. This makes it difficult for you to breathe.

Pneumonia is usually caused by bacteriaor a virus. It can also be caused by fungi or irritants that you breathe intoyour lungs.

What are the different types of pneumonia?

There are 4 types of pneumonia:

  • Community-acquired pneumonia is the most common type of pneumonia. You can catch it in public areas (such as work, school, the grocery store or the gym). Bacteria, a virus, fungi or irritants in the air can cause community-acquired pneumonia. The bacteria Streptococcus pneumoniae is the most common cause of this type of pneumonia. This type of pneumonia can also develop after you have a cold or the flu.
  • Hospital-acquired pneumonia (also called institution-acquired pneumonia) is a type of pneumonia that you can catch while you are staying in the hospital, especially if you are staying in an intensive care unit (ICU) or are using a ventilator to help you breathe. This type of pneumonia also includes pneumonia that develops after you have major surgery (such as chest surgery) and pneumonia that develops while staying in or receiving treatment in kidney dialysis centers and chronic care centers. It can be very dangerous, especially for young children, older adults and people who have weakened immune systems.
  • Aspiration pneumonia is type of pneumonia that develops after you inhale particles into your lungs. This occurs most often when small particles enter your lungs after vomiting and you are not strong enough to cough the particles out of your lungs.
  • Opportunistic pneumonia is a type of pneumonia that affects people who have weakened immune systems. It is caused by certain organisms that do not typically make healthy people sick, but they can be dangerous for people who have conditions such as the human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD) or people who have recently had an organ transplant.

 

This information was developed as part of an educational program made possible through support from Wyeth Vaccines.

Symptoms

What are the symptoms of pneumonia?

The symptoms of pneumonia can range from mild to severe,depending on your risk factors and the type of pneumonia you have. Commonsymptoms are similar to the symptoms caused by a cold or the flu. They includethe following:

You may also sweat, have a headache and feel very tired.

If you have any of these symptoms, or if you suddenly startgetting worse after having a cold or the flu, see your family doctor.

  • Cough
  • Fever
  • Bringing up mucus when you cough
  • Difficulty breathing
  • Chills
  • Chest pain

What is walking pneumonia?

Walking pneumonia is a mild case of pneumonia. It is oftencaused by a virus or the Mycoplasma pneumoniae bacteria. When you have walkingpneumonia, your symptoms may not be as severe or last as long as someone whohas a more serious case of pneumonia. You probably won’t need bed rest or tostay in the hospital when you have walking pneumonia.

Causes & Risk Factors

Who is at risk of developing pneumonia?

You are more at risk of developingpneumonia if:

You are older than 65 years of age.As you get older, your immune system becomes less able to fight off infectionslike pneumonia. Babies and young children are also at increased risk becausetheir immune systems are not yet fully developed.

You have a disease or condition that weakens your immunesystem. When your immune system is weakened, it’s easier for you toget pneumonia because your body can’t fight off the infection. People who haveweakened immune systems are also more likely to develop pneumonia frombacteria, viruses and germs that don’t cause pneumonia in healthy people.

People who have any of the followingare at increased risk:

People who have recently had an organtransplant and people who are receiving chemotherapy are also at increasedrisk.

You work in construction or agriculture.Working in environments where you breathe in dust, chemicals, air pollution ortoxic fumes can damage your lungs and make them more vulnerable to infectionslike pneumonia.

You smoke or abuse alcohol.Smoking damages the tiny hairs in the lungs that help remove germs andbacteria. Alcohol abuse can put you at increased risk of aspiration pneumonia,a type of pneumonia that develops after you inhale particles into your lungs.This occurs most often when you vomit and small particles enter your lungsbecause you are not strong enough to cough the particles out. Alcohol abusealso interferes with the way your white blood cells (which are responsible forfighting infection) work.

You are hospitalized, especially in an intensive care unit(ICU). Pneumonia that you catch in a hospital (called hospital-acquiredpneumonia) can be more serious than other types of pneumonia. Your riskincreases if you are using a ventilator to help you breathe. Ventilators makeit hard for you to cough and can trap germs that cause infection in your lungs.

You have recently had major surgery or a serious injury.Recovering from major surgery or a serious injury often makes you weak. It canalso make it difficult for you to cough, which is the body’s quickest defensefor getting particles out of the lungs. Recovery also typically requires a lotof bed rest. Lying down on your back for an extended period of time can allowfluid or mucus to gather in your lungs, giving bacteria a place to grow.

You are of Native Alaskan or Native American descent.For reasons unknown to doctors, people of these ethnic groups are at increasedrisk for pneumonia.

  • Chronic obstructive pulmonary disease (COPD), especially if you have taken inhaled corticosteroids for 24 weeks or longer
  • Human immunodeficiency virus (HIV)
  • Acquired immunodeficiency syndrome (AIDS)
  • Heart disease
  • Emphysema
  • Diabetes

Diagnosis & Tests

How does my doctor know I have pneumonia?

Your doctor will diagnose pneumonia based on your medicalhistory and the results from a physical exam. He or she may also need to dosome tests, such as a chest X-ray or a blood test. A chest X-ray can show yourdoctor if you have pneumonia and how widespread the infection is. Blood andmucus tests can help your doctor tell whether bacteria, a virus or a fungalorganism is causing your pneumonia.

Treatment

How is pneumonia treated?

Treatment depends on the type of pneumonia you have, howsevere your symptoms are, how healthy you are overall and your age.

For bacterial pneumonia, your doctor will probably prescribeantibiotics. Most of your symptoms should improve within a few days, although acough can last for several weeks. Be sure to follow your doctor’s directionscarefully. Take all the antibiotic medicine that your doctor prescribes. If youdon’t, some bacteria may stay in your body. This can cause your pneumonia tocome back. It can also increase your risk of antibiotic resistance.

Antibiotics don’t work to treat viral infections. If youhave viral pneumonia, your doctor will likely talk to you about ways to treatyour symptoms. Over-the-counter (OTC) medicines are available to lower fever,relieve pain and ease your cough. However, some coughing is okay because it canhelp clear your lungs. Be sure to talk to your doctor before you take a coughsuppressant.

If a fungus is causing your pneumonia, your doctor mayprescribe an antifungal medicine.

If your case of pneumonia is severe, you may need to behospitalized. If you are experiencing shortness of breath, you may be givenoxygen to help your breathing. You might also receive antibiotics intravenously(through an IV). People who have weakened immune systems, heart disease or lungconditions, and people who were already very sick before developing pneumoniaare most likely to be hospitalized. Babies, young children and adults who are65 years of age and older are also at increased risk.

What can I do at home to feel better?

In addition to taking any antibiotics and/or medicine yourdoctor prescribes, you should also do the following:

  • Get lots of rest. Rest will help your body fight the infection.
  • Drink plenty of fluids. Fluids will keep you hydrated and can help loosen the mucus in your lungs. Try water, warm tea and clear soups.
  • Stop smoking if you smoke, and avoid secondhand smoke. Smoke can make your symptoms worse. Smoking also increases your risk of developing pneumonia and other lung problems in the future. You should also avoid lit fireplaces or other areas where the air may not be clean.
  • Stay home from school or work until your symptoms go away. This usually means waiting until your fever breaks and you aren’t coughing up mucus. Ask your doctor when it’s okay for you to return to school or work.
  • Use a cool-mist humidifier or take a warm bath to help clear your lungs and make it easier for you to breathe.

Will I need to follow up with my doctor?

Your doctor may schedule a follow-up appointment after he orshe diagnoses you with pneumonia. At this visit, your doctor might take anotherchest X-ray to make sure the pneumonia infection is clearing up. Keep in mindthat chest X-rays can take months to return to normal. However, if yoursymptoms are not improving, your doctor may decide to try another form oftreatment.

Although you may be feeling better, it’s important to keepyour follow-up appointment, especially if you smoke. The infection can still bein your lungs even if you’re no longer experiencing symptoms.

Complications

What are possible complications of pneumonia?

Severe cases of pneumonia may require treatment in thehospital. Your doctor may give you oxygen to help you breathe or antibioticsthrough an IV.

Complications of pneumonia include pleural effusion andbacteria in the bloodstream. Pleural effusion is when fluid builds up in thelayers of tissue between your lungs and the wall of your chest and becomesinfected. This can make breathing very difficult. To drain the fluid, a tubemay need to be placed between your lungs and your chest wall, or you may needsurgery.

Bacteria in the bloodstream occur when the pneumoniainfection in your lungs spreads to your blood. This increases the risk that theinfection will spread to other organs in your body. Bacteria in the bloodstreamare treated with antibiotics.

People who have heart or lung problems, people who smoke,and people who are 65 years of age and older are more likely to experiencecomplications from pneumonia.

Prevention

How can I prevent pneumonia?

You can help prevent pneumonia by doing the following:

Getthe flu vaccine each year. People often develop bacterialpneumonia after a case of the flu. You can reduce this risk by getting theyearly flu shot. The flu shot doesn’t protect against all strains of the flu,just the 3 to 4 strains that doctors feel will be most dangerous or widespreadin the coming year.

Getthe pneumococcal vaccine. (See below for more information aboutthe vaccine.)

Practicegood hygiene. Your hands come in contact with manygerms throughout the day. You pick them up from surfaces such as doorknobs,other people’s hands and your computer keyboard. Take time to wash your handsoften, especially after using the restroom and before eating. Use lukewarmwater and soap for at least 20 seconds. If soap and water are not available,using an alcohol-based hand sanitizer is the next best thing.

Don’tsmoke. Smoking damages your lungs and makes it harder for yourbody to defend itself from germs and disease. If you smoke, talk to your familydoctor about quitting as soon as possible.

Practicea healthy lifestyle. Eat a balanced diet full of fruits andvegetables. Exercise regularly. Get plenty of sleep. These things help yourimmune system stay strong.

Avoidsick people. Being around people who are sickincreases your risk of catching what they have.

Is there a vaccine for pneumonia?

There isn’t a vaccine for all types of pneumonia, but 2vaccines are available. The first is called the pneumococcal conjugate vaccine(PCV). It is recommended for all children younger than 5 years of age. Thepneumococcal polysaccharide vaccine (PPSV) is recommended for children 2 yearsof age and older who are at increased risk for pneumonia (such as children whohave weakened immune systems), and for adults who have risk factors forpneumonia. This vaccine is recommended if you:

The pneumococcal vaccines can’t prevent all cases ofpneumonia. But they can make it less likely that people who are at risk willexperience the severe, and possibly life-threatening, complications ofpneumonia.

  • Are 65 years of age or older
  • Smoke
  • Abuse alcohol
  • Have certain chronic conditions, such as asthma, diabetes, heart disease or lung disease
  • Have cirrhosis
  • Have a condition that weakens your immune system, such as the human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), kidney failure or a damaged spleen
  • Have had your spleen removed for any reason
  • Have sickle cell disease
  • Have cochlear implants (an electronic device that helps you hear)
  • Are taking medicine for a recent organ transplant (these medicines suppress your immune system)
  • Are receiving chemotherapy

Do the pneumococcal vaccines cause side effects?

Side effects of PCV are unusual, but can include thefollowing:

Side effects of PPSV are not common, but can include thefollowing:

  • Redness and tenderness at the injection site
  • Slight fever
  • Irritability
  • Loss of appetite
  • Redness and tenderness at the injection site
  • Muscle soreness
  • Slight fever

Questions to Ask Your Doctor

  • I have a chronic condition. Am I athigher risk for pneumonia?
  • Do I have bacterial, viral or fungalpneumonia? What’s the best treatment?
  • Am I contagious?
  • How serious is my pneumonia? Will Ineed to be hospitalized?
  • What can I do at home to help relievemy symptoms?
  • What are the possible complications ofpneumonia? How will I know if I’m developing complications?
  • What should I do if my symptoms don’trespond to treatment or get worse?
  • Do we need to schedule a follow-upexam?
  • Do I need any vaccines?

When should I call my family doctor?

Pneumonia can be life-threatening if left untreated,especially in people who smoke, have heart disease, or have lung problems, andin adults 65 years of age and older. You should call your doctor if you have acough that won’t go away, shortness of breath, chest pain and a fever. Youshould also call your doctor if you suddenly begin to feel worse after having acold or the flu.

This information was developed as part of an educational program made possible through support from Wyeth Vaccines.