Pneumonia is a condition that causes the alveoli, or air sacs, to become inflamed. While some cases of pneumonia are so mild they’re barely even noticeable, in others, the alveoli may fill with fluid or pus, which can lead to a severe cough and trouble breathing. Most people recover from pneumonia without any issues, but the illness can be especially serious in babies, young children, older adults, and people with pre-existing health problems. In fact, according to the Centers for Disease Control and Prevention (CDC) and the American Lung Association, more than 50,000 Americans die each year as a result of pneumonia and influenza. With this in mind, we invite you to read on to learn about pneumonia signs, symptoms, causes, types, and treatment for this common and sometimes life-threatening condition.
Pneumonia Signs and Symptoms
Because early diagnosis and treatment can be crucial, it’s important to first be aware of the signs and symptoms of pneumonia. These include:
- Chest pain when coughing or breathing
- Shortness of breath
- Cough that produce green, yellow, or bloody phlegm
- Mental confusion
- Loss of appetite
- Fever, sweating, and chills
- Low body temperature
- Nausea, vomiting, or diarrhea
- Feeling abruptly worse after a cold or flu
Causes of Pneumonia
Pneumonia is a lung infection that affects either sections of one or both lungs (lobar pneumonia) or multiple small patches throughout both lungs (bronchopneumonia). Although there are actually greater than 30 known causes of pneumonia, each type is classified based on where the infection began.
- Community: Community-acquired pneumonia is contracted outside hospitals and other health care facilities and is the most common type of pneumonia.
- Hospital or other health care facility: Both hospital-acquired pneumonia and health care–acquired pneumonia are potentially more serious than community-acquired pneumonia, as they may be caused by antibiotic-resistant bacteria.
The cause of the pneumonia is then further broken down according to the type of organism precipitating the infection. These organisms are:
Types of Pneumonia
Again, there are more than 30 known causes of pneumonia. However, the most common types are:
- Bacterial pneumonia: The most common cause of bacterial pneumonia in the United States is the bacterium Streptococcus pneumoniae. This type of pneumonia, which is called pneumococcal pneumonia, is responsible for as many as 400,000 hospitalizations each year. Bacteria may also lead to atypical forms of pneumonia, including walking pneumonia, a common type of pneumonia caused by the bacterium Mycoplasma pneumoniae. The symptoms of walking pneumonia are generally milder than other types of pneumonia and may include sore throat, fever, and cough.
- Viral pneumonia: About one-third of cases of pneumonia are caused by viruses, including some of the same viruses that cause colds and flu. In fact, the main cause of viral pneumonia in adults is the influenza virus, while the main cause in young children is respiratory syncytial virus (RSV). Even though cases of viral pneumonia are generally mild and last less time than bacterial pneumonia, they may be complicated by secondary bacterial infections.
- Fungal pneumonia: Pneumonia caused by fungi is more common in people with chronic medical conditions or weakened immune systems and those working around contaminated soil or bird droppings.
- Aspiration pneumonia: This type of pneumonia occurs when food, saliva, liquids, or vomit is inhaled and is the most common cause of death in people with swallowing dysfunction related to neurological disease.
Risk Factors for Pneumonia
Anyone can get pneumonia, but there are certain groups with an even higher risk of developing the illness. These include:
- Children younger than 2 and adults aged 65 and older
- People with chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis
- People with other chronic medical conditions, including heart disease and diabetes
- People with compromised immune systems due to conditions such as human immunodeficiency virus (HIV), organ transplantation, or long-term steroid use
- People with neurological conditions that result in difficulty swallowing and the potential for aspiration
- People who’ve had a recent viral respiratory infection
- People who’ve had a recent intensive care unit (ICU) stay with ventilator use
- People who smoke cigarettes or abuse alcohol
- People with prior exposure to chemicals or toxic fumes
Because the signs and symptoms of pneumonia overlap with those of other illnesses, including colds and flu, to diagnose the condition, your health care provider will speak with you about your medical history and perform a physical exam and additional tests. These tests may include:
- Blood tests: These types of tests are used to confirm an infection is present and to attempt identification of the organism causing the illness.
- Chest X-ray: A chest X-ray can recognize the presence of pneumonia in the lungs and identify the exact location and extent of the illness.
- Pulse oximetry: A pulse ox is a simple, noninvasive way of determining the body’s oxygen level, which can be reduced in cases where pneumonia isn’t allowing the lungs to transport enough oxygen into the bloodstream.
- Sputum test: This test uses a sample of mucus taken after a deep cough to assess the underlying cause of the infection.
In patients who are currently hospitalized or considered high risk due to age or overall health status, additional tests may also be performed. These include:
- Computed tomography (CT) scan: A CT scan is capable of showing more detail than a chest X-ray and may be used to help determine the presence of complications such as abscesses and effusions.
- Pleural fluid culture: A procedure called a thoracentesis, or pleural tap, uses a needle to obtain a sample of fluid from the pleural cavity—the fluid-filled space that surrounds the lungs—to help determine the pathogen causing the infection.
- Bronchoscopy: In patients whose pneumonia is worsening despite treatment, a flexible tube called a bronchoscope may be used to evaluate the airways for signs of a blockage or other factors contributing to the pneumonia. During a bronchoscopy, a bronchoalveolar lavage (BAL) may also be used to collect fluid samples or take biopsies to help determine the cause of the pneumonia.
Treatment of Pneumonia
After the diagnosis of pneumonia has been made, treatment will depend on the type and severity of the illness as well as the age and overall health of the patient.
In general, however, people diagnosed with bacterial pneumonia will be treated with antibiotics, while those with fungal pneumonia will receive antifungal medications and those with viral pneumonia may be prescribed antiviral medications.
Moreover, unless symptoms are severe, most cases of pneumonia can be treated at home with supportive care, including:
- Over-the-counter medicine for fever or pain
- Healthy diet
- Hot baths
In cases severe enough to require hospitalization—or in cases in which the patient is already hospitalized—additional treatment will be required. This may take the form of:
- Intravenous (IV) antibiotics for bacterial pneumonia
- IV fluids
- Oxygen therapy
- Breathing treatments
In addition, the amino acid N-acetylcysteine (NAC) may be helpful for both the prevention and treatment of pneumonia due to its ability to replenish levels of glutathione—a powerful antioxidant that helps protect the lungs from damage—and reduce the thickness of mucus.
In fact, a recent study showed that ICU patients on ventilators who were given 600 milligrams of NAC twice daily were significantly less likely to develop ventilator-associated pneumonia, were much more likely to have a complete recovery, and had shorter ICU and hospital stays than did patients who received a placebo. And another study found that NAC was helpful in reducing oxidative and inflammatory damage in patients with pneumonia.
Potential Complications of Pneumonia
Although most people with pneumonia experience only moderate symptoms and recover without any problems, depending on age, medical history, and overall health, sometimes life-threatening complications can occur. These include:
- Respiratory failure requiring ventilator support
- Sepsis and resulting organ failure
- Fluid accumulation in the pleural cavity (pleural effusion)
- Pus-filled cavity in the lung (lung abscess)
Symptoms that indicate the presence of a serious infection with the potential for complications include:
- Chest pain
- High fever
- Difficulty breathing
- Persistent cough
- Coughing up pus or blood
If you notice any of these pneumonia symptoms or are experiencing chronic low-grade symptoms that just won’t go away, don’t hesitate to contact your doctor right away.