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Dr. Aishwarya Dubey

What is pneumonia ?

Pneumonia is an infection in one or both of your lungs caused by bacteria, viruses or fungi. When there is an infection in the lungs, several things happen, including:

  • Your airways swell (become inflamed)

  • The air sacs in the lungs fill with mucus and other fluids

How do the lungs work ?

Your lungs’ main job is to get oxygen into your blood and remove carbon dioxide. When you breathe in, air travels down the back of your throat and passes through your voice box and into your windpipe (trachea). Your trachea splits into two air passages (bronchial tubes). One bronchial tube leads to the left lung, the other to the right lung. For the lungs to perform their best, the airways need to be open as you breathe in and out. Swelling (inflammation) and mucus can make it harder to move air through the airways, making it harder to breathe. This leads to shortness of breath, difficulty breathing and feeling more tired than normal.

Is pneumonia contagious ?

 

Certain types of pneumonia are contagious (spread from person to person). Pneumonia caused by bacteria or viruses can be contagious when the disease-carrying organisms are breathed into your lungs. However, not everyone who is exposed to the germs that cause pneumonia will develop it. Pneumonia caused by fungi are not contagious. The fungi are in soil, which becomes airborne and inhaled, but it is not spread from person to person.

How is pneumonia spread from person to person ?

 

Pneumonia is spread when droplets of fluid containing the pneumonia bacteria or virus are launched in the air when someone coughs or sneezes and then inhaled by others. You can also get pneumonia from touching an object previously touched by the person with pneumonia (transferring the germs) or touching a tissue used by the infected person and then touching your mouth or nose.

How long do I remain contagious if I have pneumonia ?

If you have bacterial pneumonia, you are still considered contagious until about the second day after starting to take antibiotics and you no longer have a fever (if you had one). If you have viral pneumonia, you are still considered contagious until you feel better and have been free of fever for several days.

Who is most at risk for getting pneumonia ?
People who have an increased risk of pneumonia include:


• People who are receiving chemotherapy
• Transplanted organ recipients
• People who have HIV/AIDS
• Cystic fibrosis
• Asthma
• Chronic obstructive pulmonary disease
• Emphysema
• Bronchiectasis
• Uncontrolled diabetes
• Heart disease
• Dementia
• Parkinson’s disease
• Stroke
• People in the ICU
• People who need ventilators to breathe
• People who smoke or drink alcohol

What causes pneumonia ?

 

Pneumonia can be caused by a wide variety of bacteria, viruses or fungi. Pneumonia is most commonly classified by the type of germ that causes it and by the location where the person became infected.

Bacteria: Streptococcus pneumoniae is the most common bacterial cause of pneumonia.

Viruses: Any virus that causes a respiratory tract infection (infections of the nose, throat, trachea [windpipe], and lungs) can cause pneumonia. The viruses that cause colds and flu (influenza) can cause pneumonia.

Fungi (moulds): Pneumonia caused by fungi is the least common as pneumonia. Fungus in the soil in certain parts of the United States can become airborne and cause pneumonia. One example is valley fever.

What are the signs and symptoms of bacterial versus viral pneumonia in adults ?

Symptoms of pneumonia can range from mild (cold- or flu-like symptoms) sometimes called “walking pneumonia” to severe. How serious your case of pneumonia depends on the particular germ causing pneumonia, your overall health, and your age.

Bacterial pneumonia: Symptoms of bacterial pneumonia can develop gradually or suddenly. Symptoms include:

 

  • High fever (up to 105° F)

  • Tiredness (fatigue)

  • Trouble breathing: rapid breathing or shortness of breath

  • Sweating

  • Chills

  • Cough with mucus (might be greenish in color or contain a small amount of blood)

  • Chest pain and/or abdominal pain, especially with coughing or deep breathing

  • Loss of appetite

  • Confused mental state or changes in awareness (especially in older adults)

 

Viral pneumonia: Symptoms usually develop over a period of several days. Early symptoms are similar to flu symptoms, which include:

 

  • Fever

  • Dry cough

  • Headache

  • Sore throat

  • Loss of appetite

  • Muscle pain

  • Weakness

  • Higher fever

  • Cough with mucus

  • Shortness of breath

What are the complications of pneumonia ?

 

Breathing difficulties: Pneumonia can make breathing difficult. Pneumonia plus an existing lung disorder (such as COPD, emphysema, asthma) can make breathing even more difficult. Breathing difficulties may require a hospital stay to receive oxygen therapy or breathing and healing assistance with the use of a breathing machine (ventilator).

Fluid build-up in the lungs (called pleural effusion or “water on the lungs”): Pneumonia can cause a build-up in the fluid between the membranes that line the lungs and the inside of the chest cavity. It is a serious condition that makes breathing difficult.

Bacteria in the bloodstream (bacteraemia): The bacteria that cause pneumonia can leave your lungs and enter your bloodstream, spreading the infection to other organs. This condition is treated with antibiotics.

Lung abscess: A lung abscess is a pus-filled cavity in the lung that is caused by a bacterial infection. It can be treated by draining the pus with a long needle or removing it by surgery.

How is pneumonia diagnosed 

Your doctor will do a thorough clinical examination. During your examination he will:

 

  • Possibly order a chest X-ray to look for signs of pneumonia and the extent of the infection.

  • Conduct a pulse oximetry test to measure the amount of oxygen in your blood (indicates how well your lungs are moving oxygen into your bloodstream).

  • Order laboratory tests of your blood and/or mucus to determine the type of infection – bacteria, virus, or fungus – that has caused pneumonia.

  • Bronchoscopy - Bronchoalveolar lavage (BAL) fluid analysis can detect the exact cause of pneumonia. 

How is pneumonia treated ?

How pneumonia is treated depends on the germs that cause it.

 

Bacterial pneumonia: Bacterial pneumonia is usually treated with antibiotics. The specific antibiotic choice depends on such factors as your general health, other health conditions you may have, the type of medications you are currently taking (if any), your recent (if any) use of antibiotics, any evidence of antibiotic resistance in the local community and your age. Medicines to relieve pain and lower fever may also be helpful. Ask your doctor if you should take a cough suppressant. It’s important to be able to cough to clear your lungs.

 

Viral pneumonia: Antibiotics are not used to fight viruses. (In some cases antibiotics may be given to fight a bacterial infection that is also present.) There are no treatments for most viral causes of pneumonia. However, if the flu virus is thought to be the cause, antiviral drugs might be prescribed, such as oseltamivir or zanamivir to decrease the length and severity of the illness. Over-the-counter medicines to relieve pain and lower fever are usually recommended. Other medicines and therapies such as breathing treatments and exercises to loosen mucus may be prescribed by your doctor.

How soon after treatment for pneumonia will I begin to feel better ?

How soon you will feel better depends on several factors, including:

 

  • Your age

  • The cause of your pneumonia

  • The severity of your pneumonia

  • If you have other “at-risk” conditions

 

If you are generally healthy, most symptoms of bacterial pneumonia usually begin to improve within 24 to 48 hours after starting treatment. Symptoms of viral pneumonia usually begin to improve within a few days after starting treatment. A cough can last for several weeks. Most people report being tired for about a month after contracting pneumonia.

When would I need to be hospitalized for pneumonia ?

If your case of pneumonia is more severe, you may need to stay in the hospital for treatment. Hospital treatments may include:

 

  • Oxygen

  • Fluids, antibiotics and other medicines given through an IV (directly into the vein)

  • Breathing treatments and exercises to help loosen mucus

Are vaccines available to prevent pneumonia ?

Yes, there are two types of vaccines (shots) specifically approved to prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines won’t protect against all types of pneumonia, but if you do come down with pneumonia, it’s less likely to be as severe or potentially life-threatening – especially for people who are at increased risk for pneumonia.

 

Bacterial pneumonia: Two pneumonia vaccines, Pneumovax23® and Prevnar13®, protect against the most common causes of bacterial pneumonia.

Viral pneumonia: Get a flu vaccine (shot) once every year. Flu vaccines are prepared to protect against that year’s virus strain. Having the flu can make it easier to get bacterial pneumonia.

Besides vaccination, what else can I do to prevent bacterial and viral pneumonia ?

 

  • Quitting smoking, and avoiding second hand smoke. Smoking damages your lungs.

  • Washing your hands before eating, before handling food, after using the restroom, and after being outside. If soap is not available, use an alcohol-based hand sanitizer.

  • Avoiding being around people who are sick. Ask them to visit when they are feeling better.

  • Not touching or sharing objects that are shared with others. Germs can be transferred from object to you if you touch your nose or mouth without washing or sanitizing your hands first.

  • Eating a healthy diet, exercise, and get enough rest. Healthy habits keep your immune system strong.

  • Avoiding excessive consumption of alcohol.

What is the outlook for pneumonia ?

People who are otherwise healthy often recover quickly when given prompt and proper care. However, pneumonia is a serious condition and can be life-threatening if left untreated and especially for those individuals at increased risk for pneumonia.

 

Even patients who have been successfully treated and have fully recovered may face long-term health issues. Children who have recovered from pneumonia have an increased risk of chronic lung diseases. Adults may experience:

  • Decreased ability to exercise

  • Worsening of cardiovascular disease

  • Mental decline

  • General decline in quality of life for months or years

When can I return to work, school and regular activities if I have pneumonia ?

You typically can resume your normal activities if your symptoms are gone, mild or improving and you do not have new or worsening:

 

  • Shortness of breath or tiredness (less energy)

  • Chest pain

  • Mucus, fever or cough

If you are generally healthy, most people feel well enough to return to previous activities in about a week. However, it may take about a month to feel totally back to normal.

When should I see a doctor ?

Call your doctor if you:

  • Have new or worsening:

  • Shortness of breath with activities or when lying down

  • Fever or cough with mucus

  • Tiredness (fatigue)

  • Have a change in appetite (less hunger)

  • Feel uneasy and know that something is not right

If you or your loved one with symptoms is in a high, “at-risk” group, see your doctor as soon as possible. Pneumonia can become a life-threatening condition.

 THE HOSPITAL THAT CARES

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