Dry cough and fever

How to Tell if You Have Pneumonia: 8 Symptoms You Shouldn’t Ignore

When cold and flu season strikes, pneumonia isn’t far behind. The same viruses that make you sneeze and spike a fever can also infect your lungs. And doctors say if you’re fighting a cold or the flu, you’re more susceptible to acquiring a bacterial form of pneumonia too.

But don’t be lulled into thinking you’re safe from infection once winter is done. Despite a seasonal uptick, this common lung disease can occur any time of the year. Pneumonia is spread through coughs, sneezes, and touch, or by breathing germy air. You can also get it from inhaling foreign matter into the lungs.

Young children, older adults, and people with compromised immune systems are particularly vulnerable, according to the National Heart, Lung, and Blood Institute (NHLBI). But even healthy young adults can land in the hospital or die from pneumonia when it’s severe. That said, symptoms to be on the lookout for include cough, difficulty breathing, and fever, according to the Centers for Disease Control and Prevention (CDC).

RELATED: 11 Signs It’s More Serious Than the Common Cold

“The pneumonias that a person can get will differ at different points in their life and with different risk factors,” explains Aaron Glatt, MD, chief of infectious diseases at South Nassau Communities Hospital in Oceanside, New York, and a spokesperson for the Infectious Diseases Society of America.

Normally, your nose and airways filter out unwanted bugs. But when these invaders pass through to one or both lungs (often after you’ve had a cold or the flu), or if your immune system is too weak to defend against an infectious assault, tiny air sacs in your lungs, called alveoli, become inflamed and fill with fluid or pus.

Different types of pneumonia strike different people. Some tend to occur when folks are in the hospital for something else. This is known as “hospital-acquired pneumonia” or “healthcare-associated pneumonia.” When food, liquid, saliva, or vomit makes its way into the lungs, it’s called “aspiration pneumonia.” The most common type is community-acquired pneumonia, also called walking pneumonia, because it’s a milder type of infection.

Pneumonia in adults is usually due to a bacterial infection. Streptococcus pneumoniae (also known as pneumococcus) is often responsible. Viruses are more typically the culprit in children. Causes of viral pneumonia include influenza (the flu virus), rhinovirus (the common cold), and RSV (respiratory syncytial virus, which is common in infants and children). Fungi and chemicals may also infect the lungs.

Vaping, which has been linked to deaths across the country, has also been associated with certain types of pneumonia, including chemical pneumonia and lipoid pneumonia. Chemical pneumonia can develop after inhaling chemicals that cause your lungs to become inflamed, and lipoid pneumonia is caused when lipids (which are, essentially, fatty acids) enter the lungs, causing them to become inflamed. Symptoms for both lipoid and chemical pneumonia are similar to those that accompany bacterial pneumonia (which include cough, shortness of breath, fever, shallow breathing, chest pain, and loss of appetite, according to the American Lung Association).

RELATED: How to Keep Your Lungs Healthy, According to Pulmonologists

Dr. Glatt says the signs and symptoms of pneumonia can vary too: “It’s a constellation of symptoms that the doctor looks at, not one particular finding.” When making a diagnosis, your doctor will consider your physical exam, diagnostic test results, and medical history.

Here are some common signs and symptoms of pneumonia. If you’ve been troubled by any of these, go get checked out!

Health and Wellness Blog

6 Signs Your Cough Could Be Pneumonia

02.27.2019

Pneumonia is a common and very serious lung infection that can affect people of all ages. Cold and flu season is prime time for pneumonia to strike. That’s because the same viruses that cause cold and flu symptoms can also infect your lungs. And if you’re already sick with the cold or flu, you are also more susceptible to infection with bacterial pneumonia.

An estimated 400,000 people are hospitalized with pneumonia each year in the United States. In 2016, nearly 50,000 people died from this disease.

Signs of Pneumonia to Watch For

  • Duration. One of the most important indicators is duration. Cold and flu viruses generally last seven to 10 days, so if your cough lingers and you don’t improve after a week or two, you could have pneumonia. If your symptoms don’t lessen or they improve but suddenly get worse, you should be seen at your nearest RediClinic.
  • Phlegmy (wet) vs. dry cough. Bacterial pneumonia is the most common type of pneumonia, so it’s important to pay attention to your cough. A phlegmy cough is most common with bacterial pneumonia, while a dry cough is typically associated with viral pneumonia.
  • Fever. Fever is associated with both types of pneumonia, though absence of a fever doesn’t rule out the disease. The fever may be accompanied by severe chills and shivering.
  • Shortness of breath. When pneumonia interferes with your lung function and you cannot get enough oxygen to your blood, you may feel breathless.
  • Chest pain. The strain of coughing and breathing can exhaust the muscles, causing discomfort and even pain in the chest. You may also feel some chest discomfort from the infection in your lungs. In extreme cases, pneumonia can lead to heart attack, so call 911 if you have sharp chest pain or any symptoms of a heart attack.
  • Dizziness or confusion. This can be a very serious sign that the pneumonia infection in the lungs has spread to the bloodstream. If you experience dizziness or confusion in conjunction with some of the other above symptoms, you need to seek care immediately.

Protect Against Pneumonia With a Vaccine

If you are a smoker, one of the best ways to prevent contracting pneumonia is to stop smoking. Those who are also at greatest risk of contracting pneumonia should be immunized against the disease with pneumonia shots. If you are at risk and have not yet received a pneumonia vaccine to help protect yourself from pneumonia, visit your nearest RediClinic today. Our board-certified clinicians can administer pneumonia shots seven days a week at your convenience. Walk-ins are also welcome.

Make an online appointment to be seen at RediClinic!

Summer is the time for families to kick back, relax and have fun, but it can also be a time of discomfort and illness if the proper precautions are not taken. Start the season by reminding your family members of the importance of protecting their …

Does pneumonia really walk, and is double pneumonia just double talk?

Before answering the above questions, I want the reader and myself to be on the same initial page and agree that the basic subject about to be presented is pneumonia. Pneumonia is a disease of the lung tissue that involves inflammation of the alveoli (air sacs in the lungs where O2 and CO2 are exchanged). Although bacteria and viruses cause the majority of pneumonias, there can be other causes such as fungi, parasites, chemicals, and physical injury to the lung tissue. Pneumonias can result in fluid accumulation in alveoli (congestion, with poor gas exchange) and produce the typical signs and symptoms of cough, shortness of breath, and often fever and chest pain, especially when coughing.

Pneumonia is not bronchitis (inflammation of the bronchial tissue), and it’s not pleurisy (inflammation of the pleural lining of the lungs and chest), although both can produce some symptoms similar to pneumonias. Please note the use of the word “pneumonias”; it’s plural and, in my view, has many different words (over 30, including the veterinary literature) used in both the lay and medical literature to identify subsets of the disease. Unfortunately, this can lead to confusion because there is a considerable amount of imprecision and overlap with these modifiers. We in the medical professions are guilty of developing and then using them; I don’t see any evidence that the terminology will improve, so I’ll try at least to indicate what several of the prominent pneumonia modifiers mean (and don’t mean) and answer the questions asked above in the title.

  • Infectious pneumonia (bacterial, viral, fungal, and parasitic are all subsets of infectious pneumonia) means that an infectious agent is causing the pneumonia.
  • Chemical pneumonia (many types caused by various substances such as chlorine or gasoline fumes) means that the pneumonia results from an irritant, not an infectious or traumatic cause.
  • Traumatic pneumonia (trauma such as a blunt object striking the chest as in an auto accident or an assault) is a noninfectious or nonchemical cause of lung tissue inflammation.
  • Walking pneumonia (First question answer: Pneumonia doesn’t walk, but patients with “walking pneumonia” do!) is an imprecise term used to describe a person with symptoms of pneumonia that are “mild” enough to allow people to do daily activities and do not require patient hospitalization; it does not describe the cause of the pneumonia-like symptoms and is often used as a preliminary diagnosis without good evidence (a chest X-ray or other tests) that pneumonia is actually present. The major difference between pneumonia and walking pneumonia are the severity of symptoms, with walking pneumonia having the least severe symptoms in most individuals.
  • Double pneumonia (Second question answer: Double pneumonia is not double talk, but means that both the right and left lung has pneumonia.) means at least two lung lobes (one on the right lung and one in the left) have pneumonia. The term implies a more severe pneumonia, but the term is imprecise as it doesn’t indicate the cause or how severe the pneumonia is.
  • Atypical pneumonia: The meaning of this word is unfortunately multiple, and it changes depending on the context in which it is used. For example, atypical pneumonia is used by some medical personnel to mean mild or “walking” pneumonia, while others use it to describe pneumonia caused by Mycoplasma pneumoniae. Still others use the modifier to refer to all pneumonias caused by pathogens from birds that can also infect humans.
  • Community acquired pneumonia is pneumonia acquired outside of a hospital setting; although usually bacterial and sometimes antibiotic resistant, the term does not describe the cause.
  • Hospital acquired pneumonia is pneumonia acquired during a hospital stay; it’s usually bacterial and often antibiotic resistant, but the term again does not describe the cause.
  • Lobar pneumonia is pneumonia that at least in one (and often more) of the lobes of the lung, is consolidated, and is considered a more severe form of pneumonia, no matter what the cause.
  • Aspiration pneumonia is pneumonia caused by inhaling foods, saliva, vomit, or gastric contents that can act as both a chemical and infectious cause of pneumonia.

Because walking pneumonia was supposed to be a focal point of this article, and I’ve given my view as to what it is and is not, the rest of this article will focus on how walking pneumonia is often viewed by clinicians who diagnose and treat the disease. First, the symptoms of walking pneumonia are mild — usually a cough that can be frequent with little or no phlegm (also termed a dry cough), a low or absent fever (usually under 101 F), and feeling more tired after normal activities or simply have tiredness or fatigue. Some patients may get muscle aches or back aches, an occasional rash, appetite loss, and/or headaches. The symptoms are present for a few days usually before patients seek medical care because “the symptoms are not too bad but they just seem not to go away.” In addition, many patients have additional problems such as sinus infections, sore throats, or asthma.

Most of these symptoms can occur in both adults and children; however, children may appear more short of breath than adults. Many physicians will do a chest X-ray to help obtain evidence for a presumptive diagnosis, but others will not. Mycoplasma pneumoniae is considered the major cause of walking pneumonia by many clinicians, but it is seldom confirmed by any test. Consequently, many clinicians will give an antibiotic such as doxycycline (Vibramycin, Oracea, Adoxa, Atridox) to treat the presumed Mycoplasma infection. If the “walking pneumonia” is due to Mycoplasma, the antibiotic will help rid the person of the infection and make the person either less contagious or noncontagious. However, if the cause is not Mycoplasma, the antibiotic may not help at all. In general, walking pneumonia can be contagious for up to about a month if treatment is not given. The symptoms or recovery time also can last about a month or so if the patient is not treated.

Walking pneumonia can abate without antibiotics and the person usually recovers with no lingering problems, but occasionally symptoms become worse. Children, pregnant females, the elderly, and immunocompromised patients should seek medical care if they develop symptoms of walking pneumonia because they can more easily progress to the more severe forms of pneumonia. Some people with suppressed immune systems may seem to have walking pneumonia but actually have pneumonia caused by agents like Pneumocystis jiroveci (formerly known as Pneumocystis carinii), a fungal cause of chronic pneumonia that initially causes symptoms that resemble those of walking pneumonia.

In my view, the term “walking pneumonia” just does not give the patient enough information about their symptoms. Patients with this diagnosis should ask their doctors to please explain why they are told this is their problem and what type of follow-up is required.

Pneumonia Symptoms and Diagnosis

Pneumonia is an infection that inflames your lungs’ air sacs (alveoli). The air sacs may fill up with fluid or pus, causing symptoms such as a cough, fever, chills and trouble breathing.

What Are the Symptoms of Pneumonia?

Pneumonia symptoms can vary from so mild you barely notice them, to so severe that hospitalization is required. How your body responds to pneumonia depends on the type germ causing the infection, your age and your overall health.

The signs and symptoms of pneumonia may include:

  • Cough, which may produce greenish, yellow or even bloody mucus
  • Fever, sweating and shaking chills
  • Shortness of breath
  • Rapid, shallow breathing
  • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
  • Loss of appetite, low energy, and fatigue
  • Nausea and vomiting, especially in small children
  • Confusion, especially in older people

Questions about your symptoms?

Talk to our experts at the American Lung Association Lung HelpLine. Our service is free and we are here to help you by phone, web chat or email.

Bacterial pneumonia, which is the most common form, tends to be more serious than other types of pneumonia, with symptoms that require medical care. The symptoms of bacterial pneumonia can develop gradually or suddenly. Fever may rise as high as a dangerous 105 degrees F, with profuse sweating and rapidly increased breathing and pulse rate. Lips and nailbeds may have a bluish color due to lack of oxygen in the blood. A patient’s mental state may be confused or delirious.

The symptoms of viral pneumonia usually develop over a period of several days. Early symptoms are similar to influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness. Within a day or two, the symptoms typically get worse, with increasing cough, shortness of breath and muscle pain. There may be a high fever and there may be blueness of the lips.

Symptoms may vary in certain populations. Newborns and infants may not show any signs of the infection. Or, they may vomit, have a fever and cough, or appear restless, sick, or tired and without energy. Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness. For individuals that already have a chronic lung disease, those symptoms may worsen.

When to call a doctor

If you think you or your child has symptoms of pneumonia, don’t wait for the disease to get even worse before you seek care. Call your doctor. And see your doctor right away if you have difficulty breathing, develop a bluish color in your lips and fingertips, have chest pain, a high fever, or a cough with mucus that is severe or is getting worse.

It’s especially important to get medical attention for pneumonia if you are in a high-risk group, including adults older than age 65, children age two or younger, people with an underlying health condition or weakened immune system. For some of these vulnerable individuals, pneumonia can quickly become a life-threatening condition.

How Is Pneumonia Diagnosed?

Sometimes pneumonia can be difficult to diagnose because the symptoms are so variable, and are often very similar to those seen in a cold or influenza. To diagnose pneumonia, and to try to identify the germ that is causing the illness, your doctor will ask questions about your medical history, do a physical exam, and run some tests.

Medical history

Your doctor will ask you questions about your signs and symptoms, and how and when they began. To help figure out if your infection is caused by bacteria, viruses or fungi, you may be asked some questions about possible exposures, such as:

  • Any recent travel
  • Your occupation
  • Contact with animals
  • Exposure to other sick people at home, work or school
  • Whether you have recently had another illness

Physical exam

Your doctor will listen to your lungs with a stethoscope. If you have pneumonia, your lungs may make crackling, bubbling, and rumbling sounds when you inhale.

Diagnostic tests

If your doctor suspects you may have pneumonia, they will probably recommend some tests to confirm the diagnosis and learn more about your infection. These may include:

  • Blood tests to confirm the infection and to try to identify the germ that is causing your illness.
  • Chest X-ray to look for the location and extent of inflammation in your lungs.
  • Pulse oximetry to measure the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
  • Sputum test on a sample of mucus (sputum) taken after a deep cough, to look for the source of the infection.

If you are considered a high-risk patient because of your age and overall health, or if you are hospitalized, the doctors may want to do some additional tests, including:

  • CT scan of the chest to get a better view of the lungs and look for abscesses or other complications.
  • Arterial blood gas test, to measure the amount of oxygen in a blood sample taken from an artery, usually in your wrist. This is more accurate than the simpler pulse oximetry.
  • Pleural fluid culture, which removes a small amount of fluid from around tissues that surround the lung, to analyze and identify bacteria causing the pneumonia.
  • Bronchoscopy, a procedure used to look into the lungs’ airways. If you are hospitalized and your treatment is not working well, doctors may want to see whether something else is affecting your airways, such as a blockage. They may also take fluid samples or a biopsy of lung tissue.

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Pneumonia

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What Is Pneumonia?

Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid. This makes it hard for oxygen to reach the bloodstream.

Someone with pneumonia may have a fever, cough, or trouble breathing.

What Are the Signs & Symptoms of Pneumonia?

Symptoms vary depending on a person’s age and what caused the pneumonia, but can include:

  • very fast breathing (in some cases, this is the only symptom)
  • breathing with grunting or wheezing sounds
  • working hard to breathe; this can include flaring of the nostrils, belly breathing, or movement of the muscles between the ribs
  • fever
  • cough
  • stuffy nose
  • shaking chills
  • vomiting
  • chest pain
  • belly pain (because a child is coughing and working hard to breathe)
  • less activity
  • loss of appetite (in older kids) or poor feeding (in infants), which may lead to dehydration
  • in extreme cases, bluish or gray color of the lips and fingernails

If the pneumonia is in the lower part of the lungs near the abdomen, a person might have a fever and belly pain or vomiting with no breathing problems.

What Causes Pneumonia?

Pneumonia is caused by a variety of germs (viruses, bacteria, fungi, and parasites). Most cases, though, are caused by viruses. These include adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus (which also can cause croup).

Often, pneumonia begins after an upper respiratory tract infection (an infection of the nose and throat), with symptoms starting after 2 or 3 days of a cold or sore throat. It then moves to the lungs. Fluid, white blood cells, and debris start to gather in the air spaces of the lungs and block the smooth passage of air, making it harder for the lungs to work well.

Kids with pneumonia caused by bacteria usually become sick fairly quickly, starting with a sudden high fever and unusually fast breathing.

Kids with pneumonia caused by viruses probably will have symptoms that appear more gradually and are less severe, though wheezing can be more common.

Some symptoms give important clues about which germ is causing the pneumonia. For example:

  • In older kids and teens, pneumonia due to Mycoplasma (also called walking pneumonia) is very common. It causes a sore throat, headache, and rash in addition to the usual symptoms of pneumonia.
  • In babies, pneumonia due to chlamydia may cause conjunctivitis (pinkeye) with only mild illness and no fever.
  • When pneumonia is due to whooping cough (pertussis), a child may have long coughing spells, turn blue from lack of air, or make the classic “whoop” sound when trying to take a breath. Fortunately, the pertussis vaccine can help protect kids against whooping cough.

The length of time between exposure to the germ and when someone starts feeling sick varies, depending on which germ caused the pneumonia (for instance, 4 to 6 days for RSV, but just 18 to 72 hours for the flu).

Doctors usually make a pneumonia diagnosis after an exam. They’ll check a child’s appearance, breathing pattern, and vital signs, and listen to the lungs for abnormal sounds. They might order a chest X-ray or blood tests, but neither are necessary to make the diagnosis.

How Is Pneumonia Treated?

In most cases, pneumonia is caused by a virus that does not require antibiotics. Pneumonia caused by bacteria is treated with antibiotics taken by mouth at home. The type of antibiotic used depends on the type of bacteria thought to have caused the pneumonia.

Antiviral medicine is now available too, but is reserved for the flu when found early in the course of illness.

Children might need treatment in a hospital if the pneumonia causes a lasting high fever, breathing problems, or if they:

  • need oxygen therapy
  • have a lung infection that may have spread to the bloodstream
  • have a chronic illness that affects the immune system
  • are vomiting so much that they cannot take medicine by mouth
  • keep getting pneumonia
  • might have whooping cough

Hospital treatment can include intravenous (IV) antibiotics (given into a vein) and respiratory therapy (breathing treatments). More severe cases might be treated in the intensive care unit (ICU).

How Can I Help My Child?

Anyone with pneumonia needs to get plenty of rest and drink lots of fluids while the body works to fight the infection.

If your child has bacterial pneumonia and the doctor prescribed antibiotics, give the medicine on schedule for as long as directed. This will help your child recover faster and help prevent the infection from spreading to others in the family. For wheezing, the doctor might recommend using a nebulizer or an inhaler.

Ask the doctor before you use a medicine to treat your child’s cough. Cough suppressants stop the lungs from clearing mucus, which isn’t helpful for pneumonia. Over-the-counter cough and cold medicines are not recommended for any kids under 6 years old.

Take your child’s temperature at least once each morning and each evening. Call the doctor if it goes above 102°F (38.9°C) in an older infant or child, or above 100.4°F (38°C) in a baby under 6 months old.

Check your child’s lips and fingernails to make sure they are rosy and pink. Call your doctor if they are bluish or gray, which is a sign that the lungs are not getting enough oxygen.

How Long Does Pneumonia Last?

With treatment, most types of bacterial pneumonia are cured in 1–2 weeks. Walking pneumonia and viral pneumonia may take 4–6 weeks to go away completely.

Is Pneumonia Contagious?

In general, pneumonia is not contagious, but the upper respiratory viruses and bacteria that lead to it are. When these germs are in fluid from the mouth or nose of someone who’s infected, that person can spread the illness through coughs and sneezes.

Sharing drinking glasses and eating utensils, and touching the used tissues or handkerchiefs of an infected person also can spread pneumonia. So it’s best to keep kids away from anyone with symptoms (stuffy or runny nose, sore throat, cough, etc.) of a respiratory infection.

Can Pneumonia Be Prevented?

Some types of pneumonia can be prevented by vaccines. Kids usually get routine immunizations against Haemophilus influenzae pneumococcus and whooping cough beginning at 2 months of age.

The flu vaccine is recommended for all healthy kids ages 6 months through 19 years, but especially for kids with chronic illnesses such as heart or lung disorders or asthma.

Because they’re at higher risk for serious complications, babies born early may get treatments that temporarily protect against RSV because it can lead to pneumonia in younger kids.

Doctors may give antibiotics to prevent pneumonia in kids who have been exposed to someone with certain types of pneumonia, such as whooping cough. Those with HIV infection might get antibiotics to prevent pneumonia caused by Pneumocystis jirovecii.

If someone in your home has a respiratory infection or throat infection, keep their drinking glasses and eating utensils separate from those of other family members, and wash your hands often, especially if you’re handling used tissues or dirty handkerchiefs.

When Should I Call the Doctor?

Call your doctor right away if your child has any of the signs of pneumonia, but especially if he or she:

  • has trouble breathing or is breathing too fast
  • has a bluish or gray color to the fingernails or lips
  • has a fever of 102°F (38.9°C), or above 100.4°F (38°C) in babies younger than 6 months old

Reviewed by: Ryan J. Brogan, DO Date reviewed: December 2017

Do you have a cold, flu or pneumonia?

Our ability to breathe is often taken for granted until it’s compromised. When wintertime illnesses take the air out of your lungs, it helps to know what you have so you can treat it accordingly. While your healthcare provider is the best source of information for your specific disease, here is a cheat sheet from The Lung Association to help you sort through the symptoms and get back to breathing.

Common cold. This is the most common respiratory illness and the least severe one. The common cold is contagious and since it’s caused by a virus, no antibiotic will treat it. Symptoms include sore throat, cough that can last up to two weeks, runny nose, congestion, feeling tired and run-down, sneezing, mild headache, mild soreness and achy muscles. Treat the symptoms with over-the-counter medication. If you have a lung disease, do not take cough or cold medicine unless approved by your doctor.

Influenza (flu). Caused by the influenza virus, the flu is more serious than the common cold and infects the lungs, throat and nose. Symptoms include sudden fever or feeling feverish, chills, cough, sore throat, loss of appetite, muscle aches, fatigue, runny nose, sneezing and watery eyes. Talk to your doctor about medication to treat the flu. If you have asthma or COPD, follow the advice in your action plan. You may have to take extra medicine to control your symptoms.

Pneumonia. Unlike the common cold and flu, pneumonia settles in your lungs where the germs, bacteria or virus cause inflammation. This makes breathing a struggle. Of the three diseases, this is the most serious one and should be treated as such. Symptoms include fever, cough, phlegm, shortness of breath, feeling very tired and unwell and chest pain. Antibiotics are the best solution for pneumonia caused by bacteria. Seek medical treatment if you experience difficulty breathing.

All three sicknesses have some similarities in terms of prevention, such as avoiding contact with sick people, washing your hands and quitting smoking. Flu vaccine is also great way to prevent the flu. Two treatments that work for all are plenty of fluids and rest. Not only will rest and staying home from work speed up your recovery, you will avoid spreading your germs further and your co-workers will thank you.

What is pneumonia?

Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi. It is a serious infection in which the air sacs fill with pus and other liquid.

  • Lobar pneumonia affects one or more sections (lobes) of the lungs.

  • Bronchial pneumonia (also known as bronchopneumonia) affects patches throughout both lungs.

There are more than 30 different causes of pneumonia, and they’re grouped by the cause. The main types of pneumonia are:

  • Bacterial pneumonia. This type is caused by various bacteria. The most common is Streptococcus pneumoniae. It usually occurs when the body is weakened in some way, such as by illness, poor nutrition, old age, or impaired immunity, and the bacteria are able to work their way into the lungs. Bacterial pneumonia can affect all ages, but you are at greater risk if you abuse alcohol, smoke cigarettes, are debilitated, have recently had surgery, have a respiratory disease or viral infection, or have a weakened immune system.

  • Viral pneumonia. This type is caused by various viruses, including the flu (influenza), and is responsible for about one-third of all pneumonia cases. You may be more likely to get bacterial pneumonia if you have viral pneumonia.

  • Mycoplasma pneumonia. This type has somewhat different symptoms and physical signs and is referred to as atypical pneumonia. It is caused by the bacterium Mycoplasma pneumoniae. It generally causes a mild, widespread pneumonia that affects all age groups.

  • Other pneumonias. There are other less common pneumonias that may be caused by other infections including fungi.

Who is at risk for pneumonia?

Anyone can get pneumonia. However, the following groups are at the highest risk:

  • Adults ages 65 and older

  • Children younger than age 2

  • People with certain medical conditions

  • People that smoke

What are the symptoms of pneumonia?

The symptoms of bacterial pneumonia include:

  • Bluish color to lips and fingernails

  • Confused mental state or delirium, especially in older people

  • Cough that produces green, yellow, or bloody mucus

  • Fever

  • Heavy sweating

  • Loss of appetite

  • Low energy and extreme tiredness

  • Rapid breathing

  • Rapid pulse

  • Shaking chills

  • Sharp or stabbing chest pain that’s worse with deep breathing or coughing

  • Shortness of breath that gets worse with activity

Early symptoms of viral pneumonia are the same as those of bacterial pneumonia, which may be followed by:

  • Headache

  • Increasing shortness of breath

  • Muscle pain

  • Weakness

  • Worsening of the cough

Mycoplasma pneumonia has somewhat different symptoms, which include a severe cough that may produce mucus.

How is pneumonia diagnosed?

Diagnosis is usually made based on your recent health history (such as surgery, a cold, or travel exposures) and the extent of the illness. Based on these factors, your healthcare provider may diagnose pneumonia simply on a thorough history and physical exam. The following tests may be used to confirm the diagnosis:

  • Chest X-ray. This test takes pictures of internal tissues, bones, and organs, including the lungs.

  • Blood tests. This test may be used to see whether infection is present and if infection has spread to the bloodstream (blood cultures). Arterial blood gas testing checks the amount of oxygen in your bloodstream.

  • Sputum culture. This test is done on the material that is coughed up from the lungs and into the mouth. It’s often used to see if there’s an infection in the lungs.

  • Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. A small sensor is taped or clipped onto a finger. When the machine is on, a small red light can be seen in the sensor. The test is painless and the red light does not get hot.

  • Chest CT scan. This imaging procedure uses a combination of X-rays and computer technology to produce sharp, detailed horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than regular X-rays.

  • Bronchoscopy. This is direct exam of the bronchi (the main airways of the lungs) using a flexible tube (called a bronchoscope). It helps to evaluate and diagnose lung problems, assess blockages, and take out samples of tissue and/or fluid for testing,

  • Pleural fluid culture. In this test, a sample of a fluid sample is taken from the pleural space. This is the space between the lungs and chest wall. A long, thin needle is put through the skin between the ribs and into the pleural space. Fluid is pulled into a syringe attached to the needle. It is sent to the lab where it’s tested to find out which bacteria is causing the pneumonia.

How is pneumonia treated?

Treatment depends on the type of pneumonia you have. Most of the time, pneumonia is treated at home, but severe cases may be treated in the hospital. Antibiotics are used for bacterial pneumonia. Antibiotics may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias don’t have specific treatment. They usually get better on their own.

Other treatment may include eating well, increasing fluid intake, getting rest, oxygen therapy, pain medicine, fever control, and maybe cough-relief medicine if cough is severe.

Can pneumonia be prevented?

Check with your healthcare provider about getting immunizations. The flu is a common cause of pneumonia. Because of that, getting a flu shot every year can help prevent both the flu and pneumonia.

There is also a pneumococcal vaccine. It will protect you from a common form of bacterial pneumonia. Children younger than age 5 and adults ages 65 and older should get this shot.

The pneumococcal shot is also recommended for all children and adults who are at increased risk of pneumococcal disease due to other health conditions.

What are the complications of pneumonia?

Most people with pneumonia respond well to treatment, but pneumonia can be very serious and even deadly.

You are more likely to have complications if you are an older adult, a very young child, have a weakened immune system, or have a serious medical problem like diabetes or cirrhosis. Complications may include:

  • Acute respiratory distress syndrome (ARDS). This is a severe form of respiratory failure.

  • Lung abscesses. These are pockets of pus that form inside or around the lung. They may need to be drained with surgery

  • Respiratory failure. This requires the use of a breathing machine or ventilator.

  • Sepsis. This is when the infection gets into the blood. It may lead to organ failure.

Key points about pneumonia

  • Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.

  • There are more than 30 different causes of pneumonia, and they’re grouped by the cause. The main types of pneumonia are bacterial, viral, and mycoplasma pneumonia.

  • A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. Other symptoms include fever, shaking chills, shortness of breath, low energy, and extreme tiredness.

  • Pneumonia can often be diagnosed with a thorough history and physical exam. Tests used to look at the lungs, blood tests, and tests done on the sputum you cough up may also be used.

  • Treatment depends on the type of pneumonia you have. Antibiotics are used for bacterial pneumonia. It may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias don’t have a specific treatment and just get better on their own. Other treatment may include a healthy diet, more fluids, rest, oxygen therapy, and medicine for pain, cough, and fever control.

  • Most people with pneumonia respond well to treatment, but pneumonia can cause serious lung and infection problems. It can even be deadly.

Pneumonia is an infection or inflammation of the air sacs (alveoli) in the lungs. Fluid and/or pus get(s) into the alveoli, blocking them and preventing oxygen from reaching the blood. It is a common disease, particularly in winter and spring due to the increased circulation of bacterial and viral respiratory infections that often occurs at those times of year.

Pneumonia can be a serious illness, particularly for babies and young children, people older than 65 years of age, and people with pre-existing health problems.

Symptoms

Symptoms of pneumonia depend on the severity of the disease (which is related to the cause, your age and your general health).

Common symptoms include the following.

  • Cough, which may be dry and irritating or a wet cough producing phlegm (sputum/mucus). Cough symptoms can vary according to the type of pneumonia and change over the course of the illness – when you first get sick with pneumonia the cough may be dry, later on it may become increasingly productive.
  • Difficulty breathing or breathlessness. Feeling short of breath or breathless is a common symptom of pneumonia.
  • Chest pain that is sharp and gets worse when coughing or breathing deeply.
  • Fever and/or chills and sweating. This is common, and the fever is usually higher than 38 degrees Celsius. Older people with pneumonia are less likely to have a fever than younger adults.
  • Fatigue or extreme tiredness.
  • Muscle and joint aches and pains can also be symptoms of pneumonia.
  • Loss of appetite, nausea, vomiting or diarrhoea can affect some people and can lead to dehydration if you don’t drink enough fluids.
  • Mental confusion is another symptom of pneumonia that is usually only seen in older people.

There are many different causes of pneumonia, some more serious than others. The exact cause can’t always be identified, even after testing.

In most cases, pneumonia happens after a germ is inhaled into the lungs. However, sometimes an infection gets to the lungs by other means, such as via the bloodstream.

Common infectious causes include the following.

  • Bacteria such as Streptococcus pneumoniae (so-called pneumococcal pneumonia is the most common type of bacterial pneumonia).
  • Viruses such as the influenza virus that causes the flu (the most common cause of viral pneumonia in adults).
  • Atypical bacteria such as Mycoplasma pneumoniae and Legionella pneumophila (which causes Legionnaires’ disease).
  • Fungi – fungal pneumonia often affects people with weakened immune systems.

Pneumonia can also develop if someone accidentally breathes food, drink or vomit into their lungs. This is known as aspiration pneumonia and usually affects people who have problems coughing or swallowing (for example, after having a stroke). It can also happen if you inhale smoke, chemicals or dust into the lungs.

Types of pneumonia

Pneumonia is usually classified according to the type of germ that caused it (for example, bacterial or viral pneumonia). It can also be classified according to where you caught the infection (for example, in hospital or in the community) or how you caught it (e.g. aspiration pneumonia).

The symptoms and severity of pneumonia vary according to the type.

Bacterial pneumonia

In bacterial pneumonia, symptoms can be severe.

Symptoms may appear suddenly or gradually, and can include:

  • a rapid increase in breathing and pulse rate;
  • fever and chills;
  • productive cough with green or yellow mucus, or mucus which is red or brown from blood;
  • chest pain;
  • tiredness;
  • mental confusion; and
  • slightly blue lips and nail beds.

Viral pneumonia

Many cases of viral pneumonia are not serious and only last a short time. But the influenza (flu) virus can cause serious pneumonia, especially in older people, pregnant women and people with other health problems.

Symptoms of viral pneumonia can be similar to symptoms of flu, and include:

  • headache;
  • fever;
  • dry cough;
  • shortness of breath;
  • tiredness; and
  • muscle pains.

In some cases, viral pneumonia may be complicated by a bacterial infection.

Mycoplasma pneumonia

This is a type of atypical pneumonia, and most often affects people younger than 40 years of age. This type of pneumonia is usually mild but can be severe.

Common symptoms include:

  • headache;
  • low-grade fever;
  • a dry cough, which may become productive;
  • fatigue, which can last for several weeks after the disease has subsided;
  • nausea and vomiting;
  • joint pain and muscle aches; and
  • in some people, a skin rash.

Who is at risk?

Some adults are more at risk of getting pneumonia than others. At-risk groups include:

  • people older than 65 years;
  • heavy drinkers;
  • smokers;
  • people who have chronic (ongoing) conditions such as chronic obstructive pulmonary disease (COPD) and diabetes;
  • people taking acid-reducing medicines for conditions such as heartburn; and
  • people with weakened immune systems.

Complications

Pneumonia can lead to some serious complications. Some types of pneumonia are more likely to cause complications than others.

Complications can include:

  • Pleurisy (inflammation of the lining of the lungs – the pleura), which usually causes sharp chest pain.
  • Pleural effusion (a collection of fluid between the layers of pleura – the membranes that line the lungs), which causes increasing breathlessness.
  • Bacteraemia or septicaemia (infection of the bloodstream), which can cause increasing fevers, weakness and feeling extremely unwell. This complication is very serious and needs urgent treatment.

If you develop complications, you will likely need hospital treatment.

Diagnosis and tests

You should see your GP (general practitioner) if you are unwell with any of the pneumonia symptoms described above. Your doctor will want to ask about your symptoms and how long you have had them. They will also ask about your general health and whether you have recently been unwell with a cold or the flu.

A physical examination will help your doctor diagnose pneumonia. Your doctor will take your temperature with a thermometer, check how quickly you are breathing and listen to your chest with a stethoscope. When examining your chest, your doctor may notice reduced breath sounds on one side of the chest or cracking sounds, which can be signs of pneumonia.

If your doctor suspects you have pneumonia based on your symptoms and physical examination, the following tests may be recommended.

  • A chest X-ray can show which areas of the lungs are affected by pneumonia and sometimes gives a clue to the cause.
  • Sometimes a CT scan of the chest is required, in addition to plain chest X-rays.
  • A sputum sample (sample of mucus that you cough up) can be sent to a laboratory for testing to work out the cause of the pneumonia.
  • Blood and urine tests may also be recommended to try to determine the organism that is causing your pneumonia. Blood tests can also give an idea as to how your body is responding to the infection.
  • Sometimes, testing of nose and throat swabs may be done to help determine the cause of pneumonia.
  • If you are being assessed in a hospital, the amount of oxygen in your blood will be measured to see if you need supplemental oxygen therapy.

Early diagnosis and treatment are important for pneumonia. If you think you have pneumonia, see your doctor immediately. For people with chest pain, breathlessness, or confusion, call 000 for an ambulance or go to the nearest hospital emergency department.

Treatment

Treatment will depend on the type and severity of your pneumonia, as well as your health in general. If you are not too unwell, you may be able to be treated at home. People with more severe pneumonia will need hospital treatment.

If you are being treated at home, it’s very important you take all medicines exactly according to your doctor’s instructions. You should see your doctor if you are not getting better after 2 days of treatment.

Antibiotics or antivirals

Antibiotics are used to treat bacterial pneumonia. If your pneumonia is severe you may need intravenous antibiotics (which are given by infusion into a vein) in hospital. Antiviral medicines may be recommended for viral pneumonia.

Pain and fever relief

Medicines such as paracetamol or ibuprofen can be given to treat pain and fever. Painkillers are often needed to help relieve chest pain so that you can cough and bring up secretions from your chest.

Oxygen

Oxygen therapy may be needed if you have a low concentration of oxygen in your blood. People needing oxygen therapy need to be treated in hospital.

Self-care

It’s important to get enough rest and drink plenty of fluids to help you get better. People who are very unwell with pneumonia may need to have fluids given through a vein (via a drip) in hospital. Not smoking is also important for recovery.

Recovery

Healthy, young people usually recover from pneumonia within a week or 2. However, the cough can persist for several weeks and many people feel more tired than usual for weeks or even months after having pneumonia.

Older people may feel very weak for some time while recovering and might need an extended period of rest before they feel fully recovered.

Vaccines are available that can protect against infection with several common causes of pneumonia.

Pneumococcal vaccination

A vaccine called Pneumovax is available in Australia that can help prevent pneumonia due to the pneumococcus bacterium (pneumococcal pneumonia). It is usually recommended for adults most at risk such as:

  • people aged 65 or older;
  • people whose immune systems don’t function fully (immunocompromised);
  • all Aboriginal and Torres Strait Islander people aged 50 years or older;
  • Indigenous Australians aged 15 years and older who have medical conditions that put them at increased risk; and
  • people with a chronic illness that would put them at high risk if they got pneumococcal pneumonia.

A different type of pneumococcal vaccine is recommended for all Australian children to prevent pneumonia and other pneumococcal infections in infancy and childhood.

Flu vaccination

Pneumonia can be a complication of the flu, especially in people who have weakened immune systems or who are not in optimal health. Older people, pregnant women and young children also have a higher risk of severe illness with influenza infection.

Having a flu vaccination every year before or at the start of winter is a sensible precaution for anyone wanting to avoid influenza and its complications.

Other vaccines

Other vaccine preventable infections that can result in pneumonia include:

  • Haemophilus influenzae type b (Hib);
  • pertussis (whooping cough);
  • varicella (chickenpox); and
  • measles.

Vaccination against these illnesses is recommended as part of routine childhood vaccinations in Australia under the National Immunisation Program Schedule.

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Last Reviewed: 10/04/2019

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