What is double pneumonia?

Pneumonia Resource Center: 10 Terms You Should Know

Pneumonia has several different causes, types, and treatments. Here are 10 pneumonia phrases you should know.

The terminology may be confusing, but it’s important to understand the facts about pneumonia, because it kills about 50,000 Americans every year.

Here are some pneumonia terms you should know:

Alveoli These air sacs in your lungs can fill up with fluid or pus when a person develops pneumonia, an acute respiratory infection. Flu-like symptoms that persist for weeks often don’t respond to over-the-counter cold and sinus medicines.

Aspiration Pneumonia This is a type of pneumonia caused by breathing food or liquid into your lungs. These substances cause irritation in your lungs, and an infection may follow.

You could be at risk for this type of pneumonia if you vomit while you’re drunk, if you have a neurological disease that interferes with your ability to swallow, or if stomach acid seeps up into your throat at night, a condition known as gastroesophageal reflux disease, or GERD.

Atypical Pneumonia These pneumonias don’t have the usual symptoms of bacterial pneumonias, causing less fever, less cough, and less mucus production.

Atypical pneumonias include Legionnaires’ disease, which is caused by the Legionella pneumophila bacteria. This can be caught by inhaling infected droplets from air conditioning systems, spas, or fountains.

A Chlamydophila pneumoniae infection causes a mild, atypical pneumonia seen in older people.

Bronchial Pneumonia Any pneumonia can affect your lungs in two basic ways, and it is described accordingly as either bronchial or lobar. Bronchial pneumonia occurs in patches throughout both lungs.

The term “bronchial” means that the airways throughout the lungs are also involved with the pneumonia. People with asthma and bronchitis are at risk for pneumonia because mucus production blocks these passages.

Double Pneumonia This is a descriptive term for any type or cause of pneumonia that affects both lungs.

Influenza, or Flu This is an acute respiratory illness caused by influenza A or B viruses. While most patients recover in a couple of weeks, it can lead to potentially serious complications, such as pneumonia.

Lobar Pneumonia This term describes a pneumonia that settles in a section of your lung called a lobe.

Lobar pneumonia is usually caused by pneumococcus bacteria, and tends to be more serious and extensive.

Mycoplasmal Pneumonia This pneumonia may be described as both atypical and walking pneumonia.

It’s caused by a tiny type of bacteria called Mycoplasma pneumoniae. These infections are more common in young people and spread like a common cold in tight living conditions.

The symptoms, which are similar to those of the flu, can usually be treated with antibiotics.

This type of pneumonia usually doesn’t require a hospital stay, which is why a mycoplasmal infection is sometimes called walking pneumonia.

Opportunistic Pneumonia This term describes all pneumonias that attack anyone with a weakened immune system.

The germs that cause these pneumonias usually don’t make healthy people sick. An example is pneumocystis pneumonia, caused by Pneumocystis jirovecii, which was once considered a parasite but is now classified as a fungus.

Opportunistic pneumonias are most common in people who have HIV or AIDS, are undergoing cancer treatment, or who had an organ transplant.

Walking Pneumonia This simply means that a person with a mild case of pneumonia is well enough to “walk around.”

About one-third of pneumonia cases are caused by viruses, and they tend to be less serious than bacterial pneumonias. The term walking pneumonia is also used to describe atypical pneumonia and mycoplasmal pneumonia.

What Causes Pneumonia?

Pneumonia can be caused by a wide variety of bacteria, viruses and fungi in the air we breathe. Identifying the cause of your pneumonia can be an important step in getting the proper treatment.

Bacteria

The most common type of bacterial pneumonia is called pneumococcal pneumonia. Pneumococcal pneumonia is caused by the Streptococcus pneumoniae germ that normally lives in the upper respiratory tract. It infects over 900,000 Americans every year.

Bacterial pneumonia can occur on its own or develop after you’ve had a viral cold or the flu. Bacterial pneumonia often affects just one part, or lobe, of a lung. When this happens, the condition is called lobar pneumonia. Those at greatest risk for bacterial pneumonia include people recovering from surgery, people with respiratory disease or viral infection and people who have weakened immune systems.

Some types of bacteria cause what is known as “atypical” pneumonia, including:

  • Mycoplasma pneumoniae, a tiny wide-spread bacterium that usually infects people younger than 40 years old, especially those living and working in crowded conditions. The illness is often mild enough to go undetected and is sometimes referred to as walking pneumonia.
  • Chlamydophila pneumoniae, which commonly causes upper respiratory infections year-round, but can also result in a mild form of pneumonia.
  • Legionella pneumophila, which causes a dangerous form of pneumonia called Legionnaire’s disease. Unlike other bacterial pneumonias, Legionella is not passed from person to person. Outbreaks of the disease have been linked to exposure to contaminated water from cooling towers, whirlpool spas, and outdoor fountains.

These bacteria are referred to as “atypical” because pneumonia caused by these organisms might have slightly different symptoms, appear different on a chest X-ray, or respond to different antibiotics than the typical bacteria that cause pneumonia. Even though these infections are called “atypical,” they are not uncommon.

Viruses

Viruses that infect the upper respiratory tract may also cause pneumonia. The influenza virus is the most common cause of viral pneumonia in adults. Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in young children. Most viral pneumonias are not serious and last a shorter time than bacterial pneumonia.

Viral pneumonia caused by the influenza virus may be severe and sometimes fatal. The virus invades the lungs and multiplies; however, there are almost no physical signs of lung tissue becoming filled with fluid. This pneumonia is most serious in people who have pre-existing heart or lung disease and pregnant women. Read about the connection between the flu and pneumonia.

Viral pneumonias may be complicated by a secondary invasion of bacteria, with all the typical symptoms of bacterial pneumonia.

Fungi

Fungal pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who are exposed to large doses of certain fungi from contaminated soil or bird droppings.

Pneumocystis pneumoniais a serious fungal infection caused by Pneumocystis jirovecii. It occurs in people who have weak immune systems due to HIV/AIDS or the long-term use of medicines that suppress their immune systems, such as those used to treat cancer or manage organ transplants.

The following are three fungi that occur in the soil in some parts of the United States and can cause some people to get pneumonia.

  • Coccidioidomycosis. This fungus is found in Southern California and the desert Southwest. It is the cause of valley fever.
  • Histoplasmosis. This fungus is found in the Ohio and Mississippi River Valleys.
  • Cryptococcus. This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings.

Pediatric Pneumonia

  1. What is pediatric pneumonia?
  2. Symptoms
  3. Causes
  4. Diagnosis
  5. Treatment
  6. Complications
  7. Prevention
  8. FAQs
  9. Other names for pediatric pneumonia

What is pediatric pneumonia?

Pneumonia is an inflammation in one or both of the lungs that is almost always caused by a viral or bacterial infection. The inflammation interferes with the body’s ability to deliver oxygen and remove carbon dioxide from the blood. A person is more likely to get pneumonia as a child, known as pediatric pneumonia, than they are as an adult.

Symptoms of pediatric pneumonia depend on the cause of the infection and several other factors, including the age and general health of the child. Rapid breathing, a high temperature and coughing are three of the most common signs of the condition.

Pneumonia in newborns and very young children is more likely to be caused by a viral, rather than a bacterial infection. Potential viral causes for pneumonia include respiratory syncytial virus or influenza infection. Bacterial infections become more common in school-aged children and young adolescents. The most common bacterial cause for pneumonia is a type of bacterium known as streptococcus pneumoniae, but there are several other bacterial infections that can also cause pneumonia.

Diagnosis is generally based on a physical exam and several other tests, which may include blood tests and an X-ray.

The prognosis for pediatric pneumonia is generally good. A bacterial infection can often be treated with antibiotics, such as amoxicillin. Viral pneumonia usually resolves on its own without the need for medication. However, parents and guardians should be vigilant, as the condition is often hard to spot in children. Most deaths from pediatric pneumonia occur due to underlying health conditions, such as heart disease.

Vaccination against bacterial infection is the best way of preventing the spread of pediatric pneumonia. Children aged over six months old may also benefit from the influenza vaccine.

Symptoms

Symptoms of pediatric pneumonia depend on a number of factors, particularly the age of the affected child, and whether the cause of the infection is bacterial or viral.

Symptoms in newborns

Newborns and babies under a month old are the only age group that rarely cough as a direct consequence of pneumonia. The most common symptoms are irritability and not feeding properly. A child of this age may also display:

  • Abnormally fast breathing
  • Shortness of breath
  • Grunting sounds

Symptoms in babies over a month old

Once a baby is over a month old, then the most noticeable symptom of pneumonia is likely to be coughing. All of the symptoms that affect newborns will possibly be present too, although grunting becomes less common as the baby grows older. Other pneumonia symptoms observed in babies of this age include:

  • Congestion, the feeling that the chest is full or clogged
  • Wheezing or heavy breathing
  • Fever, particularly during pneumonia caused by bacterial infection

Toddlers and preschoolers

Fever and cough are the most common symptoms for children over a year old. Other typical symptoms include:

  • Abnormally rapid breathing
  • Congestion
  • Vomiting, particularly following coughing

Older children

Fever and coughing remain the most common signs of pneumonia in children of school age. They might also complain of the following symptoms:

  • Chest pain
  • Tiredness
  • Vague stomach pain

Other possible symptoms of pneumonia at this age include:

  • Vomiting
  • Diarrhea
  • Sore throat
  • Ear ache

If you are worried that your child, or a child that you know, may be showing signs of pediatric pneumonia or another condition, you can get a free symptom assessment by downloading the Ada app.

Causes of pediatric pneumonia

Pneumonia is an inflammation of the air sacs, also known as the alveoli, in the lungs, usually caused by infection that causes them to fill with fluid or pus.

This inflammation interferes with the lungs’ ability to breathe and properly supply oxygen to the body, causing many of the symptoms described above.

Pneumonia is almost always caused by bacteria or a virus. In children below school age, viral infection is the most common cause. School-aged children and young adolescents are more likely to develop a bacterial infection.

Potential viral infections

Viral infections that can cause pediatric pneumonia include:

  • Respiratory syncytial virus (RSV), which is the most common viral cause
  • Influenza
  • Parainfluenza virus, which also causes croup

And less commonly:

  • Rhinovirus
  • Adenovirus
  • Human Metapneumovirus
  • Enterovirus
  • Coronavirus
  • Herpes simplex virus

Potential bacterial infections

The most common bacterial cause of pediatric pneumonia is Streptococcus pneumoniae bacteria. This bacterium is often carried underneath the nose of healthy people without causing any harm, but can develop into pneumonia if the bacterium spreads to those with vulnerable immune systems, such as children and the elderly.

Another possible bacterial cause is Mycoplasma pneumoniae, which usually causes a milder form of the condition known as walking pneumonia or atypical pneumonia. Walking pneumonia is sometimes confused with the common cold and does not usually require bed rest. However, in some cases, symptoms following infection with Mycoplasma pneumoniae will be as severe as those caused by other types of bacteria.

A few other types of bacteria can cause pneumonia in children, including group B streptococcus and staphylococcus aureus.

Other potential causes

In rare cases, there can be another cause for a child developing pneumonia. These include other potential infectious causes, such as:

  • Aspiration pneumonia, which is when food, saliva or stomach acid enters the lungs
  • Inhaling fungi, such as from soil

There are also non-infectious causes, such as inhaling harmful substances and chemicals.

Read more about the different types of pneumonia “

Diagnosis of pediatric pneumonia

The first step in a diagnosis of pediatric pneumonia is usually a physical exam, where a doctor assesses the child’s symptoms. Their temperature will typically be taken and the doctor will listen to their chest with a stethoscope.

A particular challenge is finding out whether the pneumonia is bacterial or viral in origin. A doctor may ask questions about recent travel history and check their vaccination history.

A chest X-ray is sometimes used to confirm the diagnosis or to look for any complications that pneumonia may have caused around the lungs. In recent years, there has been promising progress in the use of ultrasound, a scan that uses sound waves to produce an image of the inside of the body, to diagnose pneumonia. Ultrasound may replace X-ray testing at some point in the future.

Other potential tests include:

  • A blood test can help determine whether an infection is present, the extent of its spread and possibly the cause
  • A sputum test, which is when a sample of spit or phlegm is laboratory-tested. This might confirm if a certain type of bacterium is causing the pneumonia
  • A pulse oximetry, which is a test to measure oxygen levels in the blood
  • A bronchoscopy, which is when a tube with a camera and light attached to the end is guided into the lungs so a doctor can look inside. This is rare and generally only used in complicated pneumonia cases

Treatment of pediatric pneumonia depends on the child’s age and health, as well as the cause of the infection. In most cases, particularly with school-age children, pneumonia can be treated or managed at home. Children with bacterial infections will generally be given antibiotics, whereas viral infections usually resolve themselves without the need for additional medication.

Sometimes a child may need to be hospitalized for treatment. The decision whether to hospitalize is typically based on factors such as:

  • The child’s breathing ability
  • The age of the child
  • The risk of complications due to the type of pneumonia or any underlying health conditions the child may have
  • The level of oxygen in the blood
  • The presence of any unusual symptoms, such as altered mental states

Hospitalization will usually involve giving the affected child supplemental oxygen, monitoring their condition and treatment with antibiotics. Any complications may also need to be addressed.

Pneumonia medication

Children being treated at home for bacterial pneumonia infections will generally be prescribed an antibiotic drug called amoxicillin, which can come in tablet or liquid form. If this is unsuccessful, then a doctor may recommend alternative antibiotics.

Macrolide antibiotics, such as azithromycin, may be recommended if it is thought the child is affected by atypical pneumonia.

The antibiotics used in hospital will generally vary from those recommended for use at home. A doctor will base the antibiotic treatment on several factors, such as whether a child has been immunized. In hospital, the antibiotics may be delivered directly into the bloodstream using an intravenous drip.

Antibiotics are not a useful treatment for children with viral infections. However, if the pneumonia has been caused by an influenza infection, antiviral therapy may be used to fight the spread of the disease.

A child’s fever symptoms might be helped with acetaminophen whether they are in the hospital or being treated at home.

Care tips at home

If a doctor decides a child should be treated at home, their caregiver should take the following steps:

  • Keep them hydrated by offering plenty of fluids.
  • If a child’s cough is producing mucus, encourage spitting the phlegm out to clear the airwaves. If the child is too young to understand, then an adult should lay the infant across their lap and pat their back when coughing fits occur
  • Relieve chest pain with a heated pad or warm compress on the chest area

If a child’s lips or nails are bluish or grey then this may indicate that they are not getting enough oxygen. This is a sign that medical professionals should be contacted.

Complications

The vast majority of children affected by pneumonia recover without any long-term difficulties. However, there are some potential complications, including:

Pleural effusion, which is a buildup of fluid between the layers of the pleura, the membrane that covers the lung. It is also known as water on the lungs. This liquid can sometimes become infected and cause a more dangerous condition known as empyema. Empyema can be treated by draining the excess liquid out of the body.

Lung abscesses, which are pus-filled cavities that can appear in the lungs. These can often be treated with antibiotics.

Sepsis, occurs when an infection passes into the bloodstream causing the body to respond in a dangerous way. In the most serious cases, sepsis can potentially lead to multiple organ failure

Pneumothorax, the medical term for a collapsed lung. This is when air enters the space around a person’s lungs, which can impact upon the lungs ability to stay inflated.

There are two vaccines that the Centers for Disease Control and Prevention (CDC) recommends in the U.S. to protect against Streptococcus pneumoniae bacteria, the most common cause of bacterial pneumonia. It can also cause a number of other conditions, including bronchitis and meningitis. Conditions caused by infection with Streptococcus pneumoniae bacteria are known as pneumococcal disease.

The PCV13 vaccine is recommended for all children under the age of two. It protects against 13 of the most common strains of pneumococcal bacteria. The first shot should be given at two months old, the next two at four months and six months old. A final booster shot should be administered when the child is between 12 and 15 months old. For children older than this age, a single shot is usually all that is needed.

The PPSV23 vaccine is recommended for children older than two, who have certain medical conditions, such as leukemia or chronic cardiovascular disease. PPSV23 protects against 23 types of pneumococcal bacteria. Children with these medical conditions will generally need two doses of PPSV23.

Side effects are rare. Allergic reactions to the vaccine are thought to occur only in one in a million cases. Nevertheless, a doctor should be told if a person has had an allergic reaction to any other vaccine. Taking a vaccine should usually be delayed if the child feels ill, but a doctor will be able to advise on this.

The introduction of a vaccine against Streptococcus pneumoniae in the U.S. has coincided with a significant decline in pneumococcal disease in children under the age of five.

Influenza vaccination

One of the potential viral causes of pneumonia is influenza infection, also known as the flu. The influenza vaccination cannot stop all children from getting the flu, but it is the best means of defending against infection.

The CDC recommends that all children aged over six months should get a flu vaccine shot once a year before the end of October. A new vaccination is needed every year, because the specific influenza viruses that are spreading through the population change as time passes.

Babies younger than six months old are too young to be vaccinated. The best way to ensure that they are protected against the flu is to make sure everyone around them is vaccinated.

FAQs

Q: Pediatric bronchitis vs pneumonia: what is the difference?
A: Bronchitis is the infection and subsequent inflammation of the bronchial tubes, which carry air to and from the lungs. Pneumonia describes inflammation of the alveoli, tiny air sacs inside the lungs. Under certain conditions, bronchitis can develop into pneumonia.

The two conditions cause very similar symptoms and may be difficult to tell apart. However, a child suspected to have either bronchitis or pneumonia should be taken to see a doctor, who will be able to help with a diagnosis. You can also get a free symptom assessment by downloading the Ada app.

Read more about Acute Bronchitis “

Q: Is pediatric pneumonia contagious?
A: The bacteria and viruses that usually cause pneumonia can spread from person to person. The best way to prevent a child developing the condition is to make sure they are properly vaccinated.

It is also beneficial to practice good hygiene, such as regularly washing the hands and covering coughs and sneezes.

Q: When should a child go to hospital for pneumonia?
A: A doctor will usually make a call on whether a child needs hospitalization based on a number of factors, including how well the child can breathe and how old they are.

Read more about hospitalization and other types of pneumonia treatment “

Other names for pediatric pneumonia

  • Childhood lung infection
  • Pneumonia, children
  • Pneumonia, infants
  1. “Pediatric Pneumonia: Practice Essentials.” Medscape. 05 November, 2018. Accessed: 13 February, 2019. ↩ ↩ ↩ ↩ ↩ ↩

  2. “Childhood Pneumonia.” JAMA Network. 01 August, 2017. Accessed: 13 February, 2019. ↩ ↩ ↩

  3. “Pneumonia.” Great Ormond Street Hospital for Children. July, 2011. Accessed: 13 February, 2019. ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩ ↩

  4. “Pediatric Pneumonia: Etiology.” Medscape. 05 November, 2018. Accessed: 313 February, 2019. ↩ ↩ ↩ ↩ ↩

  5. “Pediatric Pneumonia: Clinical Presentation.” Medscape. 05 November, 2018. Accessed: 313 February, 2019. ↩ ↩ ↩ ↩ ↩

  6. “Pneumonia in children: Symptoms of pneumonia in children.” British Lung Foundation. September, 2016. Accessed: 13 February, 2019. ↩ ↩ ↩

  7. “Pneumonia.” National Heart, Lung and Blood Institute. Accessed: 14 February, 2019. ↩ ↩ ↩ ↩ ↩

  8. “Mycoplasma pneumoniae Infections.” Centers for Disease Control and Prevention. 13 April, 2018. Accessed: 14 February, 2019. ↩

  9. “Pediatric Pneumonia Workup.” Medscape. 05 November, 2018. Accessed: 14 February, 2019. ↩ ↩ ↩

  10. “Pediatric Pneumonia Treatment & Management: Hospitalization.” Medscape. 05 November, 2018. Accessed: 14 February, 2019. ↩ ↩

  11. “The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.” 01 October, 2011. Accessed: 14 February, 2019. ↩ ↩ ↩

  12. “Pediatric Pneumonia Treatment & Management: Pharmacologic Therapy.” Medscape. 05 November, 2018. Accessed: 14 February, 2019. ↩ ↩ ↩

  13. “Pediatric Pneumonia Treatment & Management: Complications.” Medscape. 05 November, 2018. Accessed: 16 February, 2019. ↩

  14. “Pneumococcal Vaccination: What Everyone Should Know.” Centers for Disease Control and Prevention. 06 December, 2017. Accessed: 16 February, 2019. ↩

  15. “Children & Influenza (Flu).” Centers for Disease Control and Prevention. 05 February, 2019. Accessed: 21 February, 2019. ↩

Pneumonia Q&A: No Big Deal or Deadly?

Hillary Clinton contracted pneumonia, and everyone wondered: What did it mean? Was this serious or not?

When presidential candidate Hillary Clinton fell prey to pneumonia recently, questions about the seriousness and implications of her illness permeated the media. We also wondered if we knew as much about the illness as we thought we did.

We sought answers from Katharine DeGeorge, MD, MS, a UVA family medicine physician voted “Best General Practitioner” in C-Ville Weekly’s Best of C-Ville 2015 and 2016, who gave us some insight.

What were your first thoughts when you heard Clinton had pneumonia? “Oh dear” or “no big deal”? Or “of course, she’s probably exhausted”?

No big deal.

Why?

Because pneumonia is fairly common, and the vast majority of otherwise healthy patients will recover and be able to go about their business within a few weeks.

What exactly is pneumonia?

Regardless of whether it’s a viral or bacterial organism causing the infection, pneumonia occurs when the infectious organisms group together in the lungs along with immune cells that are trying to fight the infection and interfere with normal lung function and can block the flow of oxygen.

Sometimes people get the flu and pneumonia confused – Bill Clinton called his wife’s condition the flu, for instance. What’s the difference, and which is worse?

It’s easy to get them confused. Both are common respiratory illnesses that:

  • May cause fever, cough and excessive fatigue
  • Have the potential to cause serious illness or even death, though most people fully recover

A simple chest X-ray can help us make the correct diagnosis if we aren’t certain after a good history and physical exam. Making the right diagnosis is important because it often affects our treatment plans.

Flu vs. Pneumonia

The flu:

  • Caused by a virus – so antibiotics won’t help
  • Infects nose, throat and lungs
  • Symptoms vary but can include fever, chills, cough, headache, muscle and joint pain, sore throat, nasal congestion, general fatigue, and even diarrhea or vomiting (mainly in kids) and last about 3-7 days
  • No shortness of breath in uncomplicated cases
  • More contagious than pneumonia
  • People usually get better on their own with rest, fluids and over the counter medications
  • Can develop into pneumonia in more serious cases

Pneumonia:

  • Most often caused by a bacteria
  • Affects the lower respiratory tract and lungs
  • Symptoms that distinguish it from the flu include difficulty or pain with breathing and a persistent cough productive of thick yellow/green sputum
  • Most people need antibiotics to get better
  • More likely to require hospitalization than the flu

Who Gets Pneumonia?

Are some people more prone? Does getting pneumonia mean someone has a weak immune system or something?

Getting pneumonia doesn’t necessarily mean that your immune system is weak. Lots of perfectly healthy people get pneumonia.

However, the risk of developing pneumonia is higher for people with certain conditions such as:

  • Asthma
  • Chronic obstructive pulmonary disorder (COPD)
  • Diabetes
  • Chronic respiratory disease
  • Dementia
  • Excessive alcohol use
  • Heart disease
  • Smoking
  • Stroke

Pneumonia can also have serious complications or even be deadly, especially for people who:

  • Are very young (0-4 years old)
  • Are age 65 and older
  • Have immune systems weakened by other serious illnesses or medications

In the United States, about 10 percent of people over the age of 65 who are hospitalized for pneumonia will die within 30 days, so this can be very serious stuff.

Do symptoms present differently in older people?

They sure can. The typical symptoms of pneumonia can be more subtle in older people, or they can present differently altogether, with the only sign of illness being weakness, confusion or collapsing.

Do stress and exhaustion make it worse?

Stress and exhaustion can most definitely lead to worse symptoms or complicating conditions, most notably dehydration, in people with pneumonia. Dehydration itself can lead to weakness and confusion, and can also cause low blood pressure, which again can lead to weakness, being unsteady on your feet, and collapse. It sounds trite, but our grandmothers were right when they told us to rest and drink plenty of fluids when we are sick! Our bodies need to conserve every bit of energy they can to fight pneumonia and get on the road to a full recovery.

Is it obvious if someone has it? As in, if you were watching Clinton, or a colleague at work, would their symptoms be obvious or not?

Most people with pneumonia will appear at least a little sick. You might notice them:

  • Coughing a lot
  • Looking flushed or like they are sweating
  • Walking more slowly or unsteadily
  • Having a hard time speaking or walking without having to pause to catch their breath

Some people, however, have mild cases of pneumonia that can go unnoticed altogether or be mistaken for a simple cold, cough or allergies.

Types of Pneumonia

Some people find the difference between viral and bacterial pneumonias confusing. Which is more severe?

Often, but not always, viral pneumonia is less severe than bacterial pneumonia and requires only rest, fluids and, for some, supplemental oxygen. People with bacterial pneumonia need treatment with antibiotics without which there is a much greater risk of a prolonged or more severe disease course and complications.

Is there such a thing as ‘double’ or ‘triple’ pneumonia? Why is it called walking pneumonia?

Walking pneumonia is a colloquialism that generally refers to a mild case of pneumonia, often caused by an “atypical” bacterial organism (because it’s not the typical agent that causes pneumonia), called Mycoplasma pneumoniae. This mild form of pneumonia can be so mild that people don’t even know they have it, or if they do, the symptoms don’t preclude participation in normal activities (including walking, thus the term “walking pneumonia”).

Double pneumonia (sometimes called bronchial pneumonia) simply refers to infections in two (of the three) lobes of the lungs, and generally indicates a more severe infection that often requires hospitalization.

Triple pneumonia is a little more complicated. Basically it occurs when a person with pneumonia (often double pneumonia) is treated and clears the original infection, but then gets a subsequent case of pneumonia affecting one or both lungs. Triple pneumonia carries a much worse prognosis than uncomplicated lobar pneumonia (affecting only 1 lobe).

Treatment & Prevention

How easy it is to get rid of it or stop it in its tracks?

When appropriate antibiotics for bacterial pneumonia are started right away, many people with pneumonia can be back to their normal state of health within a couple weeks, although some will have a lingering cough or fatigue that can last for a month or more.

Smokers or people with underlying lung conditions like asthma or chronic bronchitis may have a harder time getting back to baseline. The key to stopping pneumonia in its tracks is prompt diagnosis and treatment.

Is there a vaccine?

There are two types of pneumonia vaccines available. They protect against the most common and aggressive serotypes of Streptococcus pneumoniae, the organism most often responsible for bacterial pneumonia. However, pneumonia can be caused by other organisms, including viral, bacterial, fungal and parasitic species, so the vaccines do not prevent against all forms of pneumonia. Getting pneumonia once doesn’t mean you can’t get it again.

We recommend these vaccines as part of routine childhood immunizations and for people aged 65 years and older, or those with certain medical problems that increase the risk of pneumonia or its complications. The pneumonia vaccines are only given a few times during your life, which is different than flu shots, which you should get yearly.

Concerns to Consider

As a doctor, what are your main concerns when you discover a patient has pneumonia?

The first thing that goes through my head when seeing a patient with suspected pneumonia is “sick or not sick.” Infections like this can lead to a severe systemic response that you don’t want to miss called sepsis, which requires prompt action. Vital signs such as body temperature, heart rate, respiratory rate, oxygen level and blood pressure help determine just how sick the patient is and whether or not they need to be hospitalized.

Do You Have Pneumonia Symptoms?

Find a family medicine or primary care doctor near you.

Another essential piece of the puzzle is determining if the infection may have been picked up from a hospital or other health-care facility like a nursing home. Pathogens that live in these places have a greater chance of being antibiotic resistant and require different treatment considerations.

For most people, especially those without other serious medical conditions, a simple course of antibiotics along with rest and fluids will do, and they’ll be back on their feet in no time.

What is pneumonia?

What are the symptoms of pneumonia?

If you have pneumonia, you’ll have symptoms that are similar to having flu or a chest infection. Symptoms may develop gradually over a few days but can progress much faster.

The main symptom is coughing. You may feel generally unwell, weak and tired, and you’ll probably have at least one of these symptoms too:

  • coughing up mucus that may become yellow or green
  • a high temperature – you might also sweat and shiver
  • difficulty breathing or getting out of breath quicker than normal
  • chest pain or discomfort
  • loss of appetite

Even if you have pneumonia, you may not have all these symptoms.

More severe cases may also cause:

  • quick breathing
  • confusion
  • low blood pressure
  • coughing up blood
  • rapid heartbeat
  • nausea and vomiting

Some people get a sharp pain in their chest when they breathe in and out. This may be because the thin lining between the lung and ribcage, called the pleura, is infected and inflamed. This inflammation, called pleurisy, stops your lungs moving smoothly as you breathe.

The symptoms of pneumonia are often very similar to those of other chest infections, such as bronchitis, COPD flare-ups or bronchiectasis flare-ups. To get a proper diagnosis you’ll need to visit your GP.

If you feel unwell with these symptoms, see your GP or call 111. If you have chest pain, a rapid heartbeat, quick breathing, shivers or confusion, get urgent advice from your GP or call 999. Take extra care if you’re over 65.

Who is most at risk of pneumonia?

You can get pneumonia at any age. Each year in the UK, about 5-11 adults out of every 1,000 get pneumonia.

Some groups of people are at higher risk from pneumonia. If you’re in one of these groups, you should take extra care to reduce your chances of catching pneumonia.

People in these at-risk groups include:

  • babies and young children
  • people over 65
  • people with long-term heart, lung, brain, liver or kidney diseases, or diabetes
  • people with cancer, especially those having chemotherapy
  • people who smoke or drink alcohol to excess
  • people on drugs that suppress the immune system, and those with HIV

People in hospital for other problems sometimes develop pneumonia while they’re there. This can be for several reasons including the use of mechanical ventilators, recent antibiotic use or because their resistance to infection has been weakened by other medical problems.

Next: how to prevent pneumonia >

Elderly Pneumonia

PNEUMONIA TREATMENT & MANAGEMENT

Patients are treated for pneumonia depending upon which organism triggered the disease. Your loved one’s medical provider can ascertain this through analyzing a phlegm or blood sample.

For a case of viral pneumonia, some patients may receive antiviral medications, but these are not commonly prescribed. And antibiotics are not used because they aren’t effective against viruses. Bouts of viral pneumonia usually heal without medication, provided the patient rests, eats healthy food, and takes in plenty of fluids. If new symptoms arise, it is important to contact your loved one’s doctor, as bacterial pneumonia is a possible complication.

Bacterial pneumonia is always treated with antibiotics. If a patient is in the hospital, it is typical for the hospital to follow strict treatment guidelines. These guidelines are part of pay-for-performance programs, meaning the doctor will get paid a better rate if she follows the guidelines, says Mylotte. Both the American Thoracic Society (www.thoracic.org) and the Infectious Diseases Society of America (www.idsociety.org) have standard treatment guidelines available on their respective websites. These are based on where the patient acquired the disease-in the community, in the nursing home, in the hospital-and these guidelines can be found on each organization’s website. Whether at home or in the hospital, patients are usually administered a once-a-day therapy. Effective antibiotic treatments include respiratory fluoroquinolones such as moxifloxacin, says Mylotte, although there are several antibiotic therapies that work as well as these.

Treating bacterial pneumonia has become more complicated due to antibiotic resistance: The organisms that cause this disease mutate and can become resistant to drug treatment. This is one reason that it is important for a patient to finish her entire course of antibiotics; stopping treatment early actually encourages antibiotic resistance. Up until a few years ago, antibiotic resistance associated with bacterial pneumonia had been increasing, but it has recently decreased, according to Mylotte.

Both mycoplasma and chlamydia pneumonias are also treated with antibiotics. Mycoplasma pneumonia is also known as walking pneumonia. If your loved one has this strain, he or she usually will have milder symptoms, but it can take four to six weeks to heal completely.

Most pneumonia patients heal at home. About 15 to 20 percent of people with community-acquired pneumonia are treated in the hospital, while about 20 to 30 percent of people with nursing-home acquired pneumonia are also admitted to a hospital, according to Mylotte.

Whether a patient stays at home or in a hospital, she may take medications to ease fever, aches, and coughing bouts. Because coughing actually helps rid lung infection, this action shouldn’t be entirely reduced. However, if the patient isn’t getting any sleep, a low-dose cough suppressant can be prescribed. Patients with severe strains may need oxygen therapy to increase blood-oxygen levels. Caregivers should make sure a loved one is receiving proper hydration, eating at least a small amount of healthy food, and reporting worsening or new complications, says the American Lung Association’s Edelman.

Complications that can arise from pneumonia include:

  • Bacteremia: The possibly deadly infection invades the bloodstream and can infect the body’s organs.
  • Pleurisy and Empyema: With pleurisy, the membrane that covers the lungs (pleura) becomes inflamed. Empyema occurs when fluids causing inflammation become infected.
  • Lung Abscess: A pus-filled cavity can develop in the infected lung area.
  • Acute Respiratory Distress Syndrome (ARDS): When the lungs become severely injured due to pneumonia, respiratory failure can occur. Treatment includes the use of a mechanical ventilator (vent) and supplemental oxygen.

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