Abating Pneumonia

You are feverish and shaking. You feel weak and you’re coughing up a storm and some yellowish phlegm. Your chest feels inflamed. You could have a case of pneumonia.

Pneumonia is a contagious infection in one or both your lungs caused by bacteria, viruses or fungi. When there is an infection in the lungs, your airways become inflamed and the air sacs in the lungs fill with mucus and other fluids. This interferes with the transfer of oxygen into the blood and carbon dioxide out of it.

You get pneumonia when you inhale the organism, whether it is bacterial or viral. This creates an inflammatory response including swelling, mucus production, and some disruption of normal lung function. That is why you cough up mucus. Pneumonia is typically an inflammation of one area of the lungs but in bad cases you can have more than one area involved.

In the United States, 1.5 million people were diagnosed with pneumonia in an emergency department during 2018, according to the Centers for Disease Control and Prevention. More than 40,000 people died from the disease that year in the U.S. Most of the people affected by pneumonia are adults.

Nonbacterial pneumonia is more contagious than the bacterial kind. The bacteria may pass from one person to another, but only rarely will such casual exposure cause illness. So you don’t have to isolate the patient. With the nonbacterial infection, on the other hand, you try to avoid exposure to patient’s more infectious cough. You can also catch pneumonia from touching an object held by the patient with pneumonia.

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

Pneumonia can range from mild to life-threatening. It can be serious for infants and young children, people older than age 65, people with health problems or weakened immune systems.

Signs and symptoms of pneumonia are chest pain when you breathe or cough; confusion or changes in mental awareness; cough that may produce phlegm; fatigue; fever, sweating, and chills; lower than normal body temperature; nausea, vomiting or diarrhea; and shortness of breath. Newborns and infants may not show signs of infection.

Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually does a good job in protecting the lungs from infection. But sometimes your immune system can be overpowered and before you know it, you have an infection.

Pneumonia is classified according to the type of germs that cause it and where you got the infection. Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals and other health care facilities. It can be caused by bacteria, bacteria-like organisms, fungi, and viruses including COVID-19. The most common cause of bacterial pneumonia is Streptococcus pneumoniae. Walking pneumonia is a type of bacteria-like organism to describe a condition that doesn’t require bed rest. Viruses are the most common cause of pneumonia in children younger than 5 years.

Some people may acquire pneumonia during a hospital stay for another illness. Hospital-acquired pneumonia may be difficult to treat with antibiotics because the bacteria may be resistant to it. People on ventilators are particularly susceptible to this type of pneumonia.

Health care-acquired pneumonia is a bacterial infection that occurs in people who live in long-term care facilities or who receive care at outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are resistant to antibiotics.

Aspiration pneumonia is when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your gag reflex such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Risk factors for pneumonia may include being hospitalized, chronic disease, smoking, and weakened or suppressed immune system. The two age groups that are highest in risk for getting pneumonia are children that are 2 years of age or younger and people who are age 65 or older.

To diagnose pneumonia, your doctor will ask about your medical history and do a physical examination including listening to your lungs with a stethoscope to check for abnormal crackling or bubbling sounds that suggest pneumonia. Blood tests are done to confirm an infection and trying to nail down the type of organism causing the infection. However, precise identification isn’t always possible.

A chest X-ray helps the doctor to diagnose pneumonia and to determine the extent and location of the infection. But it can’t tell what kind of germ is causing the pneumonia. Pulse oximetry measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream. A sample of fluid from your lungs (sputum) is taken after a deep cough and analyzed to help pinpoint the cause of infection.

Your doctor may order additional tests like a computerized tomography scan (CT) and a pleural fluid culture if you are older than age 65, are in the hospital, or have serious symptoms or a health condition.

Treatment for pneumonia involves curing the infection and preventing complications. Specific medicines depend on the type of pneumonia and its severity, your age and overall health. Antibiotics are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotics to treat it. Cough medicine may be used to calm your cough in order for you to get some shut-eye. It is a good idea not to eliminate your cough completely since coughing helps loosen and move fluid from your lungs.

You may take fever reducers/pain relievers for fever and discomfort. These include drugs like aspirin, ibuprofen (Advil, Motrin IB, others), or acetaminophen (Tylenol, others).

You may need to be hospitalized if you are older than age 65; you are confused about time or places or people; your kidney function has declined; your systolic blood pressure is below 90 millimeters of mercury (mm Hg) or your diastolic blood pressure is 60 mm Hg or below; your breathing is rapid (30 breaths or more a minute); you need breathing assistance; your temperature is below normal; and your heart rate is below 50 or above 100.

To avoid hospitalization or complications in general it is a good idea to get plenty of rest, stay hydrated, and take your medication as prescribed.

To prevent pneumonia you should get vaccinated. Vaccines are available for some types of pneumonia and the flu. Talk to your doctor before getting vaccinated to find out what works best for you. Get children vaccinated if needed as well. Wash your hands regularly and thoroughly. Don’t smoke. Get enough sleep, exercise regularly and eat healthy.