Pneumonia

What is pneumonia?

Pneumonia is an infection and inflammation of the lungs.

What is the cause?

Pneumonia occurs when the lungs are exposed to germs not usually present in the lungs. Your lungs may have become infected because:

• You were exposed to a large amount of a virus or bacteria.
• Your immune system was worn down because you were already ill—for example, with the flu.
• You have another illness, such as diabetes, chronic bronchitis, or cancer. The illness can make it easier for you to get all kinds of infections. This is why so many older adults develop pneumonia. Also, an underlying illness may make it difficult to survive a bout of pneumonia.
• You breathed in (aspirated) stomach contents. Aspiration pneumonia occurs when stomach contents back up into the esophagus and trachea. From there what was in your stomach can be breathed into the lungs. This can happen, for example, when you choke on food. It is especially common with illnesses or conditions that cause swallowing problems, such as a stroke. The bacteria that normally live in the mouth can cause pneumonia if breathed into the lungs.
• You have recently had surgery, especially if you had general anesthesia.

What are the symptoms?

Common symptoms of pneumonia are:

• fever and chills
• cough
• shortness of breath
• chest pain, especially when you take a breath
• coughing up mucus, sometimes blood-stained
• muscle aches

Not all pneumonias cause a high fever. The only symptom may be several days or weeks of dry cough, often with extreme tiredness. In the case of older adults, the only early sign of pneumonia may be confusion or a decrease in physical activity.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine you. Your provider will check for fever and breathing problems. He or she will listen to your lungs.

The following tests help detect pneumonia:

• chest X-ray
• blood tests
• lab tests of a sputum sample (a sample of mucus, also called phlegm, coughed up from deep in your lungs)

How is it treated?

Your healthcare provider will determine what medicine you need. Most often you will be given antibiotics and instructions for caring for yourself at home.

If your pneumonia is caused by a virus, antibiotics will not kill the virus. However, your provider may start you on antibiotics because it is often not possible to know if pneumonia is caused by bacteria or a virus. If your symptoms are very mild, you may need only rest, fluids, and observation, especially if many others in your community are having viral pneumonia.

You may need to stay in the hospital if:

• You are having a lot of trouble breathing.
• It's hard for you to drink enough fluids.
• You have no one to care for you at home.

If you are hospitalized:

• You may be given oxygen.
• You may be given IV (intravenous) fluids.
• You will be checked often by nursing staff. You may have monitors to keep track of your pulse and oxygen levels.
• You may have X-rays taken several times during your stay.

If you live in a nursing home and develop pneumonia, you can stay in the nursing home to recover if:

• You will be able to have lab tests and X-rays at the nursing home.
• There are qualified healthcare professionals at the nursing home to care for you.
• You can be treated with oral medicine or shots, or, if you need IV antibiotics, the nursing home is able to give IV medicine.

If you are well enough to go home, but need shots or IV antibiotics, a home health service may come 1 or more times a day to give your medicine.

How long will the effects last?

If the pneumonia is caused by bacteria, usually you will begin to feel better 2 to 3 days after you start taking antibiotics. If you are an otherwise healthy person, you should feel close to normal after a week or so. If you are over 60 years old or have other medical problems, it may take longer to get back to your usual strength and energy.

If your pneumonia is caused by a virus, in most cases you will feel better in just a few days, depending on your overall health.

How can I take care of myself?

• Start taking your medicine right away and follow the treatment your healthcare provider prescribes.
• Rest until you no longer have a fever, chest pain, or shortness of breath. Follow your healthcare provider's instructions for returning to activities such as school, work, or recreation.
• Drink more liquids (water or tea) every day to help you cough up mucus more easily unless your provider says you need to limit fluids.
• Cough up lung secretions as much as possible. Use cough medicine only if your provider recommends that you take it.
• Use a humidifier to put more moisture in the air. Avoid steam vaporizers because they can cause burns. Be sure to keep the humidifier clean, as recommended in the manufacturer's instructions. It's important to keep bacteria and fungi from growing in the water container.
• Ask your provider about taking aspirin, ibuprofen, or acetaminophen for fever or chest pain.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
• Use a heating pad on a low setting to reduce chest pain. Be careful not to fall asleep while you are using the heating pad. This can cause burns.
• Don't smoke or drink alcohol while you are recovering from pneumonia.
• Call your healthcare provider if you feel you are getting worse or if you are not getting better within 2 to 3 days after you start treatment.

How can I help prevent pneumonia?

• Don't smoke.
• Get a flu shot every October to protect against the flu.
• Ask your healthcare provider if you should get the pneumonia shot (Pneumovax). Adults over the age of 65 should have a second dose if they had the shot before they were 65 and it has been more than 5 years since the first shot.
• Eat a healthy diet.
• Get plenty of rest.
• Exercise regularly according to your healthcare provider's advice.