Pneumonia is inflammation of the lungs’ air sacs, usually caused by a bacterial or viral infection. In severe cases, the air sacs become filled with pus and can solidify, causing breathing difficulty. There are many complications of pneumonia, including acute respiratory distress (ARDS) and even respiratory failure if left untreated. If you are experiencing signs of pneumonia, you should make an appointment with your primary care provider or head to an urgent care facility as soon as possible.
What are the symptoms of pneumonia?
The most noticeable symptoms of pneumonia are a cough, fever, and shortness of breath. As the air sacs in the lungs fill up with fluid, breathing becomes more difficult. A pneumonia cough may produce greenish or yellow phlegm, sometimes even with traces of blood. Many patients experience sharp, stabbing chest pain when they breathe during a pneumonia infection.
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Pneumonia, by definition, is not a disease itself, but an infection and inflammation of the lungs that can be caused by one of many underlying diseases. It can range from mild to severe, and come from many different sources. The four most common types of pneumonia are:
Bacterial The most common type of bacterial pneumonia is caused by Streptococcus pneumoniae, also referred to as pneumococcus. This is from the same family of very common bacteria that causes strep throat and scarlet fever. However, pneumonia can come from a wide variety of bacteria, and it’s not always possible to know which one caused the infection. Bacterial pneumonia is the easiest to treat, as it generally responds to antibiotics.
Fungal This type of pneumonia is more common in people with weakened immune systems and chronic diseases. It can also be caused by frequent exposure to a specific organism, for instance, when people work around soil or animals and inhale large amounts of fungal spores. Fungal pneumonia is usually treated with antifungal medications.
Viral Pneumonia contracted from viruses tends to be less severe than other forms, though there are always exceptions. It usually comes from viruses that cause the common cold, especially in younger patients. However, nearly 15% of COVID-19 patients develop viral pneumonia. PCR testing, an antigen test, or other types of COVID-19 testing near you can help determine if you have COVID pneumonia. Lung inflammation can linger long after an active COVID-19 infection – your provider may want you to take a COVID-19 antibody test to confirm whether or not you’ve had the virus in the past.
“Walking” pneumonia This is simply another term for a very mild case of pneumonia – one that does not leave you bed-ridden. Symptoms are similar to any other form of pneumonia, just not as severe.
How is pneumonia spread?
Pneumonia itself is not contagious, but the viruses and bacteria that often cause it certainly are. Pneumonia is often classified by how the infection was acquired.
Community-acquired Pneumonia This refers to pneumonia spread within the community, such as in the workplace, in schools, or anywhere people gather and spend time together in significant numbers. This is how most communicable diseases are spread, and where people have the greatest chance of catching a disease that will lead to pneumonia.
Hospital- or healthcare-acquired When patients who are already seeking treatment for another illness end up contracting pneumonia as well, it is referred to as hospital-acquired pneumonia. This can be a very dangerous form of pneumonia, as it affects people whose immune systems are already compromised, or may already be on ventilators. These strains of bacteria and viruses that cause this type of pneumonia may already be resistant to medications.
Aspiration When saliva, food, or liquid is inhaled into the lungs and results in inflammation and infection, it is referred to as aspiration pneumonia. This is very rare, and is usually a result of a brain injury or overuse of drugs or alcohol.
Risk factors and prevention of pneumonia
The primary risk factors for contracting severe pneumonia are immune health and age. People with compromised immune systems or underlying conditions, especially lung conditions like cystic fibrosis, will have a harder time fighting off a pneumonia infection. If possible, people in these groups should only go into hospitals and care facilities when necessary, and should protect themselves by wearing masks and washing their hands if they do have to enter these facilities.
How is pneumonia diagnosed?
There is no single test to determine whether or not you have pneumonia. Since many symptoms are similar to the cold or flu, your provider will take a wide range of variables into consideration before diagnosing you and developing a pneumonia treatment plan. After taking your medical history and giving you a physical exam, these are some of the possible tests your provider might want to use to diagnose or rule out pneumonia:
Lab tests Since pneumonia is secondary to other types of infection, your provider may want to perform some bloodwork. Lab tests, like a complete blood count or a basic metabolic panel, may also be ordered to check your white blood cell count (a good indicator of infection), and assess your kidney function or electrolytes levels. Lab tests by themselves are not going to diagnose pneumonia, but they can be used in conjunction with other diagnostic tools to help figure out what’s wrong.
Pulse oximetry This test measures oxygen saturation of the blood. It measures oxygen levels in your extremities, to get a clear reading on how well oxygen travels to the parts of your body that are furthest from your heart. A probe is clipped to your finger or ear lobe, and uses light to measure oxygen. This is useful for determining if the lungs’ ability to take oxygen from the air has been compromised, and in combination with other factors, can help doctors diagnose pneumonia.
Imaging Scans Diagnostic imaging, most often a chest X-ray, is frequently used to diagnose pneumonia. If X-ray results are inconclusive, your provider may order a chest CT scan to get a more detailed picture of your lungs. Ultrasounds, while not as common, may also be used if the patient is unable to undergo X-rays or CT scans.
What are the 4 stages of pneumonia?
Doctors classify pneumonia’s progression into four distinct stages, based on symptoms and progress of the infection. These stages consist of:
Stage 1 The first stage is generally the first 24 hours post-infection. It is characterized by vascular congestion and alveolar edema, the medical term for an accumulation of fluid in the lungs’ air sacs.
Stage 2 Two to three days later, the lung may undergo red hepatization. This is when lung tissue is damaged to the point of resembling the liver. During red hepatization, fibrin, neutrophils, and red blood cells collect in the air sacs.
Stage 3 After the red blood cells in the air sacs break down, the stage of gray hepatization begins. The breakdown of red blood cells leaves fibrinosuppurative exudate, the medical term for pus. In severe cases, the fluid and pus may have to be drained from the lungs via a tube.
Stage 4 This is the resolution stage, when symptoms finally start to subside and patients begin to feel relief. The fluid in the lungs has been either drained or is being actively reabsorbed into the body, and is no longer being produced.
How does pneumonia affect different age groups?
People at different stages of life may react to pneumonia differently, depending on how robust their immune systems are. Symptoms can also vary from age to age.
Pneumonia in kids Children are more likely to experience nausea and vomiting with their pneumonia symptoms. Small children and infants should be monitored very closely, as pneumonia can be life-threatening for children under five. They could develop severe breathing problems, and depending on the type of pneumonia, they could even develop an accumulation of bacteria in the bloodstream.
Pneumonia in adults Healthy adults usually recover from pneumonia after getting plenty of rest and following up with their provider. While the side effects of pneumonia can leave adults bed-ridden and unable to go about their daily activities for over a week, adults without chronic underlying conditions typically make a complete recovery within a month to six weeks.
Pneumonia in the elderly One of the symptoms of pneumonia unique to elderly patients is confusion, or “fuzzy” thinking. This is due to the brain receiving less oxygen than it needs as the air sacs in the lungs fill up with fluid. As with young children, pneumonia in the elderly has a greater risk of becoming severe or even life-threatening if ignored.
How do I make an appointment to see a doctor?
If you have symptoms that could indicate pneumonia, especially if you are having trouble breathing and have a high fever, you should meet with a healthcare provider right away. Only your doctor can give you a concrete diagnosis and help you develop an effective treatment plan. If you don’t have an established primary care physician,
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Once you start to feel better, your doctor may with to schedule a follow-up appointment. He or she may order more diagnostic imaging to make sure your lungs have fully cleared and healed, especially if you had a severe infection. More lab tests might also be ordered, to make sure your body is functioning back to its usual level of peak performance.