Pneumonia

What is Pneumonia?

Pneumonia is an inflammation or swelling of the lung tissue, due to infection with a bacterium or virus. There are 3 or 4 different bacteria that are the usual causes of pneumonia, with the most common called Streptococcus pneumonia. Viral pneumonia is more common in children. Other germs such as fungi, yeasts, or protozoa can also sometimes cause pneumonia.

Who is most at risk of pneumonia?

Anyone can develop pneumonia but some groups are at greater risk, specifically;

       
  • Babies and toddlers - particularly those born prematurely
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  • People who have had a recent viral infection - such as a cold or flu
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  • Smokers
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  • People with chronic (long term) lung conditions
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  • People with suppressed immune systems
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  • People who drink excessive alcohol
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  • Patients in hospital

What are the signs and symptoms of pneumonia?

Typical symptoms are cough, fever, sweats, shivers, being off your food and feeling generally unwell. Headaches and aches and pains are common. You usually make more sputum (phlegm or mucus). This may become yellow/green coloured and is sometimes bloodstained. You may become breathless, breathe fast and develop a tight chest. A sharp pain in the side of the chest may develop if the infection involves the pleura ( the membrane between the lung and the chest wall) and a doctor may hear crackles in the chest when listening with a stethoscope.

Viral pneumonia tends to develop slowly over a number of days, whereas bacterial pneumonia usually develops quickly, often over a day. In babies and children, symptoms may be less specific and they may not show clear signs of a chest infection. Commonly they will have a high fever, appear very unwell, and become lethargic and tired. They may also have noisy breathing, have difficulty with feeding and make a grunting sound with breathing.

It is also possible for the skin, lips and nail beds to become dusky or bluish. This is a sign that the lungs are unable to deliver enough oxygen to the body. If this occurs it is vital to seek medical assistance straight away.

How is pneumonia diagnosed?

If pneumonia is suspected it is important to seek medical attention promptly so that an accurate diagnosis can be made and appropriate treatment given.

The doctor will take a medical history and will conduct a physical examination. During the examination the doctor will listen to the chest with a stethoscope. Coarse breathing, crackling sounds, wheezing and reduced breath sounds in a particular part of the lungs can indicate pneumonia.

In order to confirm the diagnosis a chest x-ray is usually taken which will show the area of the lung affected by the pneumonia. Blood tests may also be taken and a sample of the sputum may be sent to the laboratory for testing.

What is the treatment for pneumonia?

Fortunately, most cases of pneumonia can be treated at home but babies, children, and people with severe pneumonia may need to be admitted to hospital for treatment.

Pneumonia is usually treated with antibiotics, even if viral pneumonia is suspected as there may be a degree of bacterial infection as well. The type of antibiotic used and the way it is given is determined by the severity and cause of the pneumonia.

If treatment at home is appropriate, this usually includes antibiotics - given by mouth as tablets or liquid – and pain relieving medications along with paracetamol to reduce any fever. Rest is also very important for recovery.

If treatment in hospital is required, more intensive treatment is needed, usually including antibiotics given intravenously (via a drip into a vein) along with oxygen therapy, to ensure the body gets the oxygen it needs.  Intravenous fluids are given to correct dehydration or if the person is too unwell to eat or drink. Physiotherapy may also be used to help clear the sputum from the lungs.

It may take several weeks to fully recover from pneumonia and the cough may continue until the sputum has been cleared from the lungs. This is a normal part of recovery, and a person recovering from pneumonia  may also feel fatigued  and not be able to exercise as much as usual.

Can pneumonia be prevented?

Immunisation against both pneumonia and the influenza (flu) virus  are advised if you are at greater risk of developing these infections. Cigarette smoke damages the lining of the airways and makes the lungs more prone to infection, so stopping smoking will lessen the risk of developing pneumonia.