Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Knowing the signs and symptoms of pneumonia can help you determine if you or someone you love may have pneumonia. The most common symptoms of pneumonia include:
Cough
One of the most common symptoms of pneumonia is a cough. A pneumonia cough may produce green, yellow or even bloody mucus. A pneumonia cough may linger for several weeks. Coughing helps your body rid itself of infection. But severe coughing may cause pain in the chest.
Difficulty breathing
Shortness of breath or difficulty breathing may occur. Labored and rapid breathing or shallow breathing develop. Breathing may be painful or cause pleurisy — an inflammation of the lining of the lungs.
Fever
Fever is a common symptom of pneumonia. However, some people have pneumonia without a fever. In infants and small children, fever may be the only symptom of pneumonia. A low-grade fever may be present in older adults.
Chills
Chills often accompany a fever. Shaking chills are a common symptom of pneumonia. Chills indicate that your fever is spiking or that your body is fighting off infection.
Chest pain
Some types of pneumonia can cause sharp or stabbing pain with breathing or coughing. Bacterial pneumonia tends to cause severe chest pain on the side of infection.
Other pneumonia symptoms
Along with the common respiratory symptoms, pneumonia can cause other signs and symptoms, depending on your age and the germ infecting your lungs. Additional pneumonia symptoms may include:
- Sweating and clammy skin
- Lower than normal body temperature in older adults
- Nausea, vomiting or diarrhea
- Headache
- Fatigue and low energy
- Loss of appetite
Symptoms specific to infants or toddlers may include:
- Wheezing
- Rapid, shallow breathing
- Grunting noises
- Vomiting
- Poor feeding
- Dehydration
Older adults don’t always have typical pneumonia symptoms. Confusion or delirium, hypothermia, excessive sweating, and falling are possible symptoms in older adults.
When to see a doctor
See your doctor if you have difficulty breathing, cough with phlegm, weakness, sweating, chills, rising fever or chest pain. Seek emergency care if you’re having difficulty breathing, your lips or fingernails turn blue or you cough up blood. With prompt treatment, most cases of pneumonia can be treated successfully.
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Causes
Pneumonia is caused by a bacterial, viral or fungal infection of one or both lungs. The infection causes inflammation in the air sacs in your lungs, which can fill with fluid or pus. The variety of microscopic germs that can cause pneumonia include:
- Bacteria. The most common cause of pneumonia in adults is bacteria. Bacteria usually cause more severe pneumonia. Pneumonia caused by bacteria is called bacterial pneumonia.
- Viruses. Viruses are a common cause of pneumonia in children. Viral pneumonia is usually milder than bacterial pneumonia. But in some cases, viruses can result in severe illness. Viruses that can cause pneumonia include influenza, respiratory syncytial virus (RSV), SARS-CoV-2 (the virus that causes COVID-19) and adenovirus.
- Fungi. Fungal pneumonia is most common in people with chronic health problems or weakened immune systems and in those who inhale a lot of environmental molds or dust. It’s similar to bacterial pneumonia but isn’t as severe.
How pneumococcal infections lead to pneumonia
The most common cause of bacterial pneumonia in adults is Streptococcus pneumoniae (pneumococcus). This bacterium can spread in droplets released by a cough or sneeze. Here’s what happens:
- You breathe in pneumococcal bacteria present in air droplets spread by coughing and sneezing.
- The bacteria settle in your alveoli — the tiny air sacs in your lungs responsible for the exchange of carbon dioxide and oxygen.
- The bacteria multiply and cause the alveoli to become inflamed and filled with fluid and pus.
- The inflammation makes breathing painful and limits oxygen transport. This can lead to shortness of breath and other pneumonia signs and symptoms.
Risk factors
Although anyone can develop pneumonia, some people are at increased risk. Risk factors for pneumonia include:
- Being over age 65
- Being under age 2
- Having a chronic illness, especially lung or heart disease or conditions that weaken your immune system
- Smoking cigarettes
- Having recently had viral respiratory infection, such as a cold or flu
- Living in close quarters, such as a dormitory or nursing home
- Working in health care, especially exposure to unvaccinated children
- Being hospitalized, especially if you use a ventilator
- Having had a recent injury or surgery
- Aspiration due to swallowing difficulties or impaired consciousness
- Exposure to air pollution
- Traveling to areas with high pneumonia risk
Young children and infants also are at higher risk of pneumonia because their immune systems aren’t fully developed.
Complications
Even with treatment, some cases of pneumonia lead to complications:
- Bacteria in your bloodstream (bacteremia). Bacteria that enter your bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.
- Difficulty breathing. Fluid buildup in the lungs or obstruction in the airways can make breathing difficult. People with breathing difficulties may need to use a ventilator.
- Lung abscesses. An abscess, or pus-filled cavity, can develop in the lungs as a result of pneumonia. An abscess is typically treated with antibiotics.
- Respiratory failure. People with severe pneumonia may develop respiratory failure when the lungs can’t provide enough oxygen to the body or remove enough carbon dioxide from the body. Respiratory failure may require care in an intensive care unit of a hospital.
- Sepsis. Pneumonia may lead to sepsis — a life-threatening, whole-body inflammation caused by infection.
- Acute respiratory distress syndrome (ARDS). Some people with pneumonia develop ARDS. This life-threatening lung condition prevents enough oxygen from reaching the lungs and blood. Treatment focuses on providing oxygen and using a ventilator to assist with breathing until the lungs recover.
Prevention
The best way to help prevent pneumonia is to get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. The pneumonia vaccine is recommended for:
- All adults age 65 and older
- Children younger than age 5 with certain chronic conditions, such as asthma, diabetes or heart disease
- Adults age 19 to 64 who smoke cigarettes or have certain chronic medical conditions
Two different pneumonia vaccines are available:
- PCV13 (pneumococcal conjugate vaccine). The PCV13 vaccine protects against 13 of the nearly 100 strains of pneumococcal bacteria, including those most likely to cause serious infections.
- PPSV23 (pneumococcal polysaccharide vaccine). The PPSV23 vaccine protects against 23 of the most common pneumococcal bacteria strains responsible for pneumonia.
Other ways to help prevent pneumonia include:
- Avoiding cigarette smoke. Don’t smoke, and avoid secondhand smoke.
- Maintaining good health. Eat a healthy diet and exercise regularly to avoid chronic health problems. Get treatment for existing conditions.
- Washing your hands regularly. Thorough hand-washing helps prevent infections.
- Getting a flu vaccine. Influenza often precedes pneumonia.
- Limiting exposure to air pollution. Avoid exposure to burning fuel and outdoor air pollution.
Diagnosis
To determine if you have pneumonia and what’s causing it, your doctor may recommend:
- Physical exam. Your doctor will listen to your lungs with a stethoscope to check for abnormal bubbling, crackling or rumbling sounds that signal pneumonia.
- Chest X-ray. This helps confirm you have pneumonia and determines the extent and location of the infection.
- Blood tests. Blood tests measure your white blood cell count and can help pinpoint the cause of the pneumonia.
- Sputum culture. A sample of fluid from your lungs is taken after a deep cough and analyzed to identify bacteria or viruses causing an infection.
- Pulse oximetry. This painless test measures oxygen saturation in your blood. Low levels can indicate pneumonia.
Treatment
Pneumonia is typically treated with antibiotics, antiviral medications, fever reducers, cough medicine, and plenty of fluids. People with mild pneumonia may be able to rest at home during recovery while those with severe pneumonia may need care in a hospital’s intensive care unit.
Most cases of pneumonia can be treated at home with medications and rest. Treatment options may include:
- Antibiotics. These medications are used to treat bacterial pneumonia. The type of antibiotic your doctor prescribes depends on your age, symptoms and the cause of your pneumonia.
- Cough medicine. Medications may help relieve coughing, discomfort and fever.
- Fever reducers. These help treat fever and muscle pain associated with pneumonia.
- Antiviral medications. In select cases these drugs treat viral pneumonia.
- Fluids. Drinking enough fluids prevents dehydration and helps loosen mucus so your body can cough it up.
- Oxygen therapy. If low levels of oxygen in your blood become severe, you may receive extra oxygen through a face mask, nasal prongs or other device.
For those with severe pneumonia requiring hospitalization, treatment may include:
- Intravenous (IV) antibiotics. Antibiotics given through a vein are used to treat pneumonia caused by bacteria or fungi.
- Respiratory therapy. You may receive oxygen therapy and use breathing devices — such as a ventilator — to help your lungs function until you’re able to breathe easier on your own.
- Chest physiotherapy. This includes postural drainage, chest percussion or vibration to loosen lung secretions so you can cough them up.
Recovery time for pneumonia varies widely. Mild pneumonia may resolve in less than two weeks, while more severe pneumonia may last more than a month. Although feeling better early in the course of therapy, be sure to complete your entire course of antibiotics, as directed, to kill all of the disease-causing bacteria. Stopping medication too soon can allow the lung infection to return.
When to see a doctor
Make an appointment with your doctor if you develop persistent signs and symptoms that concern you and suggest you may have pneumonia. If pneumonia symptoms are severe or life-threatening, get immediate medical care. Emergency warning signs and symptoms of pneumonia include:
- Shortness of breath or difficulty breathing
- Bluish lips or nails due to a lack of oxygen
- Mental confusion, especially in older people
- High fever with shaking chills or chills that don’t subside with medications
- Coughing up blood or rust-colored sputum
- Severe chest pain with breathing or coughing
- Nausea and vomiting
- Signs and symptoms in infants and toddlers, including irritability, lack of appetite and inadequate fluid intake
Conclusion
Pneumonia is a common lung infection that can usually be treated successfully if caught early. Pay attention to symptoms, especially in young children and older adults. Practice prevention strategies such as getting vaccinated, washing hands frequently and not smoking. Seek prompt medical care if pneumonia symptoms arise, to receive antibiotics and breathe easier again soon.