Introduction

Pneumonia is a common and potentially serious respiratory infection that affects millions globally each year. Pneumonia is a condition where the air sacs in the lungs are inflamed due to an infection caused by various microorganisms such as bacteria, viruses, or fungi. The inflammation can lead to the accumulation of pus or fluid in the air sacs, resulting in symptoms like cough with phlegm or pus, fever, chills, and difficulty breathing. While the severity of the condition can vary from mild to life-threatening, it is particularly dangerous for high-risk groups including infants, young children, individuals over the age of 65, and those with underlying health conditions or compromised immune systems.¹

Even though the development of antibiotics and vaccines has significantly reduced the morbidity and mortality associated with pneumonia, it still remains a serious public health concern. Let’s explore everything you need to know about pneumonia, from its causes and symptoms to prevention and treatment options.

Signs and Symptoms of Pneumonia

The following are the crucial signs and symptoms of pneumonia:

• Chest pain when breathing or coughing
• Confusion or abnormal changes in mental state in adults aged 65 or more
• Cough with phlegm production
• Fever, sweats, and chills
• Below-normal body temperature for adults above the age of 65 and individuals with weak immune systems
• Diarrhoea
• Feeling short of breath
• Rapid, shallow breathing
• Sharp or stabbing chest pain that gets worse while coughing or taking deep breaths
• Malaise, reduced appetite and fatigue
• Nausea and vomiting, especially in young children^1,2

When to See a Doctor

If you or anyone you know has symptoms of pneumonia, seek medical attention immediately. Delay in treatment can lead to serious complications, especially for high-risk groups such as older adults, young children, and those with weakened immune systems. Severe symptoms such as difficulty breathing, chest pain, high fever, or worsening cough require immediate medical attention..²

Causes of Pneumonia

The different causes of pneumonia are as under: 

• Bacterial pneumonia is caused by various bacteria, with Streptococcus pneumoniae being the most common. It is more likely to affect those who smoke, abuse alcohol, have a respiratory disease, or a weakened immune system. Staphylococcus aureus, Group A Streptococcus, Klebsiella pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, anaerobes, and gram-negative organisms are other causative organisms.
• Pneumonia may be caused by different viruses, including the flu, and is called viral pneumonia. About one-third of all cases of pneumonia are caused by viral pneumonia. It can increase the risk of developing bacterial pneumonia.
• Mycoplasma pneumonia is a bacterial infection that affects people of all ages and often results in a moderate widespread pneumonia.
• Other less common pneumonias may be caused by fungi or other infections.
• Common illnesses that can lead to pneumonia include the common cold, COVID-19, the flu, Legionnaires’ disease, and respiratory syncytial virus (RSV).^4,5

Risk Factors for Pneumonia

The following are the factors that may increase your risk of contracting pneumonia:

• Age: Babies, children under 2 and adults over 65 are at higher risk.
• Environment or occupation: Crowded places, air pollution, and exposure to animals increase risk.
• Lifestyle habits: Smoking and drug/alcohol use weaken the immune system.
• Medical conditions: Brain disorders, weakened immune system, lung diseases, and other serious conditions pose an increased risk.³

Diagnosis of Pneumonia

Diagnosis of pneumonia involves taking a detailed medical history and physical examination. Additional tests for confirming the diagnosis:

• Chest X-ray: This imaging test takes pictures of the lungs to visualize any abnormalities.
• Blood tests: These are used to check for signs of infection in the body.
• Sputum culture: A sample of the material coughed up from the lungs is tested for signs of infection.
• Pulse oximetry: This test measures the level of oxygen in the blood using a small sensor on the finger.
• Chest CT scan: This imaging test provides detailed images of the lungs, bones, and organs.
• Bronchoscopy: A flexible tube is inserted into the lungs to evaluate and diagnose lung problems and obtain samples for testing.
• Pleural fluid culture: A sample of fluid is taken from the space between the lungs and chest wall to identify the bacteria causing the pneumonia.⁴

Treatment of Pneumonia 

The management of pneumonia usually depends on the cause and severity of the illness.

• Antibiotics may be prescribed for bacterial pneumonia, while antifungal medications may be prescribed for pneumonia caused by a fungal infection.
• Antiviral medications may be prescribed to reduce the severity and duration of viral pneumonia.
• Oxygen therapy may be used to deliver extra oxygen to the patient through a mask or nasal tube.
• IV fluids can treat as well as prevent dehydration.
• In cases of pleural effusion, where there is an accumulation of fluid between the lungs and chest wall, draining the fluid may be necessary through a catheter or surgery.⁵

Prevention of Pneumonia

Pneumonia is a serious and potentially life-threatening illness. Here are some steps you can take to prevent pneumonia:

• Vaccines: Getting vaccinated against pneumococcus bacteria and the flu virus can help prevent pneumonia. These vaccines are especially important for people at higher risk of getting pneumonia, such as older adults, young children, and people with weakened immune systems.
• Good hygiene: Washing your hands regularly can help reduce the risk of the spread of germs that can cause pneumonia.
• Quit smoking: Smoking weakens your lungs and makes it harder for your body to fight off infections. Quitting smoking can lower your risk of getting pneumonia.
• Build immunity: Getting regular physical activity and eating a healthy diet can help boost your immune system and lower your risk of getting sick.^1,6

Complications of Pneumonia

Complications of pneumonia include:

• Sepsis occurs when the infection enters the bloodstream, spreading to other organs and causing organ failure.
• Respiratory disorders: Acute respiratory distress syndrome (ARDS) is a severe form of respiratory failure that can be life-threatening.
• Pus in the lungs: Pockets of pus that can form in the lungs and may require drainage with surgery.
• Lung functioning issues: Respiratory failure may occur if the lungs can’t function properly and requires the use of a breathing machine or ventilator.
• Pleural effusion: A buildup of fluid around the lungs that can make it difficult to breathe.

It’s important to note that some people are at a higher risk of developing complications from pneumonia, such as older adults, young children, those with weakened immune systems, and individuals with certain underlying medical conditions like diabetes or cirrhosis.^4,5

Research Facts About Pneumonia

Let us see some common myths vs facts about pneumonia:

• Myth: Pneumonia is not a serious illness.

Fact: Pneumonia can be caused by a variety of germs, bacteria, and viruses, and it can lead to severe complications, especially for those with a weakened immune system. It is crucial to receive medical attention promptly and determine the cause of your pneumonia to receive proper treatment.

• Myth: Only older people are at risk of experiencing severe complications from pneumonia.

Fact: Pneumonia is a common cause of invasive bacterial infections among children, and anyone can contract the illness at any age. Although certain groups, such as the elderly, may be more susceptible to severe complications, neglecting proper medical attention can lead to further health problems.⁷

FAQ’s

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References

1. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Pneumonia: Overview. 2018 Aug 9. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525774/
2. Association AL. Pneumonia symptoms and diagnosis [Internet]. American Lung Association. [cited 2023Apr24]. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/symptoms-and-diagnosis 
3. Causes and risk factors [Internet]. National Heart Lung and Blood Institute. U.S. Department of Health and Human Services; [cited 2023Apr24]. Available from: https://www.nhlbi.nih.gov/health/pneumonia/causes 
4. Pneumonia [Internet]. Pneumonia | Johns Hopkins Medicine. [cited 2023Apr24]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/pneumonia 
5. Pneumonia: Causes, symptoms, diagnosis & treatment [Internet]. Cleveland Clinic. [cited 2023Apr24]. Available from: https://my.clevelandclinic.org/health/diseases/4471-pneumonia 
6. Prevention [Internet]. National Heart Lung and Blood Institute. U.S. Department of Health and Human Services; [cited 2023Apr24]. Available from: https://www.nhlbi.nih.gov/health/pneumonia/prevention 
7. Messimer F, Campbell County Health, Anne K. Carlsen PCSW, Grunfeld DR. Pneumonia myths and facts [Internet]. Campbell County Health. 2019 [cited 2023Apr24]. Available from: https://www.cchwyo.org/news/2019/november/pneumonia-myths-and-facts/