Lobar Pneumonia: What Is It, Causes, Symptoms & Treatment
Introduction
Did you know that pneumonia, a respiratory infection causing inflammation in your lungs, is one of the leading causes of hospitalisation and death in the world1,2?
It is important to remember that early identification of your infection can lead to complete recovery with minimal complications3.
What Is Lobar Pneumonia?
Pneumonia is an infection of the lung tissue causing inflammation in the air sacs (alveoli) of your lungs2,3. Lobar pneumonia is a type of pneumonia in which there is a rapid involvement of an entire section or lobe of your lung by the inflammatory process. However, clinically, the involvement may not always include the entire lobe and may be seen as patchy areas to confluent consolidation (replacement of air with fluid/pus cells in lungs).Typically caused by the bacterium Streptococcus pneumoniae, the condition usually presents in a severe form with a greater possibility of complications4,5.
Note: Lobar pneumonia is a type of pneumonia according to an earlier classification system used for infections of the lower respiratory tract based on X-ray patterns. The current clinical classifications, however, are usually based on the aetiology (causative organism) or whether the infection is community or hospital acquired4.
Causes of Lobar Pneumonia
Are you wondering what causes lobar pneumonia? The causative agents include1,5:
Bacteria: Pneumonia can be caused by gram positive, gram negative, and atypical bacteria1,5.
Gram negative bacteria: Haemophilus influenzae, Klebsiella pneumoniae, and Escherichia coli
Atypical bacteria: Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella species. Results in a patchy or interstitial infiltration but not true lobar consolidation in most cases6.
Viruses: This includes Influenza Type A virus, RSV (Respiratory Syncytial Virus), SARS-CoV-2 (COVID-19) and adenovirus1.
Fungi: While fungal causes of lobar pneumonia are less common than bacterial or viral causes, they mainly occur in immunocompromised individuals. Common organisms include Cryptococcus neoformans, Histoplasma capsulatum, Blastomyces dermatiditis, and Aspergillus fumigatus1.
Persistent cough with or without sputum (Bloody sputum is a classic sign of lobar pneumonia caused by Streptococcus pneumoniae)
High-grade fever with chills
Confusion or delirium
Pleuritic chest pain (sharp pain in your chest which worsens during deep inspiration due to pleural involvement).
Shortness of breath
Vomiting
Abdominal pain
Tiredness or fatigue
Complications such as acute heart failure, shock and meningitis can occur in patients with lobar pneumonia and mortality is also higher4. Thus. if you are facing any of the above-mentioned symptoms, it is ideal to seek medical care and get prompt lobar pneumonia treatment.
Who Is More Likely to Get Lobar Pneumonia?
You are more likely to develop pneumonia if you are8,9,10:
Suffering from any chronic conditions such as diabetes, chronic lung disease, heart disease, etc.
Smoking regularly as smoking impairs your mucociliary clearance and damages epithelial defences.
Consuming alcohol regularly as this is associated with impaired cough reflex, aspiration, and neutrophil dysfunction.
Immunocompromised due to HIV / AIDS or bone marrow transplant.
Exposed to metal fumes (for ex: welder) as this inhalable fume may cause damage to lung defences or the iron in the fume may facilitate the growth of the microorganisms.
Under 5 years of age or above 65 years of age. (Although a study reported men between 40-50 to be more susceptible to lobar pneumonia)4
These risk factors also indicate a higher likelihood of developing lobar pneumonia when you are exposed to causative organisms like Streptococcus pneumoniae.
Congestion (Initial stage): In this stage, the lung becomes swollen and heavy due to an increased blood flow and fluid accumulation. Microscopically, this condition involves vascular engorgement with the alveoli containing proteinaceous fluid, few bacteria and some immune cells.
Red Hepatisation: Due to capillary damage, your red blood cells and white blood cells called neutrophils leak into the alveolar spaces. The lung becomes firm like liver due to the increased neutrophils, fibrinous exudate, and red blood cells. Hence, this stage is referred to as hepatisation (liver-like).
Grey Hepatisation: The characteristic grey appearance in this stage is due to the breakdown of the red blood cells and the accumulation of fibrin, neutrophils and special immune cells known as macrophages.
Resolution (Recovery): The body starts to clean up the infection. The macrophages are the main cells in this stage and help to remove the leftover debris. The lung may return to normal, however, in some cases, a small amount of scar tissue remains.
Diagnosis of Lobar Pneumonia
To diagnose lobar pneumonia, your doctor may suggest3,11:
Chest X-ray: Key diagnostic tool for lobar pneumonia. Your chest X-ray may show segmental, homogenous consolidation of one or more lobes with visible air bronchogram (air-filled bronchi visible within the consolidated lung)1.
Computed Tomography: Helpful in cases which are unclear.
Blood Tests: These include:
Complete blood count: Elevated creatinine and white blood cells count indicates infection. Elevated erythrocyte sedimentation rate and C-reactive protein suggest inflammation. Although these are non-specific markers and cannot confirm pneumonia, they can support the diagnosis when elevated.
Arterial blood gases: Useful in severe cases such as hypoxia (low oxygen supply to tissues) and respiratory acidosis (acidic blood due to the presence of carbon dioxide).
Sputum Culture: Maybe advised in severe or hospitalised cases to identify the bacteria causing your illness. However, it is not always reliable, and confirmation of pneumonia requires correlation with clinical history and gram staining.
Liver function tests: Abnormal liver function tests are common in cases of community acquired pneumonia12.
Urinary Antigen Test: Can help to identify Streptococcus pneumoniae and Legionella pneumophila, the main causative organisms of lobar pneumonia13.
Gram Staining: To identify the causative organism. For example: Gram positive cocci may indicate Streptococcus pneumoniae, whereas gram-negative bacilli may indicate Haemophilus influenzae.
Respiratory Viral Panel: A secondary bacterial infection is common following a viral infection. This test is done by collecting a sample from your respiratory tract (nasopharyngeal swab) and helps to check for viral pathogens such as influenza, RSV or SARS-CoV-2.
A timely and accurate diagnosis of lobar pneumonia is necessary to guide appropriate treatment.
Treatment Options
The main treatment for lobar pneumonia involves the use of antibiotics.
For healthy individuals without any underlying health issues, the commonly prescribed antibiotics include3,11:
Amoxicillin(preferred for Streptococcus pneumoniae)
Doxycycline and macrolides may be preferred for atypical pathogens such as Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella species.
For individuals with chronic conditions, such as diabetes or heart disease, the treatment often involves3,11:
Combination of beta lactam antibiotic (high dose amoxicillin or amoxicillin-clavulanate, cefuroxime) along with a macrolide (such as azithromycin or clarithromycin) or doxycycline
Alternatively, your doctor may recommend a single stronger antibiotic like respiratory fluoroquinolone (such as levofloxacin or moxifloxacin). While respiratory fluoroquinolones are acceptable alternatives, it is important to note that overuse may lead to resistance and increased risk of Clostridium difficile infection14.
For hospitalized patients with moderate illness, doctors may recommend3,11:
A beta lactam antibiotic (such as ceftriaxone) along with a macrolide (such as azithromycin).
Your doctor may alternatively suggest the use of a single respiratory fluoroquinolone (such as levofloxacin).
If you are admitted to the hospital and your pneumonia is severe, your treatment will be more intensive and usually includes3,11:
A beta lactam antibiotic plus a macrolide
Empirical treatment may also require coverage for Methicillin Resistant Staphylococcus aureus (MRSA) or pseudomonas. In these cases, adding vancomycin or linezolid for suspected MRSA or anti-pseudomonal beta-lactams for high-risk patients15.
Alternatively, your doctor may recommend a beta lactam antibiotic along with a respiratory fluoroquinolone.
Note: Macrolide monotherapy is not recommended in areas with high macrolide-resistant Streptococcus pneumoniae.
Timeline for Recovery
Most people with lobar pneumonia symptoms start to show signs of recovery within 5 to 7 days, if they respond well to treatment (fever is gone for 2-3 days, no longer need oxygen, and their breathing and blood pressure have returned to normal)16.
However, depending on the causative agent, you may require a longer treatment time. For example, your lobar pneumonia is generally severe when caused by Legionella pneumonia, so you would require approximately 10-14 days to recover. Similarly for Staphylococcus aureus infection, a longer treatment duration of 14-21 days approx. will be required, especially in cases of MRSA infection16.
Moreover, if you develop any complications such as fluid buildup in your lungs (empyema), lung abscess, or lung tissue damage (necrosis), your treatment may take longer to complete. Hence, your total treatment time and recovery is dependent on how fast your symptoms improve, the causative organism and any complications3,11.
Managing Lobar Pneumonia at Home
Home management of pneumonia is appropriate for non-severe, stable patients. If pneumonia follows a viral infection like influenza or due to a pathogen with potential spread like Mycoplasma, it might be ideal to isolate from early on. Simple self-care measures that you can follow to manage lobar pneumonia at home include2:
Getting plenty of rest: Try to stay and rest at home and avoid contact with other people, and if you do not feel well enough.
Staying hydrated: It is important to drink plenty of fluids and stay hydrated.
Following good hygiene practices: Wash your hands regularly with warm water and soap, throw used tissues in the bin, and cover your mouth while sneezing or coughing.
Isolating yourself: Following social distancing or isolating early in the course of illness can be helpful in preventing spread especially if pneumonia is associated with a viral infection or due to an atypical organism.
Using over-the-counter pain relievers: You may take paracetamol or ibuprofen if you are having pain or a very high temperature. But ideally consult your doctor before prolonged use, particularly if you have any condition where the renal function may be affected.
Taking medications: Use your medications exactly as prescribed by your doctor.
If your symptoms worsen or do not improve after a few days of treatment, consulting your doctor is important2.
Lobar Pneumonia in the Elderly
Lobar pneumonia in elderly individuals can be a serious condition as they have a higher risk of complications due to age-related weakening of immune system and chronic medical conditions.
Moreover, elderly individuals may not even show symptoms or have atypical ones like increasing confusion, loss of consciousness, and low blood pressure along with high-grade fever and increased heart rate. Hence, it is important to promptly and correctly diagnose pneumonia in these individuals and start treatment early, following medical guidelines closely to reduce further complications.
Simple steps, such as getting vaccinated against pneumonia, flu, and quitting smoking, can help to lower the risk and reduce the severity of infection in elderly people17.
Prevention Strategies
Prevention strategies to reduce your risk of pneumonia include3,11,18,19:
Get Vaccinated:
Pneumococcal vaccination: PCV 15/PCV20 are conjugate vaccines while PPSV23 is a polysaccharide vaccine. It provides vaccination against Streptococcus pneumoniae, the main aetiological agent of lobar pneumonia. It is recommended in all children under 5 years of age, and in individuals with chronic conditions like diabetes, chronic lung disease, etc.In immunocompetent adults above 65 years or adults with comorbidities, vaccination with either a single dose of PCV20 or PCV15 is recommended, followed by PPSV23 after 1 year20,21.
Pertussis vaccination (DTaP / Tdap Vaccination): The pertussis vaccine helps to protect against pertussis, a highly contagious bacterial infection that causes severe coughing fits24.
Good hand hygiene practices Follow simple steps like regularly washing your hands with warm water and soap.
Avoiding smoking By smoking you not only damage your lungs but also weaken your immune system, thereby increasing your risk of lobar pneumonia.
Management of chronic conditions such as asthma, diabetes, or heart disease by ensuring prompt medical care and taking medications as directed.
Strengthening your immune system by staying physically active and following a healthy diet.
Avoiding close contact with sick individuals, avoiding crowds and practicing sneezing or coughing into a tissue or your elbow.
By following these steps, you can reduce your risk of developing lobar pneumonia.
When to See a Doctor
You should visit your doctor if you are experiencing cough for more than three weeks, or if you have shortness of breath which is getting worse, or if you are coughing up blood or if you are experiencing chest pain (especially increased pain when you breathe or cough)2.
Early diagnosis and treatment of lobar pneumonia are important to reduce complications and support recovery2.
Conclusion
Lobar pneumonia is a serious lung infection that can affect an entire lobe of your lung. Early recognition and timely treatmentare essential to avoid complications. Simple measures like vaccination, good hygiene, and managing chronic conditions can reduce your risk of developing lobar pneumonia. If your symptoms worsen or persist, you should seek prompt medical attention.
Frequently Asked Questions (FAQs)
What are the complications of lobar pneumonia?
Lobar pneumonia can cause complications such as pleural effusion (fluid around the lungs), empyema (pus in the pleural space), lung abscess (pus-filled cavity), or respiratory failure. In severe cases, it may lead to spread of infection to other organs1.
What is the difference between lobar pneumonia and bronchopneumonia?
Lobar pneumonia affects an entire lobe of the lung with uniform consolidation, while bronchopneumonia involves patchy inflammation around the bronchi and may affect multiple lobules of your lungs9.
Is lobar pneumonia more common in any specific season?
Yes, lobar pneumonia is more common during the winter and early spring seasons. Respiratory infections are more common during this season and presence of crowds increases the risk of transmission8.
Can lobar pneumonia be contagious?
Yes, as lobar pneumonia is caused by bacteria or viruses that spread through inhalation of infected respiratory droplets from coughing, sneezing, or close contact with an infected person25.
References
Franquet T. Imaging of Community-acquired Pneumonia. Journal of Thoracic Imaging [Internet]. 2018 Sep;33(5):282–94. Available from: https://pubmed.ncbi.nlm.nih.gov/30036297/
Zinserling VA, Swistunov VV, Botvinkin AD, Stepanenko LA, Makarova AE. Lobar (croupous) pneumonia: old and new data. Infection [Internet]. 2021 Sep 1;50. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8409273/
Bradley SF. Alcohol Use Disorder and Risk of Pneumonia. JAMA Network Open [Internet]. 2019 Jun 7 [cited 2019 Oct 17];2(6):e195179. Available from: https://pubmed.ncbi.nlm.nih.gov/31173114/
Pahal P, Rajasurya V, Sharma S. Typical Bacterial Pneumonia [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534295/
Jinks MF, Kelly CA. The pattern and significance of abnormal liver function tests in community-acquired pneumonia. European Journal of Internal Medicine [Internet]. 2004 Nov 1;15(7):436–40. Available from: https://www.ejinme.com/article/S0953-6205(04)00191-8/pdf
Kim P, Deshpande A, Rothberg MB. Urinary Antigen Testing for Respiratory Infections: Current Perspectives on Utility and Limitations. Infection and Drug Resistance [Internet]. 2022 Apr;Volume 15:2219–28. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9058651/
Shea KM, Hobbs ALV, Jaso TC, Bissett JD, Cruz CM, Douglass ET, et al. Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection. Antimicrobial Agents and Chemotherapy [Internet]. 2017 Jun;61(6). Available from: https://journals.asm.org/doi/10.1128/aac.00125-17
VanEperen AS, Segreti J. Empirical therapy in Methicillin-resistant Staphylococcus Aureus infections: An Up-To-Date approach. Journal of Infection and Chemotherapy [Internet]. 2016 Jun 1;22(6):351 Available from: https://pubmed.ncbi.nlm.nih.gov/27066882/
Dimitra Dimopoulou, Moschopoulos CD, Konstantina Dimopoulou, Dimopoulou A, Berikopoulou MM, Ilias Andrianakis, et al. Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review. Antibiotics [Internet]. 2024 Nov 12;13(11):1078–8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11591184/
National Heart, Lung, and Blood Institute. Pneumonia: What needs to be considered in older people? [Internet]. NCBI. Institute for Quality and Efficiency in Health Care (IQWiG); 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525776/
Gilsdorf JR. Hib Vaccines: Their Impact on Haemophilus influenzae Type b Disease. The Journal of Infectious Diseases [Internet]. 2021 Sep 30;224(Supplement_4):S321–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8482018/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Pneumonia in the Elderly: Causes, Symptoms, Treatment, and Prevention
Introduction
As people get older, they become more susceptible to infections, and a common one is the lung infection called pneumonia. It happens when bacteria, viruses, fungi or other uncommon germs enter the lungs. In the elderly, the body’s defence system becomes weak, so germs can easily enter the airways1,2. This leads to infection in the lungs where a thick fluid called inflammatory exudate, made up of immune cells, proteins and germs build up in the air spaces, causing trouble in breathing and symptoms like cough and chest pain2,3.
It is a serious concern in older people because the illness can get worse quickly, and recovery becomes more difficult. They are more likely to get a severe form of pneumonia and need hospital admission4. There are chances of death also, seen in about 5 to 15% of people admitted to the hospital, and it can rise to 30 to 50% in those who are seriously ill and need intensive care1.
But it can be managed better if we know about symptoms of pneumonia in elderly, how it is treated, and how it can be prevented, which we will discuss further in this blog5.
Types of Pneumonia in the Elderly
Pneumonia in elderly is grouped based on where and how they catch the infection. The common types are:
Community-acquired pneumonia: This happens outside hospitals, when bacteria or viruses spread through coughing or sneezing. It could also include places like old age homes, rehab centres, or other care facilities. In some elderly people, it may also occur when food, drink, or saliva accidentally enters the lungs instead of the stomach (known as aspiration pneumonia).
Hospital-acquired pneumonia: When pneumonia is seen in a person has after they have stayed in a hospital or healthcare setting for at least 2 days, it is called hospital-acquired pneumonia. This means the infection started in the hospital and was not present when the person was first admitted.
Ventilator-associated pneumonia: This develops in patients who are put on a breathing support machine like a ventilator. If pneumonia starts 48 hours or more after the tube is placed into the windpipe, it is called ventilator-associated pneumonia.
All these types of pneumonia in elderly may be caused by either a bacterium, a virus, a fungus, or a parasite that has infected the lungs2,6. Let us see what causes these types of pneumonia in the next section.
What Causes Pneumonia in the Elderly?
Bacteria are the most common cause of pneumonia in elderly population. It can happen mainly in two ways: • By accidentally breathing in food or stomach contents (aspiration pneumonia) • By catching the infection from air or people around (airborne pneumonia)
Here is a table that shows what causes pneumonia in elderly and how they spread6,7:
Among these, Streptococcus pneumoniae is the most common bacteria seen in elderly patients.
Some elderly people may get infected with strong germs that do not respond to certain antibiotics. These are hard to treat and are often seen in those who had pneumonia earlier, are admitted to the hospital often, or received injectable antibiotics in the last 90 days6.
There are other risk factors that make elderly people more likely to get pneumonia, which will be discussed in detail in the next section.
Risk Factors for Pneumonia in the Elderly
As the body ages, the immune system becomes slower, and other health issues and some medicines can increase the risk of pneumonia, as given below:
Weak immune system: With age, the body can’t make strong immune cells to fight infections. At risk are those with weak immunity, those having cancer, kidney problems, or taking medicines that lower immunity, or those without a spleen (typically due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis)5,8.
Health issues: Problems like COPD, heart disease, liver issues, or diabetes can make the lungs weak. In COPD, damaged airways, excess mucus, and changes in lung bacteria make it easier for infections to grow5,9.Liver disease alters the immune system and affects the body’s ability to clear lung infections. In heart disease, fluid gets built-up in the lungs, which may slow down the removal of bacteria and affect the lung’s defence system10,11.
Lifestyle: Being male, poor diet, not drinking enough water, pollution, alcohol, smoking, or staying in old-age homes can add to the risk.
Medicines: Drugs for mental health, sleep, acidity, allergy, or steroids can raise the risk. Some mental health medicines (like antipsychotics) and sleeping pills (like opioids or benzodiazepines) can make the body slow down and increase the chance of food or fluid entering the lungs. This can lead to a type of lung infection called aspiration pneumonia. Acidity medicines like PPIs (e.g., omeprazole, lansoprazole) may also weaken the body’s defence by affecting immune cells, making it harder to fight infections5,12.
Elderly people who lie flat for long periods, have trouble swallowing, use feeding tubes, are very drowsy, or have poor mouth hygiene are at risk of getting aspiration pneumonia. Tumours in the mouth or airways can also raise the risk5.
Symptoms of Pneumonia in the Elderly
Symptoms of pneumonia in elderly individuals may not always be typical, and only some may have common signs like:
Cough
Breathing difficulty
Mild fever (occasionally)
Others may just show vague symptoms. These include:
Sometimes, other signs like sudden falls may be seen. These are not direct symptoms of pneumonia, but when the infection spreads in the body, it can cause weakness, dizziness, or low blood pressure, leading to falls.
In people with existing heart or lung conditions, pneumonia can make those illnesses worse, even if they are not symptoms of pneumonia itself5,15.
If such symptoms appear, doctors may suspect pneumonia. A fast breathing rate (over 25 per minute) or low oxygen (below 90%) may suggest infection. However, low oxygen is not specific to pneumonia, it shows that the lungs are not working properly, and the illness may be severe. To confirm, imaging tests like X-ray or CT scan and blood tests may be done. Treatment will be started early5,13.
Treatment for Pneumonia in the Elderly
Treatment for pneumonia in older people is planned based on how severe the condition is and where the person is being treated, either at home or in the hospital. The table below shows common treatments depending on the patient’s condition5,13.
Patient Condition
Medicines Commonly Given
Treated at home with no other health problems
Antibiotics like amoxicillin are commonly used, especially if Streptococcus pneumoniae is expected. Azithromycin or doxycycline may also be used, but azithromycin alone is not preferred in areas where resistance is high.
Treated at home but has other health issues
Combination of two antibiotics like amoxicillin with azithromycin can be given. Or a single broad antibiotic like levofloxacin may also be given.
Admitted to hospital but not in ICU
Same as above but given through a vein (IV) and under close watch. Usually a beta-lactam antibiotic like ceftriaxone with azithromycin, or just a strong one like levofloxacin.
Admitted to ICU but no risk of severe infections
Strong antibiotics like ceftriaxone or cefepime, with azithromycin or levofloxacin. Doctors also check if any resistant organisms like MRSA or Pseudomonas are possible.
Lungs have pus or fluid buildup like abscess or empyema
Strong antibiotics or special ones like clindamycin may be added, especially if food or fluid accidentally entered the lungs.
Along with antibiotics, in severe cases, steroids are given to calm the immune system. Oxygen and IV fluids help with breathing and hydration. Patient is watched closely to see if they get better or have any issues. Recovery depends on how well they respond to the treatment5,13.
Recovery from Pneumonia in the Elderly
Recovery from pneumonia in older people is often slower compared to younger people. If the treatment for pneumonia in elderly is in the hospital, it may take up to 8 weeks or longer to fully recover, while people treated at home may feel better sooner. Even after the person feels better, the chest X-ray may still show signs of infection. This is common in older people and does not always mean the pneumonia is still active13.
Avoid smoke or wood fires, as they can irritate the lungs.
Do breathing exercises as advised by doctor. Chest physiotherapy is usually recommended only in people with lung conditions like COPD or when it is hard to clear mucus1,3.
Recovery also depends on the person’s ability to do daily activities. Those who are weak or have other health issues may take longer to recover and may face complications1,13.
Complications of Elderly Pneumonia
In people who are very old and frail and have other diseases like heart or kidney problems, pneumonia recovery can be hard, and complications may occur.
The infection can spread and cause sepsis, which could be seen as one of first signs of pneumonia in elderly
Lung damage such as pus collection (empyema) or severe tissue damage (necrotizing pneumonia) or abscess can occur
Heart failure or clots in the legs/ lungs can occur due to low oxygen, poor movement, or inflammation
Some may eat less and face a nutritional drop
These problems are common in elderly pneumonia when not treated early. Symptoms like confusion or delirium may lead to poor outcomes2,6.
How to Prevent Pneumonia in Older Adults
Pneumonia in elderly individuals can be dangerous with complications, but by preventing it, you can make sure you’re ageing healthily and maintain your quality of life. Here are some ways how to prevent pneumonia in elderly:
Vaccines: Get vaccinated against pneumococcal bacteria, flu virus, and COVID-19. Flu vaccine is for all ages, but people above 65 should take it every year. Pneumococcal vaccine (PCV) may be given to people above 65 as either one shot (PCV20) or two shots (PCV15 followed by PPSV23).
Lifestyle changes: Quit alcohol and smoking. Take care of problems like trouble swallowing, poor nutrition, and oral hygiene. Also, get your medicines checked to see if they increase pneumonia risk. Do breathing exercises and keep your body moving as physical activity helps reduce risk.
Good hygiene: Wash your hands with soap and water regularly. Cover your mouth and nose while coughing or sneezing.
Manage ongoing health problems: Conditions like COPD, heart failure, and diabetes should be treated well to prevent pneumonia3,15.
So, by getting vaccines, following infection control, and managing chronic illnesses, you can reduce the risk of pneumonia.
When Should You See a Doctor?
The following symptoms of pneumonia in elderly people require medical attention:
Fever
Cough
Breathing difficulty
Chest pain
Feeling confused or very tired
Signs like trouble breathing, bluish lips, or low blood pressure need urgent care.
Especially those who have heart disease, diabetes, or kidney problems should not wait but see the doctor early so they can avoid complications and recover faster3,16.
Pneumonia in older people can be serious and even life-threatening if not treated early. However, with the right medicines, along with good nutrition, proper care for existing health problems, and support for any complications, pneumonia in elderly can show good recovery. Closely watch for symptoms like cough, fever, breathing trouble, or confusion. So, knowing the signs and risks helps you visit the doctor in time and start appropriate treatment to avoid any complications of pneumonia from occurring.
If you are older and have poor dental hygiene, you may be at risk of getting pneumonia. When you do not brush properly, bacteria can build up in the mouth. These bacteria can accidentally enter the lungs and cause pneumonia6.
Is my nutrition affected when I get pneumonia?
Yes, pneumonia can affect your nutrition. The illness causes your body to use up nutrients faster, and many people eat less when they are sick. This can lead to poor nutrition, which may slow recovery and lead to worse outcomes6.
Why do some older people get aspiration pneumonia?
People who have trouble swallowing, lie down for long hours, use feeding tubes or oxygen, take painkillers, or have poor mouth hygiene are more likely to get aspiration pneumonia5.
What does a geriatrician do for an older person with pneumonia?
Yes, a geriatrician checks for problems that can make pneumonia worse, like poor nutrition, weakness, memory loss, or confusion. They address these issues early, give the right support and medical care, and help reduce the risk of getting pneumonia6.
References
Chebib N, Cuvelier C, Malézieux-Picard A, Parent T, Roux X, Fassier T, et al. Pneumonia prevention in the elderly patients: The other sides. Aging Clinical and Experimental Research. 2019 Dec 31;33(1). https://link.springer.com/article/10.1007/s40520-019-01437-7
Li W, Ding C, Yin S. Severe pneumonia in the elderly: a multivariate analysis of risk factors. International Journal of Clinical and Experimental Medicine [Internet]. 2015 Aug 15;8(8):12463. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4612842/
Restrepo MI, Sibila O, Anzueto A. Pneumonia in Patients with Chronic Obstructive Pulmonary Disease. Tuberculosis and Respiratory Diseases [Internet]. 2018;81(3):187–97. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6030662/
Xu L, Ying S, Hu J, Wang Y, Yang M, Ge T, et al. Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models. RESPIRATORY RESEARCH. 2018 Dec;19(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6280505/
Shen L, Jhund PS, Anand IS, Bhatt AS, Desai AS, Maggioni AP, et al. Incidence and Outcomes of Pneumonia in Patients With Heart Failure. Journal of the American College of Cardiology [Internet]. 2021 Apr 27 [cited 2021 Sep 18];77(16):1961–73. Available from: https://pubmed.ncbi.nlm.nih.gov/33888245/
Manian FA, Hsu F, Huang D, Blair A, Mosarla R, Mulugeta W, et al. Coexisting Systemic Infections in Patients Hospitalized Because of a Fall: Prevalence and Risk Factors. The Journal of Emergency Medicine. 2020 May;58(5):733–40. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0736467920300214
Antje Häder, Nilay Köse-Vogel, Schulz L, Lucja Mlynska, Hornung F, Hagel S, et al. Respiratory Infections in the Aging Lung: Implications for Diagnosis, Therapy, and Prevention. Aging and Disease. 2024 Jan 1;14(4):1091–104. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10389836/#sec11
Institute for Quality and Efficiency in Health Care. Pneumonia: What needs to be considered in older people? [Internet]. Nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG); 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525776/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
1
Is HPV Herpes? Our Doctor Explains the Difference
Introduction
“Is HPV herpes?” Well, it’s common to get confused between the two because both are sexually transmitted infections (STIs). But HPV is not herpes.
Although both commonly affect the genital area and may not always show symptoms, they are caused by different viruses and differ in their characteristics1,2.
HPV is caused by the Human Papillomavirus (HPV), a DNA virus belonging to the papilloma virus family. The low-risk type HPV may lead to genital warts, and high-risk types can sometimes lead to cancers in the cervix, anus, penis and some parts of the throat1,3. Herpes, on the other hand, is caused by the Herpes Simplex Virus (HSV), a DNA virus from the herpesvirus family. Herpes infection leads to painful sores or blisters in the genital area and the mouth2.
In this blog, we will see more details to clear the doubt: is HPV the same as herpes?
What is human papillomavirus (HPV)?
HPV is the most common STI in sexually active men and women. Nearly 90% of men and approximately 50% to 80% of women who are sexually active are likely to get it at some point in life. This can vary based on the population and how the test is done. There are about 200 types of this virus, and they fall into two main groups: low-risk types (HPV 6 and 11) and high-risk types (like HPV 16 and 18). Low-risk types are not that serious. They usually cause warts on the skin, genital area, mouth, or throat. High-risk types are more serious, as they can lead to cancers of the cervix (lower part of the womb), private parts like the anus, penis, vulva, vagina and certain areas of the throat (especially the area at the back of the mouth)1,3,4.
What is herpes simplex virus (HSV)?
There are currently 8 types of human herpes viruses. Herpes simplex virus (HSV) is a subtype of this human herpes virus family belonging to the subfamily Alphaherpesvirinae and genus Simplexvirus. They are of two main types: HSV-1 and HSV-2.
HSV-1 mostly affects the mouth, causing cold sores, but it can also cause genital herpes, which is common in young people through oral sex (mouth-to-genital contact). It mainly spreads through saliva or contact with infected body fluids2,5,6.
HSV-2 more commonly affects the genital region and is mainly spread through sexual contact2,7.
Once the virus enters the body, it travels to the nerves and goes into a sleeping or quiet stage (called latency), where it can stay without showing any symptoms.
HSV-1 usually stays latent in the nerve cells in skull, near the face (called the trigeminal ganglia).
HSV-2 stays latent in the nerves in the lower back, near the genital area (called the sacral ganglia)5,7,8.
Herpes virus can stay in the body for a lifetime. The immune system keeps the virus under control, but it cannot fully remove it, as virus stays hidden in the nerves without showing symptoms. The virus can get reactivated when there is weakening of immune system or factors such as stress, exposure to sunlight or hormonal changes5,6,7.
The HSV infections are commonly confused with HPV as they can both be sexually transmitted and may present similarly, affecting the mouth and genitals. So, when we say herpes virus infections, we will be referring to these two subtypes of herpes virus only, that is HSV.
HPV vs Herpes
HPV and herpes have some common but also different features, so let us compare them side by side as seen in this table HPV vs Herpes:
Clinical examination, Pap/anal smear, or PCR test for virus DNA9.
Swab from blister or PCR blood test to detect virus. If no visible sores are present, blood test (serology) may be done to check for presence of HSV antibodies5,7.
Treatment
No cure; warts removed by medicines or surgery. Cancer treated if found1.
Managed with antiviral medicines like valacyclovir and acyclovir5,7.
Long term effects
May return. Some types cause cancer in weak immunity10.
HSV-1 mild but may affect brain/eye. HSV-2 may cause brain infection and nerve problems if untreated5,7.
HSV-1 mild, HSV-2 recurs more often but manageable with treatment5,7.
Both viruses can stay in the body for long time, but regular care and management helps in recovering well.
How Do You Get HPV and Herpes?
The main mode of transmission of HPV is by having vaginal, anal, or oral sex with an infected person. But you can also get it through skin-to-skin contact where even if your skin rubs on to any part of the person infected with HPV, you contract the infection.
You can have HPV without symptoms and unknowingly pass it to another partner later by these types of spread11.
Herpes also spreads through sexual and skin contact. If you touch a herpes sore, saliva, or genital fluids of an infected person, or if your skin touches their mouth or genital area, you can get herpes.
Some infected people may not have visible sores but can still pass it to a partner, called asymptomatic shedding. Genital herpes can also spread to mouth through oral sex12.
By knowing the spread of HPV vs herpes, you can stay careful and protect yourself and your partner from these infections.
Who’s at Risk?
Anyone sexually active is at risk of HPV, especially those with multiple partners or who started sexual activity early, have not got vaccinated for HPV, do not use condoms consistently, smoke, or use birth control long-term7. Herpes risk is higher with unprotected sex, multiple partners, or during childbirth from infected mothers13.People with weak immunity like those who received organ transplants, people living with HIV, and cancer patients are at risk of severe herpes5.
These individuals who are at high risk need to stay safe and plan to get regular check-ups depending on what infection they have and based on personal risk factors as advised by their doctor.
Symptoms of HPV and Herpes
Most HPV cases do not show many symptoms and clear on their own, within 1 to 2 years. But in some people with multiple sexual partners, smoking habits, or weak immunity, the infection may stay longer and become persistent13,14.
For those who do have symptoms, small lumps or warts that look like cauliflower may appear in the genital area. Warts in the mouth or throat are rare but can happen in some people, including children or adults after oral sex. Some HPV types may lead to cancer without clear symptoms10,15.
HSV-1 commonly causes blisters or cold sores in the mouth, often affecting the gums, palate, cheeks and tongue (herpetic gingivostomatitis) in children. In some cases, it may affect the eyes, leading to mild conjunctivitis causing pain redness and light sensitivity. Recurrent infection can cause sores on the lips (herpes labialis) or severe eye problems (herpes keratitis).
HSV-2 often causes painful genital sores, swelling, and burning during urination (sometimes due to infection in the urinary tube). Other general symptoms like fever, tiredness, body pain, and headache, can occur especially during the first outbreak. Later outbreaks tend to be milder5,6,7.
This mix of symptoms often makes people wonder Is HPV Herpes? But remember, HPV usually does not cause blisters, which is seen in herpes. If you experience any of these symptoms, you need to get tested early by seeking proper medical care to avoid complications.
Diagnosis
This section about the difference between HPV and herpes, especially in how they are diagnosed using different methods. Mostly diagnosed clinically, testing for both may be done if symptoms are present or in high-risk populations.
HPV is usually diagnosed by checking visible warts. A wart may be removed and sent to a lab to check for cell changes. But testing warts is not done always, as most are harmless. Genital warts are mostly diagnosed by how they look, but HPV itself may not be confirmed just by seeing warts.
A Pap smear can be done to detect changes linked to high-risk HPV, such as a cervical or anal Pap smear for cancer screening. These tests are mainly done in people who are at risk or as advised. PCR tests help confirm infection by detecting HPV’s genetic material and may be done if needed1,16.
Herpes is diagnosed by examining ulcers or sores. A swab may be taken from a blister and sent to a lab to identify the virus type. PCR testing can also be done to detect herpes simplex virus DNA. When visible sores are not present, blood tests may be done. For HSV-1, the gold standard is serology, where the presence of HSV-1 antibodies is detected in the blood. Even for HSV-2, blood tests can be used to detect antibodies. But these blood tests may not always be reliable, as they can sometimes give false-positive results and cannot tell exactly where the infection is in the body5,7,17.
Routine HSV testing is usually not advised unless symptoms are present or a partner has/had herpes18.
Treatment for HPV and Herpes
HPV and herpes do not have a specific medicine that can fully cure them. Most medicines and medical care help manage the symptoms. That is why it is important to know the difference and confusing between the two can be misleading when it comes to treatment approaches.
For HPV:
Most people clear the virus on their own within 1 or 2 years.
Warts caused by HPV may be removed by freezing them or by using creams or ointments.
If HPV leads to cancer, then depending on the condition, surgery, radiotherapy, or chemotherapy may be needed9,10.
For mouth herpes:
Antiviral medicines like valacyclovir or acyclovir may be given. These may be given as topical creams or as tablets. Valacyclovir may be given as 2 grams twice a day for one day, or acyclovir may be given at 15 mg/kg doses, 3 to 5 times a day.
For people who have repeated infections, acyclovir 400 mg can be given 3 times daily for 5 days.
For genital herpes:
Usually, it gets better on its own in about 2-3 weeks without medicine.
Antiviral medicines like acyclovir may be given as tablets, taken by mouth, applied as a cream on the affected area, or given as an injection, based on your condition. (The dose may vary for mild and severe cases and for preventing future recurrences.)
For milder cases like cold sores, a doctor may suggest a short course of oral tablets (e.g., acyclovir 400 mg three times daily for 5 days).
In severe cases, acyclovir may be given as an IV injection (15 mg/kg every 8 hours).
If someone keeps getting herpes again and again, or has other health concerns, doctors may suggest long-term antiviral treatment like valacyclovir (usually 500 mg or 1 g daily) to help reduce the chances of future episodes and lower the risk of passing it to a partner5,7.
Note: Antivirals do not cure HSV, and continuous treatment is usually given to those who get this infection frequently or to prevent spreading it to their partners.
So always check with your doctor if you unsure of your condition. They will diagnose properly and prescribe the treatment based on your needs.
Complications of HPV and Herpes
Most people recover well after herpes, but medicines may not fully remove the virus. Although Herpes virus HSV-1 usually does not cause serious problems, but it can stay in the body for a long time and, in some cases when it gets reactivated, may cause inflammation in brain (herpes encephalitis) or eyes (herpetic keratitis) affecting vision5.
HSV-2 mainly causes genital herpes, but in severe cases it can affect the brain, causing meningitis. HSV-2 can also cause eye problems like redness, pain, and vision loss, and in rare cases, can lead to brain infections7.
On the other hand, high-risk type HPV may also lead to cancers of the cervix, vagina, vulva, penis, anus, or certain areas of mouth and throat, especially in people with weak immunity like HIV patients. Also, most people with HPV have a risk of developing other sexually transmitted infections because of shared risk factors like unprotected sex or having multiple partners10.
The overlap of symptoms between the two has led many to ask, “is herpes a HPV virus?”, but the answer is no; their complications clearly differ. HPV is associated with risk of cancers while HSV usually not very severe, can lead to some serious health issues. So, despite their risks, they are not the same disease.
The risk of HPV transmission may be reduced by using condoms and avoiding anal or oral sex. Vaccination can also help protect against certain types of HPV, including those linked to genital warts and some high-risk cancer-causing types. The HPV vaccine is recommended for young individuals aged 9 to 25 years, those with weakened immunity, and men who have sex with men, as they may benefit from its protection1,9.
The risk of herpes transmission may be reduced by avoiding sexual contact during active outbreaks (when sores or blisters are present) and by using condoms or dental dams during sexual activity19.
In addition, quitting smoking and maintaining good nutrition can help keep your immune system working to fight these infections. These preventive steps, along with appropriate medical guidance, help lower the risk of infections.
Conclusion
HPV and herpes are not the same, but both are long-term infections that can return. There is no cure for these, but symptoms and complications can be managed with timely medical care. By knowing the difference between HPV and herpes, you can take the right preventive steps like regular screening, practicing safe sex, and getting vaccinated for HPV to help prevent serious health risks. Always consult a doctor early to stay protected and keep your partner safe.
Those who have allergy to yeast, pregnant women, people with bleeding disorders, or anyone who had an allergic reaction to a past vaccine should not get it. Your doctor can help you decide on this9.
How many days after getting herpes will it show symptoms?
Usually, symptoms may not show for some individuals, but if they do, it can appear in 2 to 12 days after getting infected.
Herpes blisters are causing a lot of discomfort. What to do?
A salt bath or applying an ice pack may help. Betadine, which contains iodine, is a good antiseptic and may help in drying the blister and prevent other infections. But always use as advised by your doctor.
Does herpes virus infect children?
Yes, primary outbreaks of HSV-1 are more common in childhood while HSV-2 usually occur later as associated with sexual activity.
A. Garolla, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. Journal of endocrinological investigation. 2023 Sep 28;47(2):261–74. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10859347/
Soheili M, Keyvani H, Soheili M, Nasseri S. Human papilloma virus: A review study of epidemiology, carcinogenesis, diagnostic methods, and treatment of all HPV-related cancers. Medical Journal of The Islamic Republic of Iran. 2021 Apr 30;35(35). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8278030/
60.Maroui MA, Callé A, Cohen C, Streichenberger N, Texier P, Takissian J, et al. Latency Entry of Herpes Simplex Virus 1 Is Determined by the Interaction of Its Genome with the Nuclear Environment. Benedict CA, editor. PLOS Pathogens. 2016 Sep 12;12(9):e1005834. Available from: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005834
Brown DR, Weaver B. Human Papillomavirus in Older Women: New Infection or Reactivation? Journal of Infectious Diseases. 2012 Dec 12;207(2):211–2. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3532821/
Huber J, Mueller A, Sailer M, Regidor PA. Human papillomavirus persistence or clearance after infection in reproductive age. What is the status? Review of the literature and new data of a vaginal gel containing silicate dioxide, citric acid, and selenite. Women’s Health. 2021 Jan;17:174550652110207. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8785287/
Soheili M, Keyvani H, Soheili M, Nasseri S. Human papilloma virus: A review study of epidemiology, carcinogenesis, diagnostic methods, and treatment of all HPV-related cancers. Medical Journal of The Islamic Republic of Iran. 2021 Apr 30;35(35). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8278030/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Is Bronchitis Contagious? Causes, Transmission, Symptoms & Treatment
Introduction
Bronchitis is a condition where the large airways in your lungs get inflamed (swollen), and they produce more mucus, which makes you cough. It can be short-term, lasting a few days or weeks, called acute bronchitis, which is mostly caused by viruses and rarely by bacteria (occurring as secondary infections)1. Around 50 to 60 per 1,000 people get affected every year2.
Sometimes, bronchitis becomes a long-term issue that may continue for months or even years, known as chronic bronchitis. This may occur due to smoking, air pollution, or in people who already have lung problems. Chronic bronchitis is more often seen in people over the age of 40 and tends to affect women more than men, even at times causing more severe symptoms in them1,2.
In this blog we’ll discuss in detail about bronchitis, its causes, how it spreads, is bronchitis contagious, its symptoms, and treatment.
What Is Bronchitis?
Our respiratory system that includes the nose, pharynx (throat), trachea (windpipe), bronchi and lungs, work together to help us breathe in oxygen and expel carbon dioxide. When the two main tubes which connect the windpipe to lungs, called bronchi, become inflamed, it can cause bronchitis3.
There are 2 types of bronchitis:
Acute bronchitis is a short-term infection that affects the bronchi. It is mostly caused by viral infection and lasts for about 1 to 3 weeks. The main symptom is cough with mucus. Other signs like feeling tired, having body aches, or a slight fever may also be seen. Based on these symptoms usually the doctor diagnoses acute bronchitis and performs other checks if needed to rule out conditions like pneumonia.
Chronic bronchitis is a long-term lung condition, usually a component of Chronic obstructive pulmonary disease or COPD (conditions causing airway obstruction). This condition causes cough with mucus that lasts more than 3 months for at least 2 years in a row. In this case, the airways become narrow or blocked, making it hard to breathe. This happens when irritants like cigarette smoke, polluted air, or repeated lung infections keep affecting the airways. The lining inside the bronchi produces too much mucus to protect themselves, but the mucus becomes thick and hard to clear. Over time, this can make it harder to breathe and may cause damage to the lung tissues, especially if associated with emphysema (a condition where the tiny air sacs in the lungs get damaged, making it harder to take in oxygen)1,2.
So, bronchitis can be short-term or long-term, but both affect your breathing and often cause excessive mucus. Let’s now look at what causes bronchitis in the first place.
What Causes Bronchitis?
The causes of acute and chronic bronchitis vary, as acute is mostly due to infection with viruses, but chronic may be due to other factors like irritants or underlying lung problems.
The causes of acute bronchitis include:
Viruses are the most common cause. These include influenza, RSV, rhinovirus, coronavirus, parainfluenza, human metapneumovirus (hMPV), adenovirus, measles, and enteroviruses.
Atypical bacteria like Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis cause around 10% of cases and are often linked with prolonged cough and bronchitis-like illness in young adults.
Co-infections with more than one virus can occur, and newer viruses like bocavirus and parainfluenza type 4 have also been linked to acute bronchitis.
Rare causes in those with weak immunity may include herpes simplex virus and Bordetella bronchiseptica (a canine germ), though these are not typical causes4.
Chronic bronchitis may be caused by:
Cigarette Smoke (main cause), active or passive exposure
Environmental exposure to air pollution, gas, dust, fumes, cooking fire, or dung for a long time
Asthma, allergies and frequent respiratory infections can increase the risk of chronic bronchitis5.
Now, coming to the question is: Is bronchitis contagious? Let’s find out in the next section.
Is Bronchitis Contagious?
While bronchitis itself doesn’t spread directly, acute bronchitis is contagious, especially because it is mostly caused by viruses like influenza, rhinovirus, coronavirus, RSV, and others. These viruses usually spread from one person to another during winter and early spring, when outbreaks are common2.
Even bacterial infections like Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis seen in acute bronchitis can be contagious through close contact1,4.
Chronic bronchitis, however, is usually not contagious because it mainly develops when exposed to smoke, air pollution, dust, or chemical fumes for a long time. Even passive smoking can increase risk.
While chronic bronchitis can worsen when infected with influenza or rhinovirus, the chronic condition doesn’t usually spread from person to person1,5.
So, whether bronchitis is contagious or not depends upon its type or more importantly the cause.
How Is Bronchitis Spread?
Acute bronchitis caused by viruses or bacteria can be spread in various ways6,7:
When droplets are breathed in during coughing, sneezing, talking, or even breathing out
When you touch your nose, eyes, or mouth after touching contaminated surfaces
If you stay in poorly ventilated, crowded indoor spaces (poor airflow allows virus particles to stay in the air longer and spread more easily) or in close contact with someone who’s sick.
Chronic bronchitis may not spread, but it’s important to be careful to avoid getting an infection with a virus or bacteria, as it can worsen the condition.
How Long Is Bronchitis Contagious?
How long is bronchitis contagious depends on the type of infection.
Some infections like the flu spread quickly, with symptoms starting in 2 to 4 days.
Others, like Mycoplasma pneumoniae, take longer (7 to 21 days) to show symptoms and spread slowly from person to person.
Acute bronchitis caused by virus can spread to other people in the first few days when you have symptoms like cough and fever.
When you are recovering from acute bronchitis symptoms and have 1 day without fever, without using any fever medicine, and symptoms are reducing, then you are likely less contagious. But as the body may take some time to clear the virus, you may still spread it to others, especially in the first week. Also, cough alone can still spread germs, even after the fever is gone. Moreover, some viruses like respiratory syncytial virus or adenovirus can continue to spread for an even longer time, especially in those with weak immune system4,8. So, even until a week after your symptoms subside, it’s best to take precautions like covering your mouth and avoiding close contact to reduce the risk.
When Will I Know I Have It?
You will know you have bronchitis by observing the symptoms, which differ slightly between acute and chronic types.
Runny nose, sore throat, and mild fever commonly in the first 1 to 5 days.
Cough with sputum, usually clear or yellowish, lasting 10–20 days but sometimes continues for 4 weeks or more
Tiredness
Mild breathing difficulty or wheezing (severe breathing difficulty commonly seen in asthma or pneumonia)
In chronic bronchitis, symptoms are similar but last longer5:
Cough with or without sputum and wheezing that lasts for at least 3 months in a year, for 2 consecutive years.
Breathing difficulty on exertion, chest tightness, and wheezing are common.
Weight gain can happen due to reduced activity in early stages.
In advanced stages, weight loss or muscle wasting may occur due to reduced activity.
When you notice these symptoms, addressing them early is important to help manage the condition better.
How Long Does Bronchitis Last?
The duration of bronchitis depends on whether you have the short-term acute type or the long-term chronic type.
Usually, acute bronchitis starts suddenly and may last for 7 to 10 days in healthy young adults. In some cases, the cough can stay for up to 3 weeks.
Influenza virus: Most symptoms clear up in 5 to 7 days, but cough and tiredness may last longer4,10.
Mycoplasma pneumoniae: Incubation period is 10–21 days; cough may persist with minimal sputum, but chest discomfort can be significant.
In elderly or those with heart/lung disease: If infected with RSV or HMPV, it may last for 16 to 27 days4.
In chronic bronchitis, a cough for 3 months continuously for 2 consecutive years is seen. Symptoms may come and go, but often last for months to years, especially if the cause like smoking, is not removed11.
Can Bronchitis Go Away on Its Own?
Yes, acute bronchitis often goes away on its own, especially if it is caused by a virus. You can try to follow these tips for relief from symptoms and faster recovery12:
Get good rest
Consume lots of water and fluids
If you have a stuffy nose, you can use a clean humidifier or vaporiser or saline spray
For babies, you may use a rubber suction bulb to remove mucus
Inhaling steam from hot water or during a shower
Cough drops or throat lozenges help, but not for children below 4 years
Honey (only for children 1 year or older) may relieve cough
The tips can also help relieve symptoms of chronic bronchitis sometimes, but other medicines may be needed to manage symptoms in serious cases.
Treatment of Bronchitis
Acute bronchitis usually goes away on its own, but certain medicines may help relieve symptoms:
Cough medicines like dextromethorphan or expectorants like guaifenesin may be useful to reduce cough or loosen mucus.
Bronchodilators like salbutamol inhaler may be advised by a doctor to open the airways if breathing difficulty is present.
Antibiotics are generally not needed unless the doctor suspects a bacterial infection, which is more common in children1.
Chronic bronchitis often needs long-term care to manage symptoms and improve breathing:
First step is to stop smoking and avoid exposure to second-hand smoke.
Medicines like bronchodilators help relax airway muscles to make breathing easier (can be inhaled).
Sometimes given in combination with steroids to reduce inflammation.
Antibiotics may be given when the symptoms, such as more mucus production, change in colour of mucus or breathing difficulty worsen, and if a bacterial infection is present.
Oxygen therapy may be needed when oxygen levels go low in severe cases (based on tests which show blood oxygen level less than 55-60 mmHg).
Pulmonary rehab with exercises may help in long-term breathing issues.
In rare cases, if symptoms don’t improve with medicines, lung transplant may be the last option5,13.
You should always inform your doctor about any medicine you are taking or any other health condition and avoid trying to take antibiotics or any other medicine by yourself. Always consult a doctor if anyone is showing symptoms of bronchitis and know how to prevent bronchitis which we will be discussing in the next section.
How Can You Prevent Spreading Bronchitis?
By following a few simple hygiene steps, you can prevent spreading infectious bronchitis to others.
Washing your hands regularly
Don’t touch your face with your fingers
When you cough or sneeze, do it on your elbow, not on your hand as elbow sneezing/ coughing helps reduce droplet spread
Tissues used must be discarded immediately
Social distancing can help
When having cold, don’t hug or shake hands with kids or those with weak immunity, especially if you’re showing symptoms.
Cover your nose and mouth with a mask
For those at risk of chronic bronchitis, getting flu or pneumococcal vaccine may be helpful in reducing the occurrence of respiratory infections that trigger bronchitis.
Even if your symptoms are mild, by taking these steps, you can protect your family from getting sick from bronchitis13,14.
Bronchitis is a common condition. It can be short-term (acute) or long-term (chronic). Acute is often due to viruses and can spread. Chronic bronchitis is not contagious as it is caused by long-term exposure to smoke or pollutants. Most acute cases get better with good rest and proper care. Vaccines may help reduce risk of lung infections which can trigger bronchitis, especially those who are at high risk. By knowing what causes bronchitis, its symptoms, and how it spreads, you can treat it early and stop it from spreading.
Can I get any complications because of bronchitis?
Yes, some people may get pneumonia, a lung infection, as a complication of bronchitis. Sometimes, bronchitis symptoms may not go away for a long time, with cough lasting up to 8 weeks. Flu and COVID vaccines may reduce the risk of getting complications with such infections3.
How do doctors find out if I have bronchitis?
The doctor first asks about your symptoms and medical history and then does a physical check-up to detect if you have bronchitis. Then they may order blood tests to confirm any signs of infection. A chest X-ray may be suggested to see if the lungs and airways are normal. They also do other tests to rule out pneumonia, COVID, or asthma, as these also have cough as a common symptom1.
Can I go to a pharmacy and get cough or cold medicine for my child with bronchitis?
No. For kids under 4 years, you should not buy medicine yourself without a doctor’s prescription. Using over-the-counter (OTC) medicine on your own can cause serious side effects. Even for individuals above 4 years, always discuss with the doctor before using any medicine.
Can I take antibiotics if I have acute bronchitis?
No. Acute bronchitis usually does not need antibiotics. If you take antibiotics when not needed, it may harm your body, causing side effects like rashes or severe diarrhoea. Your doctor may prescribe antibiotics only if they suspect a bacterial infection, like pneumonia12.
Marie-Hélène Blanchet Zumofen, Frimpter J, Hansen SA. Impact of Influenza and Influenza-Like Illness on Work Productivity Outcomes: a Systematic Literature Review. Pharmacoeconomics. 2022 Dec 14;41(3):253–73. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9748403/
Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. Acute bronchitis: Overview [Internet]. www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG); 2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK458291/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Is Pneumonia Contagious? Causes, Transmission, Symptoms & Treatment
Introduction
Did you know that you have an increased risk of developing pneumonia if you are above 65 years of age or under 2 years of age1? Pneumonia is one of the leading causes of death worldwide2.
While pneumonia itself is not contagious, the causative agents (bacteria, virus) generally are. Understanding how pneumonia spreads, what causes it, how to recognise whether your infection is contagious and knowing about the right treatment are essential to protect yourself1.
What Is Pneumonia?
Pneumonia is a serious infection that can affect either one or both of your lungs, causing the air sacs of your lungs or alveoli to be filled with fluid or pus3,4.
Pneumonia is a clinical syndrome with multiple aetiologies and classifications, which include5:
Community-Acquired Pneumonia: Pneumonia acquired outside of hospital settings or in a community setting.
Hospital-Acquired Pneumonia: Pneumonia acquired 48 hours or more of admission in any hospital.
Ventilator-associated Pneumonia: Pneumonia acquired more than 48 hours after endotracheal intubation.
What Causes Pneumonia?
Pneumonia is the inflammation of alveoli in your lungs mostly caused by bacteria, viruses or fungi. These include6,7,8:
Bacterial Pneumonia: Bacteria are a common cause of pneumonia in adults. The most commonly noticed bacterium is Streptococcus pneumoniae while others like Haemophilus influenzae, Bordetella pertussis etc may also be the cause. Atypical bacteria such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella are also causes of pneumonia, especially in younger individuals.
Viral Pneumonia: Viruses such as influenza virus, SARS-CoV-2, respiratory syncytial virus (RSV), and rhinovirus can also cause pneumonia.
Fungal Pneumonia: Not as common as bacterial and viral pneumonia, but fungi such as Pneumocystis jirovecii, cryptococcus, histoplasma and blastomyces may also lead to the development pneumonia, especially in individuals with weak immune systems.
Aspiration Pneumonia is one subtype of pneumonia, which occurs when food, liquids, or vomit are inhaled into the lungs, and is not caused by infectious organisms per se9.
Understanding the cause of pneumonia can help to identify whether it is contagious and prevent its spread.
Is Pneumonia Contagious?
This depends upon the underlying cause of pneumonia. Certain types can be contagious based on the causative organism, while others may not spread directly6.
Contagious pneumonia is generally caused by bacteria or viruses, which can be transmitted through respiratory droplets when an infected person coughs, sneezes, or talks6.
Non-contagious pneumonia does not spread from person-to-person. This type of pneumonia occurs due to inhalation of foreign substances (aspiration pneumonia) and is not caused by an infectious agent so cannot spread to others9.
Another type of pneumonia that is less likely to be contagious is that caused by fungal infections, which typically affect people with weakened immune systems. While these are not transmitted between individuals, they can occur in clusters due to shared environmental exposure10,11.
Let’s have a look at the contagious ones in detail.
Which Pneumonia Types are Contagious?
Are you wondering which pneumonia is contagious? Well, as mentioned, not all pneumonias are contagious. Some can spread from person to person, while others do not.
Bacterial pneumonia: Bacteria such as Streptococcus pneumoniae can cause infections that can spread through cough, sneezes, or close contact.
Atypical pneumonia: Some bacteria may cause pneumonia with different symptoms which are usually milder that those in typical pneumonia (referred to as walking pneumonia or atypical pneumonia). This is mostly caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila and generally affects younger populations. This is contagious and spreads through inhalation of infected respiratory droplets or aerosolised contaminated water.
Viral pneumonia: Viruses such as influenza virus, RSV, or SARS-CoV-2 are also highly contagious and spread similarly via airborne droplets or contact with contaminated surfaces.
Fungal pneumonia: These are acquired from environmental exposure, and person-to-person transmission is exceedingly rare or non-existent, except sometimes in transplant settings (e.g., organ donation from infected donor)12.
How Does Pneumonia Spread?
Pneumonia can spread in several ways, which includes9,10:
Airborne Droplets: This occurs when an individual affected with pneumonia coughs, sneezes or talks. This causes the release of respiratory droplets (infectious as they may contain bacteria or viruses). When you inhale these droplets, you may develop pneumonia.
Contact with Contaminated Surfaces: When an individual touches a surface that is contaminated with bacteria and viruses, and then touches their nose or mouth, they may develop pneumonia.
Aerosols or water droplets: Some organisms which cause pneumonia (such as Histoplasma, Blastomyces, Legionella) are present in the aerosolised soil particles or contaminated water droplets. Hence, when an individual is exposed to these factors, they may inhale an infectious organism and develop pneumonia.
Aspiration: This is not actually a mode for person-to-person transmission, rather a mechanism of entry of oropharyngeal or gastric contents into the lungs. It is a non-infectious event, though it can lead to secondary infection.
Despite these, developing pneumonia depends on host factors, virulence, and exposure dose. Not everyone exposed develops pneumonia. Certain factors may increase risk of pneumonia such as a weakened immune system (this includes HIV, or any chronic diseases like asthma, diabetes, etc). It’s important to be especially vigilant of pneumonia symptoms if you have any preexisting conditions8.
How Long is Pneumonia Contagious?
The contagious period can vary based on the type of pneumonia you are suffering from. The table below lists when pneumonia is contagious6,9:
Type of Pneumonia
Contagious Period
Bacterial Pneumonia
Contagious for approximately 48 hours after starting antibiotics and until fever reduces
Walking Pneumonia
Contagious for several weeks (2-4 weeks before your first symptoms appear and until symptoms resolve)
Viral Pneumonia
Several days to over a week (until fever reduces and symptoms subside)
Fungal Pneumonia
Generally, not contagious
Aspiration Pneumonia
Not contagious
Is Pneumonia Contagious After Antibiotics?
An individual infected with bacterial pneumonia is said to be contagious for approximately 48 hours after starting effective antibiotics, while viral pneumonia may remain contagious longer (several weeks). You are likely to be contagious until your symptoms subside and fever resolves. It is always best to consult your doctor and follow instructions to reduce the spread of infection6.
Symptoms of Pneumonia
The signs and symptoms of pneumonia may include4,13,14:
Fever and chills
Headache
Chest pain (pleuritic pain, which is a sharp pain on breathing and coughing)
Muscle pain or myalgia
Productive cough (may be associated with greenish, yellow or even bloody mucus)
If you are facing any of these symptoms, consult your doctor and seek immediate medical care.
How to Tell If a Cough Might Be Pneumonia
A cough can indicate any infection from a common cold, bronchitis, to pneumonia. The below table summarises the key differences in these 3 infections and helps you to understand if your cough might be pneumonia14,16,17.
Common Cold
Bronchitis
Pneumonia
Duration of Cough
Short duration
Short duration
Persistent Cough
Type of Cough
Productive / nonproductive cough
Productive cough (Clear or yellow-green mucous)
Productive cough (greenish, yellowish or blood stained mucous)
Symptoms
Sore throat, runny nose, sneezing, coughing and headache
Chest discomfort, productive cough, tiredness, low-grade fever, shortness of breath
Rest, fluids, and over-the-counter pain or cold or cough medicines
Rest, fluids, and over-the-counter pain or cold or cough medicines
Antibiotic treatment
Diagnosis
After a careful assessment of your symptoms, your doctor will be able to diagnose your condition with the help of18,19:
Chest X-ray: If you present with clinical symptoms, your chest X-ray may show infiltrates, consolidation, or opacities in your lungs which maybe a sign of pneumonia.
Blood Tests: Your doctor may recommend laboratory tests such as:
Complete blood count: To check for any infections, such as leucocytosis with neutrophilia (bacterial) or lymphocytosis (viral).
Arterial blood gases: Used only in severe cases. It can be used to help assess the oxygenation and acid-base balance in cases of hypoxia or when any other respiratory compromise is expected.
Pulse Oximetry: To measure your oxygen level in your blood. Pneumonia fills air spaces in lungs with fluids, impairing gas exchange, which leads to hypoxemia. If you are suffering from pneumonia, it can prevent your lungs from getting enough oxygen into your blood.
Sputum Test: To identify the organism causing your illness.
Blood Culture Test: To identify the causative agent and to check for bacterial infection in your blood which has prognostic implications in severe CAP or suspected sepsis.
Polymerase Chain Reaction (PCR) Test: To identify the DNA of the causative agent
Bronchoscopy: A tube is inserted into your airway and your doctor may collect samples of the tissue and fluid from your lungs to identify the cause of your pneumonia. This method is only done in complicated cases, cases of unresolved pneumonia or immunocompromised patients.
Chest Computed Tomography (CT) Scan: This tool can help to identify the extent to which your lungs are affected by pneumonia and can also identify abscesses and other lung disorders.
Based on these tests, your doctor will be able to accurately diagnose your condition and will suggest the appropriate treatment for your condition18.
Treatment for Pneumonia
Depending on the type of pneumonia you have, your doctor may suggest the following treatments20,21:
Bacterial pneumonia: Antibiotics may be prescribed. You should start to notice a reduction in your symptoms in 48-72 hours. However, complete recovery can take a much longer time in elderly patients (several weeks). Take your medications as prescribed by your doctor and do not discontinue your medication.
Viral pneumonia: While in most cases, viral pneumonias clear up by itself, Influenza, RSV and SARS-CoV-2 can cause severe disease, especially in children, elderly individuals and individuals who are immunocompromised. Oseltamivir may be prescribed for managing influenza, ribavirin may be prescribed for RSV, parainfluenza virus, adenovirus, and measles virus22.
Fungal pneumonia: Treatment prescribed is dependent on the causative organism. For example, if your infection is caused by Pneumocystis jirovecii, your doctor may prescribe a combination of trimethoprim-sulfamethoxazole, or if your infection is caused by Histoplasma, your doctor may prescribe itraconazole or amphotericin B for the management of your condition22.
Apart from these medications, it is important to get plenty of rest, drink plenty of fluids, and you may take over-the-counter medications for pain, cough, cold and fever.
In cases of severe pneumonia, you may have to be a hospitalised to receive medications (antibiotics and fluids) through an intravenous (IV) line. Your doctor may also recommend oxygen therapy to increase the amount of oxygen in your blood. If you are suffering from a serious infection, you may need ventilator support20,21.
Prevention Tips
Taking a few proactive steps and getting vaccinated, can reduce your chances of developing pneumonia. This includes23:
Apart from getting vaccinated, certain simple tips that you can follow to protect yourself against pneumonia include23,25:
Avoid close contact with infected and sick individuals.
If you are sick, stay at home to prevent the spread of infection.
When in a public place, cover your nose and mouth with a tissue while sneezing and coughing or cough or sneeze into your elbow followed by good hand hygiene.
Quit smoking and avoid alcohol consumption.
Make sure you wash your hands regularly with warm water and soap for at least 20 seconds.
It is important to clean and disinfect frequently contacted surfaces to reduce the risk of infection.
Consult your doctor for any medical issues such as heart disease, diabetes and take medications as directed. These conditions can lead to secondary pneumonia and managing them is essential for pneumonia prevention.
You should consult a doctor if you experience symptoms of pneumonia. If you face difficulty in breathing, high fever, difficulty breathing, chest pain, and a productive cough, seek immediate medical care26.
Moreover, it is important to get immediate medical care in high-risk individuals (adults over the age of 65, children below the age of 2 and adults with any underlying health condition such as diabetes, heart disease) or weakened immune system (immunocompromised individuals) as the disease can progress quickly in these individuals. Moreover, if you notice symptoms such as bluish lips or nails (cyanosis), confusion, and rapid breathing, it is best to seek prompt medical care26,27.
Conclusion
Talking about the main question – is pneumonia contagious in adults? Well, it may or may not be, depending on its underlying cause. It is important to recognise the type of pneumonia you have and how it may be transmitted. Taking appropriate precautions such as getting timely vaccinations and promoting good hygiene can help prevent its spread. Early diagnosis and treatment are essential for a quick recovery.
What are the complications of pneumonia, if left untreated?
The complications of untreated or incompletely treated pneumonia include respiratory failure, accumulation of pus in between the lung and the lining of the chest wall (empyema), lung abscess, sepsis and may also lead to multi organ failure5.
Is pneumonia more dangerous during pregnancy?
Yes, pregnant individuals are at higher risk of complications of pneumonia such as low weight at birth and increased risk of preterm birth due to weakened immunity28.
Can pets transmit pneumonia to humans?
Yes, this can occur, though rarely. Certain infections such as Q fever (caused by Coxiella burnetii) and Psittacosis (caused by Chlamydophila psittaci) may occur in individuals working closely with animals or livestock29,30.
What is the difference between bronchitis and pneumonia?
Bronchitis affects your bronchial tubes (airways), while pneumonia affects the air sacs (alveoli) in the lungs. The symptoms of pneumonia tend to be more severe and may involve high-grade fever, chest pain, and shortness of breath14,17.
Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SRM, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Infectious Diseases [Internet]. 2018 Nov;18(11):1191–210. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6202443/
Smith DJ, Williams SL, Benedict KM, Jackson BR, Toda M, Adame G, et al. Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019. MMWR Surveillance Summaries [Internet]. 2022 Aug 19;71(7):1–14. Available from: https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm
José RJ, Periselneris JN, Brown JS. Opportunistic bacterial, viral and fungal infections of the lung. Medicine [Internet]. 2020 Jun 1;48(6):366–72. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7206443/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Bacterial Pneumonia: What Is It, Causes, Symptoms & Treatment
Introduction
Pneumonia is one of the leading causes of mortality in the world, making it a global health concern1. It is a serious infection that affects your lungs by causing inflammation and fluid or pus accumulation in the alveoli (air sacs) of your lungs2. Bacterial pneumonia, especially from Streptococcus pneumoniae or Haemophilus influenzae type b, is a common cause of pneumonia-related deaths. However, viral pneumonia, caused by viruses like respiratory syncytial virus (RSV) and influenza, also contributes significantly to pneumonia cases and fatalities1,3.
What Is Bacterial Pneumonia?
Bacterial pneumonia, as the name suggests, is caused by various bacteria that invade your lungs. Your body’s natural defence system tries to fight these bacteria as a part of the immune response, leading to inflammation of the air sacs of your lungs and the accumulation of fluid and pus in them4. Inflammation occurs as part of the immune response, but sometimes pathogenic bacterial factors also directly damage tissue, e.g., inflammation caused by the toxin pneumolysin from S. pneumoniae5. Bacterial pneumonia can be of different types, including3:
Community-acquired Pneumonia: Occurs in individuals who acquire the infection outside of hospital settings or within 48 hours of admission.
Hospital-acquired Pneumonia: This type of pneumonia occurs in individuals who develop the infection 48 hours after admission to any hospital.
Atypical Pneumonia: This type of pneumonia is generally caused by bacteria that are less commonly associated with pneumonia, e.g., Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella spp. These organisms are not generally identified by the traditional staining methods (Gram stain), but the pneumonia often presents with symptoms that occur outside the lungs. Though atypical bacterial pneumonia is mostly bacterial in origin, it may not be categorised as typical bacterial pneumonia6.
Ventilator-associated Pneumonia: This type of pneumonia occurs 48 hours or more after a person has been placed on a ventilator to help them breathe.
Community-acquired Pneumonia: The main organisms that cause this infection include S. pneumoniae, H. influenzae, M. pneumoniae, Legionella spp., Moraxella catarrhalis, and Staphylococcus aureus (especially methicillin-resistant S. aureus), which is commonly associated with severe cases or following a viral infection like influenza.
Hospital-acquired Pneumonia: The main organisms that cause this infection include S. aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii.
Atypical Pneumonia: The main organisms that cause this infection include M. pneumoniae, C. pneumoniae, or Legionella pneumophila.
Ventilator-associated Pneumonia: The main organisms that cause this infection include S. aureus, P. aeruginosa, enterobacter species (such as Klebsiella, E. coli) and gram-negative bacilli8.
In 50% of pneumonia cases, the etiological factor remains unknown. Identifying the causative organism is essential for appropriate treatment7.
How Does Bacterial Pneumonia Spread?
Bacterial pneumonia is contagious and can spread from person to person. This infection is transmitted through contact with infected surfaces. It can also spread when the droplets released when an infected person coughs or sneezes are inhaled by another person3,7.
It is always recommended to avoid close contact with infected individuals, wear a mask and practice proper hand hygiene to reduce your risk of infection9.
Who Is More Likely to Get Bacterial Pneumonia?
While bacterial pneumonia can affect anyone, certain groups of people, including the following, are more likely to develop bacterial pneumonia3,7,10:
Children (under 5 years of age) or older adults (over 65 years of age).
Chronic conditions (such as diabetes, chronic lung disease, and heart disease).
Weakened immune system.
Smoking and alcohol consumption.
Poor oral hygiene
Use of certain medications (e.g., proton pump inhibitors like omeprazole and pantoprazole).
Symptoms of Bacterial Pneumonia
The signs and symptoms of bacterial pneumonia include3,7:
Productive cough with mucus that can be clear, yellow/green, or contain blood. Dry cough is more common with viral and atypical pneumonia6,11.
Systemic symptoms of bacterial pneumonia may include3,7:
Headache
Sweaty and clammy skin or chills
Altered mental status or confusion
Hypotension
Cyanosis due to low oxygen levels
Increased heart rate (tachycardia). Decreased heart rate (bradycardia) is uncommon and may be associated with pneumonia caused by Chlamydia sp, Legionnaire’s disease, and typhoid12.
In children under 5 years of age, the signs and symptoms of bacterial pneumonia may include rapid breathing, chest pain, abdominal pain, and pale colour of the face3,7.
Diagnosis of Bacterial Pneumonia
After a careful assessment of your symptoms, your doctor will be able to diagnose your condition with the help of3,7:
Chest X-ray: If you present with symptoms of pneumonia, your chest X-ray serves as a first-line imaging tool for the diagnosis of bacterial pneumonia. Your chest X-ray may show pulmonary infiltrates and may suggest the type of pneumonia present (for example, lobar or interstitial pneumonia). However, it cannot accurately distinguish between bacterial and non-bacterial pneumonia (such as viral pneumonia).
Computed Tomography: Helpful in unclear cases or when other conditions may be present.
Blood Tests: Your doctor may recommend laboratory tests such as:
Complete blood count: Creatinine levels and complete white blood cell count (for the diagnosis and detection of severity of infection)
Liver function tests: Abnormalities on the liver function tests may be observed in cases of severe or complicated pneumonia or Legionella infections13.
Inflammatory biomarkers (e.g., erythrocyte sedimentation rate and C-reactive protein): Supportive markers for inflammation and severity. Elevated levels of C-reactive protein are suggestive of bacterial pneumonia. However, this result is not definitive, and these tests cannot distinguish between bacterial and viral pneumonia.
Arterial blood gases: Used in severe cases where hypoxia (low oxygen supply to tissues) and respiratory acidosis (acidic blood due to the presence of carbon dioxide) are present.
Sputum Culture: May be advised in severe cases or hospitalised cases to identify the bacteria causing your illness.
Gram Staining: To identify the bacteria and guide your treatment. For example, Gram-positive cocci, such as S. pneumoniae, and Gram-negative bacilli like H. influenzae.
Respiratory Viral Panel (including influenza): Done by collecting a sample from your respiratory tract (nasopharyngeal swab) to check for viral pathogens such as influenza, RSV or SARS-CoV-2. The results may indicate a secondary bacterial infection, which is common after a viral infection.
Based on these tests, your doctor will be able to diagnose your condition accurately and will suggest the appropriate treatment for your condition. A definitive diagnosis, especially in hospitalised cases or complicated cases will always require identification of the organism.
Bacterial vs. Viral Pneumonia
While bacterial and viral pneumonia are two common types of lung infections that share similar symptoms, the table below highlights the key differences between the two types of pneumonia3,7,11.
Bacterial Pneumonia
Viral Pneumonia
Aetiology
Bacterial (e.g., Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus)
Viral (for example, Respiratory syncytial virus or RSV, influenza virus, adenovirus and coronaviruses like SARS-CoV-2)
Onset
Sudden onset and more severe symptoms
Gradual onset and symptoms may not be severe initially
Nasal or throat swab (PCR), Chest X-ray, and patient’s history
Treatment
Antibiotics
Supportive care (rest, fluids, fever control); antivirals in some cases (e.g., influenza)
Complications
Abscess, empyema, and sepsis
Respiratory failure, liver failure, heart failure, and secondary bacterial infection
If you are suffering from any lung infection and are unsure whether it is a bacterial or viral infection, it is best to consult your doctor and get appropriate medical treatment.
Bacterial Pneumonia Treatment
The main treatment of bacterial pneumonia involves the use of antibiotics. If you are healthy and do not have any other chronic medical conditions, the treatment may include antibiotics like3,7:
If you have any chronic medical conditions such as diabetes or heart disease, the treatment may include combination treatments like3,7:
Amoxicillin/clavulanate or cephalosporins (such as cefpodoxime or cefuroxime) along with a macrolide (such as azithromycin or clarithromycin) or doxycycline.
Alternatively, your doctor may recommend a single stronger antibiotic like levofloxacin or moxifloxacin.
If you are admitted to the hospital but your pneumonia is not too severe, your doctors may recommend3,7:
A beta-lactam antibiotic (such as ceftriaxone) along with a macrolide (such as azithromycin or doxycycline).
Alternatively, a single respiratory fluoroquinolone (such as levofloxacin) may be used. However, it is important to note that overuse of these respiratory fluoroquinolones may lead to resistance to the antibiotic and an increased risk of Clostridium difficile infection14.
If you are admitted to the hospital and your pneumonia is severe, your treatment will be more aggressive and usually includes3,7:
A beta-lactam antibiotic plus a macrolide
Alternatively, your doctor may recommend a beta-lactam antibiotic along with a respiratory fluoroquinolone.
Prevention of Bacterial Pneumonia
Certain tips that you can follow to reduce your risk of pneumonia include3,7,9:
Ensure good hand hygiene by washing your hands regularly with warm water and soap.
Avoid smoking and alcohol consumption.
Maintain good oral hygiene, as poor oral hygiene is a risk factor for bacterial pneumonia.
Ensure prompt medical care if you have chronic conditions such as asthma.
Consult your doctor regarding the following vaccinations for infants and children to prevent pneumonia:
H. influenzae type b vaccination (Hib Vaccination): Recommended for infants and children under 5 years of age. The vaccination schedule can be a 3-dose series with doses taken at 2, 4, and 6 months plus a booster dose at 12-15 months or a 2-dose series with doses taken at 2 and 4 months plus a booster dose)15,16
Pertussis vaccination (DTaP / Tdap Vaccination): The DTaP vaccine is administered during childhood, while the Tdap booster is advised for adolescents and adults, especially for pregnant women. However, this vaccination does not directly prevent bacterial pneumonia17.
Pneumococcal vaccination (PCV 15/PCV20 and PPSV23): Helps protect against S. pneumoniae. This vaccination is recommended for all children under 5 years of age and for children and adults with chronic conditions like diabetes and chronic lung disease18.
By following these steps, you can reduce your risk of developing bacterial pneumonia and improve your overall health3,7.
If left untreated, bacterial pneumonia can lead to complications like7:
Fluid buildup around the lungs (pleural effusion)
Pus collection in the lung area (empyema)
Infection in the lung (lung abscess)
Breathing difficulty due to lung damage
Residual lung scarring after severe pneumonia or acute respiratory distress syndrome (ARDS)19
Widespread infection in the body (sepsis)
Bacteria in the bloodstream (bacteraemia)
Low oxygen levels in the blood (hypoxemia)
Early diagnosis and proper treatment of bacterial pneumonia can help prevent serious and potentially life-threatening complications7.
When to See a Doctor
You should consult a doctor for bacterial pneumonia if you experience symptoms like a persistent cough, chest pain, difficulty breathing, or a high fever3,7.
You should seek immediate medical attention if you are at an increased risk of developing bacterial pneumonia (if you are an adult over 65 years of age, a child under 5 years of age, or if you are facing any other chronic medical conditions)3,7.
Bacterial pneumonia is a serious infection that continues to pose a major global health challenge. Understanding its causes, risk factors, symptoms, and the importance of timely diagnosis and appropriate antibiotic treatment is key to improving outcomes. Preventive measures such as good hygiene, vaccination, and lifestyle modifications play a crucial role in reducing the risk of bacterial pneumonia. Most importantly, early medical attention, especially for high-risk individuals, can significantly lower the chances of complications and ensure better recovery.
Yes, bacterial pneumonia can recur after treatment. The chances of recurrence are increased in individuals with underlying health conditions, weakened immunity, or poor lung function. Recurrence may also happen if the initial infection wasn’t completely treated3,7.
When will my symptoms start to improve?
Most patients show improvement in 48 to 72 hours. If there is no improvement, an alternative cause should be suspected3.
Can bacterial pneumonia develop as a complication of viral pneumonia?
Yes, bacterial pneumonia can often develop as a secondary infection following viral illnesses like COVID-19 or influenza, often worsening the clinical outcome11.
What benefits does walking have for individuals with bacterial pneumonia?
Mild physical activity like walking can aid recovery; however, strenuous exercise should be avoided until your doctor confirms full recovery and lung function is stable. Consult your doctor to understand if exercises are suitable for your condition20.
References
Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SRM, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Infectious Diseases [Internet]. 2018 Nov;18(11):1191–210. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6202443/
Miyashita N. Atypical pneumonia: Pathophysiology, diagnosis, and treatment. Respiratory Investigation [Internet]. 2021 Nov;60(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34750083/
Pahal P, Rajasurya V, Sharma S. Typical Bacterial Pneumonia [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534295/
Kohbodi GA, Rajasurya V, Noor A. Ventilator-associated Pneumonia [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507711/
Ostergaard L, Huniche B, Andersen PL. Relative bradycardia in infectious diseases. The Journal of Infection [Internet]. 1996 Nov 1;33(3):185–91. Available from: https://pubmed.ncbi.nlm.nih.gov/8945708/
Patterson CM, Loebinger MR. Community acquired pneumonia: assessment and treatment. Clinical Medicine [Internet]. 2012 Jun;12(3):283–6. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4953496/
Shea KM, Hobbs ALV, Jaso TC, Bissett JD, Cruz CM, Douglass ET, et al. Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection. Antimicrobial Agents and Chemotherapy [Internet]. 2017 Jun;61(6). Available from: https://journals.asm.org/doi/10.1128/aac.00125-17
Gilsdorf JR. Hib Vaccines: Their Impact on Haemophilus influenzae Type b Disease. The Journal of Infectious Diseases [Internet]. 2021 Sep 30;224(Supplement_4):S321–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8482018/
Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute Respiratory Distress Syndrome. Nature Reviews Disease Primers [Internet]. 2019 Mar 14;5(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6709677/
Ikeda T, Inoue S, Konta T, Murakami M, Fujimoto S, Iseki K, et al. Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People? Scientific Reports [Internet]. 2020 May 22;10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244731/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
HPV in Men: What It Is, Causes, Symptoms & Treatment
Introduction
HPV (Human Papillomavirus) infection is a sexually transmitted infection commonly affecting both men and women. Some types of HPV are considered low-risk and may cause warts, while others are high-risk types and that can even lead to cancer.
HPV is more often discussed in women due to the risk of cervical cancer. However, there a 90% probability of men too being infected with HPV through their lifetime. Though not always serious, it can sometimes cause cancer of the penis, anus, or certain parts of the throat, such as the base of the tongue and tonsils1.
In this blog, we will focus on HPV in men, how to get tested and manage this infection.
What is HPV (Human Papillomavirus)?
HPV is a virus that infects the surface layers of the skin and mucus membranes (thin linings) of the body areas like the genitals, anus, and parts of the throat, commonly spread through sexual contact. It can cause infections in these areas of skin with minor or sometimes even no symptoms, especially in cases of genital infection. The rate of HPV in men is high throughout their lives, while in women, the infection rate reduces as they age.
There are over 200 HPV types and are mainly classified as: the low-risk type (like HPV-6, 11) the high-risk type (like HPV-16, 18) of HPV. Women are infected more often with the high-risk type, while in men, both the high- and low-risk types are equally common1,2.
How is HPV Transmitted?
HPV is easily spread from one person to another in different ways, such as:
Through vaginal, oral, and anal sex.
Through skin-to-skin contact.
By touching contaminated underwear or shared objects.
By hand contact, if the virus is present on the skin2.
The risk is higher in men who have sex with men, in those who are HIV-positive, or in those with infected partners. In rare cases, HPV can also pass to a unborn children through sperm or egg, leading to infection3.
Why HPV is a Concern for Men
HPV infections can be concerning for men because they often have no symptoms, and many are unaware that they have an infection which can easily pass to their partners.
In men, the low-risk type HPV can cause warts (growths on skin) on gentiles or mouth/throat, but the high-risk type can lead to more serious health issues like cancers affecting the skin around the penis and anus and some mouth/throat cancers. Some research studies also suggest that HPV may affect sperm quality in men, although a clear link has not been proven yet.
Moreover in men, the immune response to HPV is often less effective in clearing the virus completely, and it may remain in the body or come back later. This means the virus can stay for a long time in the body or become active again, causing reinfection and unintentional spread to their partner.
Unlike for women who have HPV related cervical cancer screening, there is no regular screening for the HPV test for men. However, the risk of HIV infections is higher in some categories of men such as those who have sex with other men or those with HIV3,4.
Therefore, though HPV is commonly spoken about in women, men may also have serious health issues when infected with HPV and need regular HPV-related cancer screening using anal smears or HPV DNA testing, especially in certain groups4,5.
Risks & Complications of HPV in Men
HPV is not always dangerous and often goes away without causing much trouble5. But in some cases, it can lead to various health issues like:
Condyloma acuminata: Small, flesh-coloured or grey, painless growths (warts) around the penis, anus, or nearby areas, usually caused by low-risk HPV types.
Adult-onset recurrent respiratory papillomatosis (AoRRP): A rare condition where HPV (mainly types 6 and 11) causes wart-like growths in the throat. It typically appears in men in their 30s–40s and presents with symptoms such as hoarseness. Seen in men who have oral sex.
Cancers: High-risk HPV types may cause cancers in the penis, anus, mouth, certain parts of the throat, tongue and tonsils1,2.
These risks show that it is important for men to be aware of HPV, identify the symptoms and take steps to manage it early.
Symptoms of HPV in Men
Usually, men with HPV do not show many symptoms. But when symptoms are present, they depend on the type of HPV and the location of the infection. Some possible symptoms include:
Warts: Small, painless, flat, or cauliflower-like growths on the penis, anus, or groin (usually caused by low-risk HPV).
Throat symptoms: Hoarse voice, breathing trouble, or airway blockage due to wart-like growths (seen in recurrent respiratory papillomatosis).
Cancer signs: High-risk HPV may cause penile or anal cancer. Penile cancer may show red or painful growths. Anal cancer may cause lumps, bleeding, discharge, pain, itching, or bowel changes1,6. HPV related cancer in the base of the tongue or tonsils often shows up as a neck lump or sore throat. It may also cause trouble swallowing, throat pain, or an earache. All these symptoms may not appear early, but later as the disease progresses7.
These symptoms may also occur in other conditions. While there is no standard test for HPV in men, a specific test like the anal pap smear test may be advised for those who have sex with men or HIV patients. So, it is better to consult a doctor who may advise you to get the HPV test male and accordingly manage the condition based on the results1,6.
Cancers Linked to HPV in Men
Several cancers in men are linked to the high-risk HPV type, especially HPV-16 and HPV-18. HPV is a major cause of certain throat cancers, especially those in the oropharynx (like the base of the tongue and tonsils), often seen in men with a history of oral sex. It also causes 40–50% of penile cancers and about 90% of anal cancers, particularly in men who have sex with men or in HIV-positive men. These cancers may start as small precancerous growths and progress to become cancerous1,2.
But how do men test for HPV to reduce the risk of getting these cancers? We will find it in the next section.
HPV Testing for Men
As of now, there are no standard HPV test for men that are approved for screening. In males without any symptoms, it is hard to test for HPV. However, HPV testing may be recommended in the following situations:
When the man’s partner is HPV positive or has an HPV-related disease.
When he shows HPV symptoms.
In high-risk categories such as men who have sex with men or men who have HIV2,4.
Most of the time, warts are checked by doctors just by looking at them and are diagnosed based on how they appear. Testing is usually done on warts or visible spots only if the doctor thinks it could be a serious type of HPV.
While not routinely done, anal cytology (Pap smear) can be advised for detecting HPV in men who may have weakened immune systems or those who engage in anal intercourse (high-risk categories). Here, a soft swab is used to collect cells from the anal region to check for early signs of cancer4.
Male HPV tests, particularly for high-risk categories, also include molecular tests like PCR, used to detect HPV DNA (genetic material of virus) and identify its type. Samples can be taken from areas like the penis, throat, mouth, or skin growths2.
For men who had cancer linked to HPV, their follow-up after treatment involves regular check-ups, scans, or cytology. HPV DNA test may be done only if the doctor recommends it2,6.
Treatment Options for HPV in Men
HPV infection cannot be cleared by any specific antiviral medicine, and there is no standard management plan. In most cases, the immune system clears the HPV virus on its own7,8,9. However, for HPV related growths and cancers, especially genital warts and early signs of cell changes that could turn into cancer, there are clear treatment options available10.
The focus is mainly on addressing visible growths and related health problems. For growths around the penis, topical creams like imiquimod may stimulate an immune response and clear the warts, though they do not remove the virus completely in that area.
Surgery, radiation, or cancer-related medicines may be suggested in cases where cancer has developed due to HPV8,9.
Immunotherapy medicines such as nivolumab, and pembrolizumab help the body’s immune system fight cancer and are used in some HPV-related cancers of certain areas of the throat11.
Managing HPV should include both partners to help reduce the chance of passing the virus back and forth8,9.
HPV Vaccine for Men
HPV vaccines may help reduce the chances of getting HPV and may lower the risk of HPV-related cancers by up to 90%. Though vaccines are often focused more on women, men may also benefit, as they experience more than 90% of certain HPV-related cancers. HPV vaccines help protect against the many high-risk types of the virus (like types 16 and 18), which can cause cervical cancers and many other cancers in the genital and throat areas.
HPV vaccines have shown strong benefits with good efficacy and immune response. In India, in 2021, Gardasil 9, a vaccine that may be given to both men and women, was introduced8.
The HPV vaccine can be given to males aged 9 to 26 years. It may also be given up to age 45, based on a person’s health and risk factors, as advised by a doctor.
For boys aged 9 to 14 years, two doses are given. The second dose is given 6 to 12 months after the first. If the second dose is given too early (less than 5 months apart), a third dose is needed.
For males aged 15 to 45 years, three doses are given. The second dose is given after 2 months, and the third dose after 6 months from the first8,12.
Getting vaccinated is one way you may help reduce the risk of spreading HPV and avoid the health risks associated with HPV.
How to Prevent Spreading HPV
You can reduce the chances of getting HPV and its related complications by following these tips13,14:
Safe sex: If you are sexually active, using condoms may give you some protection against HPV, though the virus can still spread through skin contact in uncovered areas.
HPV vaccine: This vaccine may help you and your partner stay protected from certain types of HPV that are linked to cancer.
Screening: Routine screening is usually not done in men, but a Male HPV test, such as an anal Pap test for anal cancer or an HPV DNA test may be used in certain high-risk groups like men who have sex with men or those with HIV. If you have a female partner, she may need screening for cervical cancer, as HPV can be a cause in both.
Quit smoking: Avoiding smoking is advised, as it may make it harder for the body to clear HPV and increase the risk of HPV-related cancers.
By taking timely action and staying aware, you and your partner may be safeguarded from serious health risks related to HPV.
You need to see a doctor if you observe any changes in your body or any symptoms that are unusual. This could include a new growth or lump in the genital or anal area, sometimes with pain or bleeding. If you come to know that your partner has HPV, you may ask the doctor if you can get the HPV testing for men and, also get guidance on whether the vaccine can be taken to reduce the risk of exposure6,13.
HPV cannot be taken lightly in men, as it may lead to cancer in some cases. The symptoms may not always be visible, but being aware, taking necessary precautions, getting vaccinated, and seeking medical advice can help you and your partner stay healthy and safe.
Frequently Asked Questions (FAQs)
How long does it take for symptoms to develop if I have HPV?
HPV symptoms do not appear immediately after getting infected with HPV. It may take weeks, months, or even years for signs to show up6.
If I have genital warts, will I have cancer?
Genital warts are usually non-cancerous. They are typically caused by low-risk HPV and resolve on their own. However, in case of persistent lesions, it’s best to consult your doctor. They will examine the lesion and advise HPV testing if needed1.
How can I protect my son from HPV?
HPV can cause genital warts and, in some cases, lead to cancers in the anus, penis, mouth, or throat, even in men. You may get your son vaccinated before the start of sexual activity. Consult your doctor to know more about the HPV vaccine and prevention strategies.
Can men be tested for HPV related cancer?
Yes, anal cancer screening through cytology may be advised for men at high risk, such as those who have sex with men or are HIV-positive. Regular checkups can help detect early signs6,8.
References
A. Garolla, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. Journal of endocrinological investigation. 2023 Sep 28;47(2):261–Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10859347/
Lenzi A, Mirone V, Gentile V, Bartoletti R, Ficarra V, Foresta C, et al. Rome consensus conference – statement; human papillomavirus diseases in males. BMC Public Health. 2013 Feb 7;13(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3642007/
Naidoo D, Govender K, Mantell JE. Breaking barriers: why including boys and men is key to HPV prevention. BMC Medicine. 2024 Nov 8;22(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11549739/
Giovannelli L, Migliore MC, Capra G, Caleca MP, Bellavia C, Perino A, et al. Penile, Urethral, and Seminal Sampling for Diagnosis of Human Papillomavirus Infection in Men. Journal of Clinical Microbiology. 2007 Jan;45(1):248–51. Available from: https://journals.asm.org/doi/10.1128/jcm.01576-06
Lechner M, Liu J, Masterson L, Fenton TR. HPV-associated oropharyngeal cancer: epidemiology, molecular biology and clinical management. Nature Reviews Clinical Oncology. 2022 Feb 1;19(19). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8805140/
Zou K, Huang Y, Li Z. Prevention and treatment of human papillomavirus in men benefits both men and women. Frontiers in Cellular and Infection Microbiology. 2022 Nov 24;12. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9729793/#s4
Kaur KN, Niazi F, Nandi D, Taneja N. Gender-Neutral HPV Vaccine in India; Requisite for a Healthy Community: A Review. Cancer Control. 2024 Jan 1;31. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11440547/
O’Mahony C, Gomberg M, Skerlev M, Alraddadi A, de las Heras‐Alonso ME, Majewski S, et al. Position statement for the diagnosis and management of anogenital warts. Journal of the European Academy of Dermatology and Venereology [Internet]. 2019 Jun 1 [cited 2021 Aug 9];33(6):1006–19. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593709/
Huang Y, Lan Y, Zhang Z, Xiao X, Huang T. An Update on the Immunotherapy for Oropharyngeal Squamous Cell Carcinoma. Frontiers in Oncology [Internet]. 2022 Mar 15 [cited 2024 Jan 27];12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965058/
Gallego LS, Dominguez A, Parmar M. Human Papilloma Virus Vaccine [Internet]. Nih.gov. StatPearls Publishing; 2024 [cited 2025 Jul 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562186/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Walking Pneumonia: What Is It, Causes, Symptoms, Diagnosis & Treatment
Introduction
Are you wondering what is walking pneumonia? Walking pneumonia or atypical pneumonia is an infection of the lower respiratory tract1. This condition is generally a milder form of pneumonia where the patient may be well enough to walk around, that’s why it’s called “walking pneumonia2”.
This type of pneumonia is usually acquired outside of hospital or healthcare settings and caused by pathogens that are not commonly associated with pneumonia and not easily detectable by common staining and culture methods1. The most common organisms associated with walking pneumonia include the bacteria Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumoniae3.
Bacterial atypical pneumonia comprises around 15% of the total pneumonia cases acquired outside of hospital and healthcare settings4.Although, usually these infections are not very severe, the mortality of walking pneumonia among the elderly is 8.0%, while in younger, healthy individuals, the mortality is 0.5-2.0%5.
What Is Walking Pneumonia?
Walking Pneumonia, scientifically referred to as atypical pneumonia, is a milder form of lung infection, often caused by Mycoplasma pneumoniae, that generally does not require hospitalisation.
As this pneumonia usually has a mild course , most affected individuals can still continue their routine without any interruption to your daily activities and hence, this condition is commonly referred to as walking pneumonia2. However, it is important to note that the severity of pneumonia can range from mild to life-threatening depending on factors such as age, the type of organism causing the infection, and when the walking pneumonia treatment is started1.
Causes of Walking Pneumonia
You may be wondering what causes walking pneumonia. Actually, walking or atypical pneumonia is caused by an invasion of bacteria (most commonly), and viruses or fungi (less commonly), that leads to inflammation of your air sacs or alveoli in your lungs1.
Bacteria: Bacteria such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumoniae are the most common causative organisms of atypical pneumonia3.
Viruses: Viruses such as the severe acute respiratory syndrome coronavirus 2 may cause atypical pneumonia3.
Fungi: Rarely, pneumonia may be caused by fungi, especially in individuals with a weak immune system6.
Walking pneumonia is typically acquired from the community (outside a hospital setting), most often by inhalation of respiratory secretions that contain the causative organism.
Types of Atypical Pneumonia
Based on what causes walking pneumonia, the different types of atypical pneumonia include:
Mycoplasma pneumonia: This condition generally affects children, adolescents and young individuals (typically 5-15 years), but it can occur at any age7,8. In individuals, it can cause a range of symptoms, from mild respiratory tract infections to severe atypical pneumonia9.
Chlamydia pneumonia: This condition can cause upper and lower respiratory tract infections causing symptoms such as headaches, tiredness, hoarseness of voice, fever, sore throat and cough that becomes worse over time10.
Legionnaire’s disease: This condition generally affects middle age and older individuals. It is more often noticed in individuals with a weak immune system or chronic illness and in smokers7. This infection mainly spreads by inhalation or aspiration of contaminated water (For example: showers, hot tubs, etc) The symptoms noticed include fever, muscle pain, headaches, shortness of breath, diarrhoea and cough11.
Q Fever: This condition is caused by the bacteria Coxiella burnetii which may present with symptoms such as fever, tiredness, muscle aches and chills. Q fever is often zoonotic (infection transmitted from animals to humans) and it is commonly noticed in individuals who work closely with animals or livestock. Individuals may get infected by inhaling dust contaminated with animal products and excreta such as faeces, urine and milk3,12.
Psittacosis: Less commonly noticed, this condition generally affects individuals in close contact with pet birds and poultry and is caused by the bacteria, Chlamydophila psittaci (formerly Chlamydia psittaci) which is a zoonotic atypical pneumonia. Common symptoms of psittacosis include headaches, fever, chills, dry cough and muscle pain3,13.
Signs and Symptoms
Though walking pneumonia is a mild infection, it does not always mean that you may be asymptomatic or fully functional. The walking pneumonia symptoms are generally mild and mainly include1,7:
Fever and chills
Shortness of breath
Dry cough that worsens at night
Sore throat
Headaches
Loss of appetite
Tiredness and low energy
Chest pain
Sweaty skin
Muscle pain and joint stiffness
Less common signs of walking pneumonia that may be noticed in the different types of walking pneumonia include7:
Mycoplasma pneumonia: Otitis media (Ear pain), cervical lymphadenopathy (lump in the neck), erythema multiforme (rashes), and conjunctivitis (eye pain and soreness)
Legionella pneumonia: Diarrhoea, vomiting, blood in mucous
Chronic medical conditions such as diabetes, heart or lung disease, chronic liver disease, etc.
Living in crowded settings
Smoking
Excessive alcohol consumption
You may pose an increased risk of developing specific types of atypical pneumonia if you are:
A child, teenager or an adult under 40 years of age (Risk factor for Mycoplasma pneumonia). Although it can occur in older adults, it is less common7.
Increased age, smoking, weak immune system, chronic lung disease and exposure to contaminated water (Risk factor for Legionella pneumonia)7 ,11.
In close contact with infected birds and poultry or exposure to bird droppings and secretions increase your risk of Psittacosis infection. (Risk factor for Psittacosis)13.
Is walking pneumonia contagious?
Yes, it is contagious and walking pneumonia symptoms can spread from person to person. However, infections caused by Legionella pneumonia and Coxiella burnetii (Q fever) are not spread from person-to-person1.
The most common type of walking pneumonia caused by Mycoplasma pneumonia is highly contagious and spreads through infected droplets of affected individuals especially when they cough and sneeze. The disease spreads when you inhale these infected droplets15.
Hence, close proximity with an infected individual over an extended period of time causes the spread of infection. The symptoms are generally noticed two to three weeks post exposure to the causative agent (Mycoplasma pneumonia). However, it is important to note that you may be contagious before any symptoms appear and generally, once infected, the contagious period is around 10 days and may be longer, if not treated15.
How is walking pneumonia diagnosed?
Your doctor will be able to diagnose walking pneumonia with certain examinations and laboratory tests such as7:
Chest X-ray: Your Chest X-ray may show patchy infiltrates which is a feature of atypical pneumonia. However, it cannot accurately distinguish between walking pneumonia and other pneumonias or respiratory conditions like bronchitis4.
Blood Tests: Based on the severity of your condition, your doctor may recommend laboratory tests such as:
Measurement of arterial blood gases: To check oxygen and carbon dioxide levels in blood (Used in cases where ventilatory failure or hypoxia is suspected)16.
Other blood tests: To identify the specific bacteria causing your illness.
Bronchoscopy (Tube with a camera is passed to your lungs): Only used when diagnosis is unclear, atypical presentations, or failure to respond to treatment.
Swab of nose or throat: To identify any bacteria and viruses
Sputum Culture: To identify specific bacteria causing your illness.
Urine Test: To help in the diagnosis of Legionella pneumonia.
Based on these tests, your doctor will be able to accurately diagnose your condition and will suggest the appropriate walking pneumonia treatment.
Treatment
After a careful assessment of your condition, your doctor will be able to suggest the best walking pneumonia treatment suitable for you.
Macrolide antibiotics: This is generally the first line of treatment to manage walking pneumonia. Macrolide antibiotics prescribed may include azithromycin and clarithromycin1.
The macrolide antibiotics may be combined with broad-spectrum medications including ceftriaxone, cefotaxime depending on the severity of your condition (particularly when both typical and atypical pathogens are suspected)1. If your condition is severe, your doctor may recommend antibiotics intravenously7.
Over-the-counter medications: Non-Steroidal Anti-Inflammatory Drugs or NSAIDs (such as aspirin, ibuprofen, naproxen) and cough medication may be effective in managing symptoms such as fever and cough7. However, in children, aspirin is not recommended.
Drink lots of fluid. This will help to loosen your secretions and bring up the phlegm7.
Delayed treatment in individuals suffering from Legionella or weakened immune systems can worsen treatment outcomes. While delayed treatment may not always lead to severe disease in cases of Mycoplasma infections, early treatment is key for good recovery and prognosis1,11.
Prevention
To reduce your risk of infection, you can follow these steps2,7:
Wash your hands regularly with warm water and soap.
Avoid close contact with individuals who are sick and wear a mask to reduce your risk of infection.
Exercise regularly and eat timely meals with a well-balanced diet.
Ensure that you get a flu vaccination every year to reduce your chance of infection.
If you have a weak immunity, it is recommended to avoid crowds.
Consult your doctor about pneumonia vaccination. Your doctor may suggest that you get vaccinated for pneumococcal pneumonia as it can help protect against Streptococcus pneumoniae, which causes a type of pneumonia not associated with healthcare settings.
To ensure good respiratory health, consult your doctor about DTaP/ Tdap Vaccination (Diptheria, tetanus and pertussis vaccine) as it helpful for your respiratory health.
By following these simple methods, you can avoid catching pneumonia especially if you are at high risk and protect your overall health2.
While individuals with walking pneumonia may be able to carry on with routine activities, certain self-care and hygiene measures can aid in a faster recovery. These include2,7,17:
Get adequate rest and sleep well.
Pay attention to your diet; choose food that is healthy for your heart and stay hydrated.
Quit smoking and avoid alcohol.
Do light exercise. (You doctor can suggest the appropriate regimen)
Practise deep breathing.
Take medications as advised by your doctor.
Keep a watch of your symptoms. If there is no improvement or there is worsening of symptoms even after taking antibiotics, contact your doctor immediately.
Remember, if you are walking around with pneumonia, it’s your responsibility to prevent its spread to others. Avoid any unnecessary contact with other individuals. Avoid going to public places and always cover your mouth while sneezing and coughing or wear a protective mask. Wash your hands with soap and water regularly. Following these simple measures can have a huge public health impact.
You should consult your doctor if you develop signs of walking pneumonia such as fever, shortness of breath, or cough. Your doctor will thoroughly assess your condition and will advise you on the best method to manage your condition.
You should also consult your doctor if you have been diagnosed with pneumonia and if your walking pneumonia symptoms get worse after an initial improvement7.
Walking pneumonia, or atypical pneumonia, is generally a mild respiratory infection commonly caused by atypical bacteria such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumoniae. While walking pneumonia symptoms are not very severe, it still requires proper medical care. With timely diagnosis, appropriate walking pneumonia treatment, and good hygiene, you can recover smoothly and avoid complications. Tips like handwashing, vaccinations, and avoiding smoking play a key role in reducing your risk and promoting your overall health.
Frequently Asked Questions (FAQs)
Can walking pneumonia recur after treatment?
Although not very common, walking pneumonia can recur after treatment. The chances of recurrence are increased if the infection is not completely removed with antibiotics or if you face any antibiotic resistance1.
What are the complications of walking pneumonia?
If not diagnosed and treated properly, complications may arise and may include brain and nervous system infections (such as meningitis, encephalitis), severe lung damage, haemolytic anaemia (a condition in which the body destroys its own red blood cells) and respiratory failure7.
Can walking pneumonia be detected on a regular physical exam?
Walking pneumonia may not be detected on a routine physical exam alone and your doctor may require a chest X-ray or other laboratory tests to confirm the diagnosis7.
Can I exercise if I have pneumonia?
Exercise may be beneficial in pneumonia. A study18 has shown lower mortality rate in elderly individuals having pneumonia who walk daily compared to individuals who did not walk or exercise in any other form. However, you doctor will guide you best if exercising or walking is suitable for you if you have pneumonia.
References
Stamm DR, Stankewicz HA. Atypical Bacterial Pneumonia [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532239/
Miyashita N. Atypical pneumonia: Pathophysiology, diagnosis, and treatment. Respiratory Investigation [Internet]. 2021 Nov;60(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34750083/
Dueck NP, Epstein S, Franquet T, Moore CC, Bueno J. Atypical Pneumonia: Definition, Causes, and Imaging Features. RadioGraphics [Internet]. 2021 Apr 9;41(3):200131. Available from: https://pubs.rsna.org/doi/full/10.1148/rg.2021200131
Bajantri B, Toolsie O, Venkatram S, Diaz-Fuentes G. Mycoplasma Pneumoniae Pneumonia: Walking Pneumonia Can Cripple the Susceptible. Journal of Clinical Medicine Research [Internet]. 2018 Dec 1;10(12):891–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225856/
Meyer Sauteur PM, Unger WWJ, Nadal D, Berger C, Vink C, van Rossum AMC. Infection with and Carriage of Mycoplasma pneumoniae in Children. Frontiers in Microbiology [Internet]. 2016 Mar 23;7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803743/
Levin KP, Hanusa BH, Rotondi A, Singer DE, Coley CM, Marrie TJ, et al. Arterial blood gas and pulse oximetry in initial management of patients with community-acquired pneumonia. Journal of General Internal Medicine. 2001 Sep;16(9):590–8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC1495269/
Ikeda T, Inoue S, Konta T, Murakami M, Fujimoto S, Iseki K, et al. Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People? Scientific Reports [Internet]. 2020 May 22;10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244731/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Pneumonia Diet: What to Eat & Avoid During Recovery
Introduction
Good nutrition plays a crucial role in helping the body recover from any illness, and pneumonia is no exception1,2. Studies2,3,4 show that undernutrition in children can significantly increase the risk of contracting pneumonia and worsen its outcomes, as a weakened immune system makes them more vulnerable to respiratory infections.
Pneumonia can spread through droplets, inhalation, or in newborns, through the bloodstream during or just after birth. Although it isn’t always contagious (as its spread depends on the cause), more research is needed to understand the transmission of pneumonia better2.
While precise numbers may vary, evidence consistently demonstrates that good nutrition can play a vital role in supporting pneumonia recovery5. In fact, targeted dietary interventions in malnourished older adults led to a 77% reduction in pneumonia-related hospital readmission, highlighting the importance of improved nutrition for recovery, immune function, and long-term management of pneumonia6.
If you’ve been diagnosed with pneumonia, adhering to your prescribed treatment plan, which typically includes antibiotics (for bacterial pneumonia only), and respiratory support is essential for recovery7. While it is not the primary treatment, a balanced, nutrient-rich diet can help promote the healing process by strengthening your immune system5,7. Additionally, monitoring your symptoms and maintaining good hygiene can help prevent the infection from spreading to others.
Following a nutritionally supportive diet during pneumonia helps ensure your body receives all the essential nutrients needed to fight the infection and recover quickly. In this article, we’ll share valuable tips on what to avoid during pneumonia recovery to help support a faster, safer, and more complete healing process.
How Diet Affects Pneumonia Recovery
A well-balanced nutritious diet plays a crucial role in recovering from pneumonia. When the body is fighting an infection, it needs extra nutrients to repair tissues, restore energy, and strengthen the immune system. A proper diet can support recovery from pneumonia by:
Promoting tissue repairand minimising muscle loss during illness8,9.
Improving energy levels andproviding the energy needed to combat fatigue8,10.
Supporting lung health and healing (with certain anti-inflammatory foods like omega-3 fatty acids)8,11.
Foods to Eat During Pneumonia
A balanced diet for pneumonia patients plays a crucial role in speeding up recovery by providing essential nutrients. In individuals with pneumonia, diet that includes the following five types of foods is beneficial:
Fruits and Vegetables: Foods like oranges and apples and vegetables like spinach, carrots, and broccoli are rich in vitamins, antioxidants, and fibre and help boost immunity and fight infections7,8,12.
Lean Proteins: Protein-rich foods for pneumonia, such as chicken, eggs, and legumes, help repair body tissues, support muscle strength, and help improve overall health7,10,12.
Whole Grains: Brown rice, oats, and whole wheat bread provide long-lasting energy and fibre to support digestive health7,10,12.
Healthy Fats (Monounsaturated and Polyunsaturated Fats): Good fats such as olive oils, walnuts, and avocados support the body’s anti-inflammatory processes and help in cell repair11,12.
Warm Fluids Like Soups, Broths, and Teas: Warm and easily digestible food for pneumonia, such as chicken soup or vegetable broth, herbal teas, and warm water with honey can soothe the throat, help in mucus clearance, and provide the much-needed energy13,14,15,16.
Foods to Avoid During Pneumonia
In patients with pneumonia, foods to avoid include certain food products that may increase mucus production. Here’s what to limit or avoid and why:
High-Sodium Foods: Processed meats, salty snacks, and canned soups might worsen respiratory distress in patients with compromised lung function due to fluid retention12,17.
Saturated Fats: Fatty meats, butter, full-fat dairy, and fried foods may contribute to inflammation, which can further impair lung function and the immune system in individuals with pneumonia12,18.
Added Sugars: Sugary beverages, desserts, and candy may suppress immune function and promote inflammation12,18.
Highly Processed Foods: Fast food, instant noodles, and ready-made sauces often contain unhealthy fats, excess sodium, and preservatives that might impair recovery12.
Alcohol: Alcohol may interfere with medications, weaken immunity, and slow healing. It’s best to avoid alcohol entirely during recovery12.
Note: Some people report increased mucus production after consuming dairy, but scientific evidence on this is inconclusive. Thus, the focus should instead be on avoiding foods that may impair immunity or promote inflammation. Always consult a doctor or a registered dietitian for personalised dietary advice, especially during illness.
The ideal diet for pneumonia patients includes warm fluids, soft foods, and meals high in vitamins A, C, and E to support lung health. You can follow the below-mentioned pneumonia diet chart to help with pneumonia recovery7,12:
Mealtime
Options
Breakfast
Mixed fruits (apple, grapes, prunes), A handful of almonds or sunflower seeds 100% fruit or vegetable juice
Mid-Morning Snack
Mixed fruits (apple, grapes, prunes), A handful of almonds or sunflower seeds, 100% fruit or vegetable juice
Lunch
Brown rice or whole-grain bread, Stir-fried tofu or lean turkey with kale, Mixed legume soup, Steamed carrots or beans
Afternoon Snack
Brown rice or whole grain roti, Steamed vegetables (carrot, broccoli, spinach) Grilled salmon or skinless chicken, Low-fat yoghurt
Dinner
Brown rice or whole-grain bread, Stir-fried tofu or lean turkey with kale, Mixed legume soup Steamed carrots or beans
Tip: Stay hydrated by consuming plenty of water throughout the day.
A pneumonia diet chart helps plan meals that are light, nutritious, and rich in essential vitamins to support better health. Along with dietary guidance, adopting a few lifestyle tips can further speed up the healing process:
Practice Deep Breathing: Perform several deep breathing exercises daily to help improve lung function.
Prioritise Rest and Sleep: Ensure you get ample sleep to allow your body to strengthen and repair your immune system.
Maintain Good Posture: Sit upright to enhance comfort and facilitate easier breathing.
Stay Hydrated: Drink plenty of fluids throughout the day to maintain good hydration, which is crucial for recovery.
Engage in Light Physical Activity: Gradually incorporate gentle movement into your routine to rebuild strength. However, avoid strenuous activity that causes dizziness or significant shortness of breath; consult your doctor for guidance on appropriate activity levels.
Avoid Smoking and Second-hand Smoke: Refrain from smoking and avoid exposure to second-hand smoke (inhaling smoke from being near people who are smoking), as both can worsen pneumonia.
Limit Alcohol and Illicit Drug Use: Steer clear of alcohol and illegal drugs, as they can compromise your immune system and increase the risk of complications12.
Choosing the right diet for a pneumonia patient may help reduce inflammation and support lung function. Nutrient-rich foods that may support recovery include warm soups, fruits rich in vitamin C, and leafy green vegetables. Additionally, knowing which foods may hinder recovery or worsen inflammation can help prevent complications and promote faster healing.
By providing essential nutrients, staying hydrated, getting adequate rest, and avoiding harmful substances like tobacco smoke and alcohol, you can support your immune system and significantly enhance your healing process. Also, staying up to date with vaccines, especially the pneumococcus vaccine and the flu vaccine, can help reduce the risk of developing pneumonia or experiencing severe complications.
How much fluid should a pneumonia patient drink daily?
A pneumonia patient should aim for at least 1.5 litres of fluids per day unless advised otherwise by a doctor17,19. Staying hydrated helps thin mucus and ease coughing.
Can pneumonia patients take supplements like vitamin C?
Yes, supplements like vitamin C may help strengthen the immune response18,20. However, they should be taken under medical supervision, especially if the patient is already on medication.
Can pneumonia patients eat outside or restaurant food?
It’s best to avoid restaurant food during recovery, as it may contain excess salt, sugar, oil, and preservatives. Home-cooked, hygienic, and freshly prepared food is safer and more nourishing for pneumonia patients7.
Are herbal teas helpful for pneumonia?
Yes, warm herbal teas like black tea, green tea, peppermint tea, sage tea, and thyme tea can soothe the throat, reduce coughing, allow mucus clearance, and may boost the body’s anti-inflammatory processes16.
Srivastava AD, Awasthi S, Jauhari S. Prevalence of persistent pneumonia among severe pneumonia and nutritional status as its associated risk factor: A prospective observational study among under-five children. J Family Med Prim Care. 2024 May;13(5):1911-1916. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11213408/
Vu TT, Van Horn L, Achenbach CJ, Rydland KJ, Cornelis MC. Diet and Respiratory Infections: Specific or Generalized Associations? Nutrients. 2022 Mar 11;14(6):1195. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8954090/
Yang PH, Lin MC, Liu YY, Lee CL, Chang NJ. Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial. Int J Environ Res Public Health. 2019 Nov 27;16(23):4758. Available from : https://pmc.ncbi.nlm.nih.gov/articles/PMC6926802/
National Heart, Lung, and Blood Institute. Pneumonia Recovery [Internet]. National Heart, Lung, and Blood Institute; [cited 2025 Jun 10]. Available from: https://www.nhlbi.nih.gov/health/pneumonia/recovery
Office of Dietary Supplements. Dietary Supplements for Immune Function and Infectious Diseases – Health Professional Fact Sheet [Internet]. National Institutes of Health; [cited 2025 Jun 10]. Available from: https://ods.od.nih.gov/factsheets/ImmuneFunction-HealthProfessional/
Katagiri R, Yamaji T, Sawada N, Iwasaki M, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group. Total, animal, and plant protein intake and pneumonia mortality in the Japan Public Health Center-based Prospective Study. Am J Clin Nutr. 2022 Mar 4;115(3):781-789. Available from: https://pubmed.ncbi.nlm.nih.gov/34918031/
Masters B, Aarabi S, Sidhwa F, Wood F. High-carbohydrate, high-protein, low-fat versus low-carbohydrate, high-protein, high-fat enteral feeds for burns. Cochrane Database Syst Rev. 2012 Jan 18;1(1):CD006122. Available from: https://pubmed.ncbi.nlm.nih.gov/22258965/
Alperovich M, Neuman MI, Willett WC, Curhan GC. Fatty acid intake and the risk of community-acquired pneumonia in U.S. women. Nutrition. 2007 Mar;23(3):196-202. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2293281/
PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. Selected Vegetables/Sun’s Soup (PDQ®): Health Professional Version. 2018 Aug 24. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. [cited 2025 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65862/
Abuelgasim H, Albury C, Lee J. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evid Based Med. 2021 Apr;26(2):57-64. Available from: https://ebm.bmj.com/lookup/pmidlookup?view=long&pmid=32817011
Hacioglu M, Dosler S, Birteksoz Tan AS, Otuk G. Antimicrobial activities of widely consumed herbal teas, alone or in combination with antibiotics: an in vitro study. PeerJ. 2017 Jul 26;5:e3467. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5533155/
Brown RB. Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19. Medicina (Kaunas). 2021 Jul 22;57(8):739. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8399536/
Kiecolt-Glaser JK. Stress, food, and inflammation: psychoneuroimmunology and nutrition at the cutting edge. Psychosom Med. 2010 May;72(4):365-9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2868080/
Hooper L, Abdelhamid A, Ajabnoor SM, et al. Effects of fluid and drinking on pneumonia mortality in older adults: A systematic review and meta-analysis. Clin Nutr ESPEN. 2022 Feb;47:96-105. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8631606/
Padhani ZA, Moazzam Z, Ashraf A, et al. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database Syst Rev. 2020 Apr 27;4(4):CD013134. doi: 10.1002/14651858.CD013134.pub2. Update in: Cochrane Database Syst Rev. 2021 Nov 18;11:CD013134. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7192369/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
3
Human Papillomavirus (HPV): What Is It, Causes, Symptoms, and Prevention
Introduction
Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) prevalent globally. This virus primarily affects the skin and mucous membranes of the genital area, mouth, and throat, causing asymptomatic infections or growths called as warts. While most HPV infections resolve on their own without medical intervention, persistent infection with certain high-risk strains can lead to serious health issues, including certain cancers such as cervical, oropharyngeal (tonsils, base of tongue), anal, and penile cancers1,2.
In India, HPV-related cancers pose a significant public health challenge. Projections for 2025 estimate approximately 121,302 new HPV-related cancer cases, accounting for 7.7% of the total cancer burden in the country (3.3% among males and 12.0% among females).3 Therefore, understanding the causes, symptoms, and prevention methods for HPV infections is crucial for reducing the risk of diseases caused by this virus and promoting public health. In this article, we will discuss what is HPV, and why is it something we should all be aware of!
What is Human Papillomavirus (HPV)?
HPV belongs to a group of small, non-enveloped, double-stranded DNA viruses known as papillomaviruses. It mainly infects the basal cells of the skin or mucous membranes, usually entering through tiny cuts or tears on the surface3.
Once inside the basal layer of the skin (stratified squamous epithelium), the virus begins its life cycle. As the infected skin cells mature and move toward the surface, HPV replicates along with them.
In some cases (especially with high-risk types like HPV 16 and 18) the virus can interfere with normal cell functions. These high-risk types may integrate with the DNA of host cells, leading to the continuous production of proteins that block the body’s natural control over cell growth. Over time, this uncontrolled cell growth can lead to cancer, such as cervical cancer.
On the other hand, low-risk HPV types (like types 6 and 11) are not linked to cancer occurrence, though they can cause conditions like genital warts3.
Scientists have made major progress in understanding HPV, especially through genetic research, but there is still more to learn about how the virus behaves and changes over time4.
Types of HPV
There are over 200 types of HPV viruses, and they are classified based on where they infect and the level of risk they pose. These types are broadly divided into:
1. Non-mucosal Infection Site
These infect the skin rather than the mucosal (tissue lining of organs) areas5,6,7:
These infect the mucosal (tissue lining of organs) areas and are classified into two types:
Low-risk HPV types: These conditions are non-cancerous but can be recurrent or obstructive and may require ongoing medical treatment:5,6,7
Genital warts and respiratory papillomatosis (e.g., HPV types 6 and 11)
Other low-risk HPV types include 40, 42, 44, 54, 55, 61, 62, 71, 74, 81, 84, 89, and 90.
High-risk HPV types: These types can cause pre-cancerous changes and cancers, especially5,6,7:
Cervical cancer (mostly caused by HPV types 16 and 18). These types are also linked to anal, vaginal, vulvar, penile, and throat cancers
Other high-risk HPV types include HPV 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, and 82.
Causes of HPV
The HPV virus is mainly spread when a healthy person comes in direct contact with an infected person. Common human papillomavirus causes/modes of transmission include:
Skin-to-skin contact (especially genital-to-genital contact, even without intercourse or ejaculation).It is important to note thatHPV can spread through contact with infected genital, anal, or oral areas, even if there is no penetrative sex.
Having multiple sexual partners (which increases the exposure risk)5
Early age of sexual activity (linked to longer lifetime exposure)5
Weakened immune system (makes the body more susceptible to infection)8
Transmission from mother to baby during childbirth (rare)5. This is known as vertical transmission, and in some cases, it can lead to a condition called juvenile-onset recurrent respiratory papillomatosis (JORRP) in the newborn, where non-cancerous growths develop in the airways.
HPV is mostly transmitted sexually, in very few instances it is non-sexual for example when an infected person shares certain personal items ( like towel etc.). In such cases educating masses on maintaining personal hygiene is of paramount importance.
In most cases, human papillomavirus infection causes no symptoms and goes unnoticed, especially in the early stages. However, in some cases, HPV symptoms may appear due to wartsorlong-term complications of persistent infection:
Small, rough, lump-like growths (called genital warts) on or around the genitals, anus, groin, or thighs.1,8
Itching or irritation in the genital or anal area may occur if warts are present, however, this is not specific to HPV and could be caused by other skin problems or STIs1.
Note: Vaginal or anal bleeding may occur in advanced cervical/anal disease; however, this is not an early or direct symptom of HPV itself.
Complications of HPV
HPV can lead to several serious health complications, particularly when caused by high-risk strains of the virus. While many human papillomavirus infections are asymptomatic and clear on their own, persistent infections can result in the following complications:
Genital Warts: These growths are non-cancerous, but they can recur due to persistence or reactivation of the virus1.
Recurrent Respiratory Papillomatosis (RRP): A rare condition where warts grow in the respiratory tract, particularly the larynx (voice box), leading to breathing difficulties9.
Cervical Cancer: Almost all cervical cancer cases (over 99%) are linked to persistent infection with high-risk HPV types10.
Other Cancers: Oropharyngeal cancers (including tonsil and base of tongue),anal cancer, vaginal and vulvar cancers (in women), penile cancer (in men)7,8.
Diagnosis and Testingfor HPV
Since human papillomavirus infections are often asymptomatic, routine screening and specific diagnostic tests are essential, especially for women. While there is no general screening test for HPV in men, several tests can help identify HPV-related complications in both sexes. Common methods of HPV diagnosis include:
Visual Inspection: Doctors may examine visible warts during a physical exam. In some cases, acetic acid (vinegar) may be applied to highlight mucosal lesions, such as cervical or anal abnormalities to detect areas that may require further evaluation2.
Biopsy and Histopathological Examination: Cells of warts may be examined under a microscope to confirm HPV involvement and rule out any other cause2.
Pap Test (Pap Smear): This test checks for abnormal changes in cells that may develop into cancer. It includes Pap smears for the cervix and anus and can be done in both men and women2,8.
HPV DNA Test: This test detects the presence of high-risk HPV types in cervical cells and is commonly used alongside the Pap test to assess the risk of cervical cancer. While HPV DNA testing can also be done on anal cells, it is not part of routine screening and is typically used in research settings or high risks groups2,4.
Colposcopy: A follow-up diagnostic procedure using a colposcope to closely examine the cervix, vagina, or anus for abnormal areas after an abnormal Pap or HPV test result2.
Treatment and Management for HPV
There is currently no cure for human papillomavirus infection itself, but various treatment options are available for HPV-related conditions, including genital warts and HPV-associated cancers.
Warts
Warts caused by HPV can be managed using various methods, depending on their location, size, and the patient’s immune response. However, it’s important to note that there is no antiviral cure to eliminate the HPV virus itself. Most HPV infections are cleared naturally by the immune system within 1 to 2 years. Treatment focuses on removing visible warts and relieving symptoms, not eradicating the virus. Common treatment options include2,4:
Cryotherapy: Freezing the wart tissue using liquid nitrogen.
Laser therapy: Using focused light to destroy wart tissue.
Surgical removal: Physically excising the warts, typically in cases where other treatments are ineffective.
HPV-Related Cancers
If HPV infection progresses to cancer (such as cervical, anal, vulvar, penile, or mouth cancer), management involves2:
Surgical removal of the tumour
Radiotherapy
Chemotherapy therapy
Note: HPV-positive cancers, especially oropharyngeal cancers, generally have a better prognosis and may respond differently to therapy, which can influence treatment planning.
Prevention Steps
While HPV is a quite common virus, several steps can significantly reduce the risk of infection and its complications. These measures include:
1. Getting Vaccinated
The HPV vaccine is the most effective way to avoid infection from the most harmful types of HPV virus, including those that cause genital warts and cancer. It is ideally given before the onset of sexual activity, typically recommended for children aged 9 to 14, with a 2-dose schedule. Older individuals (aged 27 to 45) may also benefit from vaccination based on risk factors and in consultation with their doctor11.
HPV vaccine should be taken by all boys as well as girls. Talk to your doctor about the right age to take vaccine for your daughter/sister/ wife.
Using condoms and protection during vaginal, anal, and oral sex also helps to reduce the risk of HPV transmission1. Additionally, limiting the number of sexual partners can also decrease the risk of exposure.
3. Getting Regular Health Screenings
Routine cervical cancer screening is recommended for women aged 21 to 65 years. This includes a Pap test every 3 years, or for women aged 30 and above, a combination of Pap test plus HPV co-testing every 5 years12. These screenings help detect early abnormal cell changes caused by HPV, allowing for timely intervention and prevention of cervical cancer.
4. Educating Yourself and Others
Increasing awareness about HPV transmission, symptoms, and prevention methods helps reduce stigma and encourages initiative-taking healthcare. Parents should also be informed about the benefits of HPV vaccination for their children.
Human papillomavirus causes an cause warts and serious cancers, but most infections have no symptoms and clear on their own. Therefore, understanding what HPV is, what are the common HPV symptoms, and how to protect yourself through vaccination, testing, and awareness, are key to preserving long-term health and reducing the risk of serious complications.
Vaccines protect against the high-risk cancer-causing types (like HPV 16 and 18) and some low-risk types that cause warts (like 6 and 11), but they do not treat existing infections. Additionally, regular testing helps detect early changes caused by HPV for timely treatment. Together, vaccination, testing, and awareness are key to reducing HPV-related health problems and protecting public health.
It can take several years, often 15 to 20 years, for a persistent HPV infection to develop into cancer1.
What are the risk factors for acquiring HPV?
Several factors can increase the risk of HPV infection, including early age at first sexual intercourse, having multiple sexual partners, smoking, long-term use of oral contraceptives (over 5 years), chewing betel nut, and exposure to radiation or ultraviolet (UV) light4.
Can HPV be cured?
There is no cure for the virus itself, but most infections clear naturally. Treatments are available for warts and precancerous changes2.
How is HPV different from other STIs?
HPV is unique because many infections cause no symptoms and clear on their own, but some types can lead to cancer, unlike many other STIs1.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. Lyon (FR): International Agency for Research on Cancer; 2007. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 90.) 1, Human Papillomavirus (HPV) Infection. Available from: https://www.ncbi.nlm.nih.gov/books/NBK321770/
Ramamoorthy T, Sathishkumar K, Das P, Sudarshan KL, Mathur P. Epidemiology of human papillomavirus related cancers in India: findings from the National Cancer Registry Programme. Ecancermedicalscience. 2022 Sep 7;16:1444. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9666279/
Mlynarczyk-Bonikowska B, Rudnicka L. HPV Infections-Classification, Pathogenesis, and Potential New Therapies. Int J Mol Sci. 2024 Jul 11;25(14):7616. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11277246/
Mlynarczyk-Bonikowska B, Rudnicka L. HPV Infections-Classification, Pathogenesis, and Potential New Therapies. Int J Mol Sci. 2024 Jul 11;25(14):7616. Available from: https://pmc.ncbi.nlm.nih.gov/articles/pmid/39062859/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
