Pneumonia

Pneumonia is an infection of the lungs that can affect anyone, from young children to older adults. However, many factors can increase your chances of getting sick and having a more severe illness.

At Banner Health, we are here to help you understand pneumonia and make smart decisions about your respiratory health. Whether you’re seeking information for yourself or a loved one, we have you covered.

What is pneumonia?

Pneumonia is an infection that affects one or both of your lungs. When you have pneumonia, the tiny air sacs (alveoli) deep inside your lungs swell and fill with fluid or pus.

The swelling makes it difficult for the air sacs to hold air. It also creates a wall between the air in the sacs and the blood vessels surrounding them. This can make it difficult to breathe and cause other problems.

What causes pneumonia?

Pneumonia can be caused by a variety of bacteria, viruses and fungi in the air we breathe. The main types of pneumonia include:

• Viral pneumonia: This form of pneumonia is caused by viruses, including the common cold, flu (influenza), COVID-19 and respiratory syncytial virus (RSV).
• Bacterial pneumonia: This type of pneumonia is caused by various bacteria, most often Streptococcus pneumoniae. Bacterial pneumonia usually happens when the body is weak, such as from a recent illness or old age.
• Fungal pneumonia: Fungi such as Cryptococcus or Pneumocystis jirovecii may cause pneumonia, especially in people with weak immune systems.
• Mycoplasma pneumonia (walking pneumonia): Also called atypical pneumonia, this type is caused by the bacterium Mycoplasma pneumoniae. This illness is often mild enough to go undetected, which is why it’s sometimes called walking pneumonia.

Who is most at risk for pneumonia?

Anyone can get pneumonia. However, certain factors can increase your risk:

• Age: Very young children (under 2) and older adults (over 65) have higher risks due to weak immune systems.
• Underlying health conditions: Several chronic medical conditions can increase your risk for pneumonia. These include:
  • Asthma
  • COPD (chronic obstructive pulmonary disease)
  • Cystic fibrosis (CF)
  • Diabetes
  • Emphysema
  • Heart disease
  • HIV/AIDS
  • Tuberculosis (TB)
• Weak immune system: Heavy alcohol use, taking certain medications and undergoing chemotherapy or an organ/bone marrow transplant can weaken the immune system.
• Smoking: Smoking damages the lungs’ defenses, making them vulnerable.
• Hospitalizations: You can get hospital-acquired pneumonia while in a hospital for a procedure or another illness. Using a ventilator can raise your risk as well.
• Community living: Health care-associated pneumonia is the second most common cause of infection among nursing home and long-term care facility residents.
• Aspiration: Inhaling food, liquids or vomit into the lungs can lead to aspiration pneumonia.

What are the symptoms of pneumonia?

The symptoms of pneumonia vary depending on the type of pneumonia, how severe it is and your age.

Symptoms in adults:

• Cough (an ongoing cough that may bring up phlegm or mucus)
• High fever (fever of 105°F (40.5°C))
• Shortness of breath (difficult breathing, especially during physical activity or when lying down)
• Chest pain (especially when it worsens with coughing or deep breathing)
• Fatigue (feeling unusually tired and weak)
• Rapid heart rate
• Sweating or body chills
• Bluish lips or fingernails (lips or nails may turn blue due to lack of oxygen)

Symptoms in young children:

• Cough
• High fever
• Fast and/or difficult breathing
• Irritability or crying more than usual
• Lack of energy or more tired than usual
• Chest pain
• Stomach aches or pains
• Loss of appetite or difficulty feeding

Symptoms in adults over age 65

Symptoms of adults over age 65 may be mild or less noticeable. Older adults with pneumonia may suddenly get confused, have low appetite or have decreased energy.

When should I see a health care provider and when should I call 911?

Call your health care provider if you develop new or worsening symptoms of pneumonia. Go to the emergency department or call 911 if it’s hard to breathe, you experience new or worsening chest pain and/or if you are confused or can’t think clearly.

Is pneumonia contagious?

Pneumonia can be contagious, depending on the underlying cause of the infection.

Bacterial and viral pneumonia can spread from person to person through tiny droplets that are made and passed along when an infected person coughs or sneezes.

Pneumonia caused by factors like aspiration (when food, liquids or other substances enter the lungs) is not contagious.

How is pneumonia diagnosed?

Your health care provider will perform a physical exam, carefully review your medical history and ask you questions about any recent illnesses or surgeries.

They may also order the following tests to confirm the diagnosis:

• Chest X-ray to look for inflammation (swelling) in your lungs
• Blood tests to see if your immune system is fighting an infection
• Sputum culture (spit test) to find out what germ is causing your illness
• Pulse oximetry to check oxygen levels in your blood
• Bronchoscopy to look inside your airways

A CT scan may be ordered to get a clearer picture of your lungs and assess the infection.

How is pneumonia treated?

The treatment of pneumonia depends on the cause, how severe the infection is, your overall health and any underlying medical conditions.

Here is an overview of how pneumonia is generally treated:

• Antibiotics: Bacterial pneumonia is often treated with antibiotics (such as penicillin, amoxicillin, azithromycin and others), based on the bacteria causing your infection or your sensitivity to different antibiotics.
• Antifungal medications: Antifungal drugs (such as fluconazole and voriconazole) may be used, depending on the type of fungal infection.
• Antiviral medications: Pneumonia caused by the flu or other viruses cannot be treated by antibiotics. However, if you are at high risk for serious illness, your provider may prescribe antivirals (such as Tamiflu) to shorten how long you are sick from the virus.
• Oxygen therapy: You may need extra oxygen if you have low oxygen levels in your blood.
• Respiratory therapy: Breathing treatments such as nebulized (a fine mist that can be breathed in) medications may help open airways and improve breathing.
• Supportive care: This includes drinking lots of fluids, getting plenty of rest, and using over-the-counter (OTC) medications to lower fever and help you feel better.

If you have a serious case of pneumonia or any complications, you may need to stay in the hospital for treatment. It can take six to eight weeks to feel back to normal if you’ve been hospitalized with pneumonia.

What are the possible complications of pneumonia?

Most people do well with treatment, but pneumonia can be very serious and even deadly. Those who are more likely to have complications are over age 65, under the age of 2, have a weak immune system or have a serious medical condition.

Complications may include:

• Acute respiratory (breathing) distress syndrome or respiratory failure (not breathing at all)
• Lung abscesses (pockets of pus that form inside or around the lung)
• Sepsis (bacteria in your bloodstream) 
• Pleural effusion (fluid around your lungs)

Ways you can prevent pneumonia

A few easy steps can help you avoid getting pneumonia. These include:

• Vaccination: Vaccines are very effective in preventing certain types of pneumonia. The most important vaccines are:
  • Pneumococcal vaccine: Protects against the most common cause of bacterial pneumonia
  • Influenza (flu) vaccine: Get an annual flu shot to stop the possible complications of the flu, including pneumonia
• Good hygiene practices: Wash your hands regularly with soap and water, avoid close contact with people who are sick and cover your mouth and nose with a tissue or elbow when you cough or sneeze.
• Healthy lifestyle: Eat a healthy diet with lots of fruits and vegetables, whole grains and lean proteins to support your immune system. Exercise regularly to keep your lungs and body strong.
• Avoid smoking and secondhand smoke: Smoking damages the lungs’ natural defenses and makes it easier for you to catch respiratory infections. You should also avoid secondhand and thirdhand smoke as much as you can.
• Planning around a weakened immune system: Work with your health care provider to make a plan to reduce your risk of infections, especially during cold and flu season.