Pneumonia: Know the Symptoms & How to Treat
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What is pneumonia?
Pneumonia is an infection that causes inflammation in your lungs. Specifically, it causes the air sacs in one or both of your lungs to become inflamed. This causes a cough, chest pain, and a fever.
Pneumonia is caused by a virus or a bacteria. It often develops after having an illness like the flu, or other virus.
Bacterial pneumonia can be treated with antibiotics. You’ll usually feel better within a few days of taking medication.
Viral pneumonia can’t be treated with antibiotics.
Both bacterial and viral infections can take anywhere from a few weeks to a few months before you’re fully recovered.
A common misconception is that pneumonia is a “bad cold.” Although the initial symptoms may be similar, pneumonia is an infection of the lungs. If not recognized early, it can be serious and lead to death. Particularly in those that are really young or old, as well as those with significant medical problems. —Dr. Chandra Manuelpillai
The most common symptoms are fever (temperature above 100.4 F) and cough.
Some people may also have trouble breathing, wheezing, chest pain, exhaustion, or headache. Usually, you’ll also notice mucus with the cough.
The mucus clogs the lungs. It can lead to symptoms similar to bronchitis, and allergies.
Other symptoms you may have
- Body aches
How is pneumonia caused?
Pneumonia is an inflammation in the air sacs of one or both of your lungs. It happens when you have a viral or bacterial infection that moves into your lungs. The air sacs may fill with fluid or pus, which causes the coughing and chest symptoms.
You catch pneumonia when you’re exposed to the infection, usually from infected droplets that have settled on a surface.
Treatment for pneumonia
Technically there isn’t a classification of “walking” pneumonia in medicine. It is used to label less severe pneumonia that you feel well enough to walk around despite being sick. —Dr. Manuelpillai
You may be admitted to the hospital if you have trouble breathing, low oxygen levels, dehydration, can’t tolerate oral medications or fluids, or have other concerning symptoms.
If your pneumonia is a bacterial infection, your doctor will prescribe antibiotics.
Otherwise, treatment involves taking care of the symptoms.
- Take acetaminophen or ibuprofen to control fever and pain.
- Take cough suppressant (for adults only, as they’re not safe and effective in children).
- Children older than 1 years old can be given honey for coughing. Do not give to younger children as honey may contain a bacteria that can cause infant botulism.
- Take antihistamines and decongestants to clear stuffy noses.
- Drink fluids like water and tea, soup, etc. Children will often benefit from frequent, small amounts of fluid.
- Use a humidifier in the bedroom or steam from a hot shower.
- Cough lozenges (do not give to children or elderly with choking risk).
- Plenty of rest.
Pneumonia in children
Symptoms and treatment depend on how old your child is and if they have any risk factors.
Newborns and infants (less than 1 year old) will usually have a fever. Instead of a cough, they will look like they are working harder to breathe. You may see the skin pull in between the ribs, under the collar bone, or under the diaphragm (under the bottom ribs). Also grunting noises, flaring of the nostrils, or cyanosis (blue discoloration particularly in the lips or nail beds).
Toddlers and young children may start with a runny nose, are less active, and may not want to eat or drink. Then, they usually develop a cough and fever. It’s important to keep in mind that allergies and aspirating (inhaling into lungs) a non-edible object both have similar symptoms.
- Working hard at breathing
- Poor appetite
- Less active
Severe or concerning symptoms that require immediate attention
- Cyanosis (blue discoloration particularly in the lips or nail beds)
- Dehydration (dry lips, not making tears, no wet diapers, fast heartbeat)
- Slow to respond or not very alert
If your child has any of the “severe or concerning” symptoms listed above, call 911 immediately. If they just have the other symptoms, call your child’s pediatrician or go to urgent care. If your child has any of the risk factors below, call your pediatrician to determine if you should see them, go to urgent care (preferably one that can do chest X-rays, or go to the ER, but, if there is a delay in reaching your pediatrician, go to the ER.
Treating pneumonia in children depends on the type of pneumonia, the child’s age, risk factors, and how bad the symptoms are. They may be hospitalized or you may be able to treat at home.
Factors that make children more susceptible to pneumonia
- Being less than 6 months old, but particularly less than 2 months and/or if born prematurely.
- Having an underlying disease: heart/lung disease, metabolic disorder.
- Weakened immune system: from a cancer, receiving chemotherapy or radiation, chronic steroid use, transplant, sickle cell disease, or HIV.
- Being exposed to tobacco smoke.
- Attending daycare.
- Having a recent hospital admission.
- Having close sick relatives.
- Not being up-to-date on immunizations.
- Children who have poor nutrition (malnourished) are also at increased risk.
- Already have respiratory syncytial virus (RSV) or influenza (common flu).
Pneumonia in older adults
People over 65 years old are at a higher risk for more serious infections in general, including pneumonia. This is because the immune system becomes less effective naturally as we get older. Plus, often there are other medical issues that make infections like pneumonia worse.
If you live in a nursing home or other facility, you are more likely to be around people who may be sick and contagious.
Adults who are much older or have had a stroke may not be able to cough strongly and are at risk for choking. If you have difficulty swallowing or increased chance of choking, you are more likely to either inhale saliva or food contents into your lungs. This can result in inflammation and/or infection. Also, since you may also have difficulty coughing, it is difficult to expel mucus from inflammation, which also increases your risk of infections.
Symptoms of pneumonia in older adults
Older adults with pneumonia may not have the typical symptoms of fever and cough. Sometimes the only symptom is confusion or other behavioral changes. Sometimes you may only have one symptom below, which can easily be confused with another illness:
- High or low body temperature (above or below 98.6°F)
- Difficulty breathing
- Chest pain
- Altered state of mind (less responsive, hallucinations, delirium)
What makes you more likely to have pneumonia?
It is important to talk to your doctor about your risks of developing pneumonia and which vaccines will help protect you from it. —Dr. Manuelpillai
You’re most at risk for pneumonia if you:
- Are older than 65 years old or less than 6 months old, but particularly less than 2 months and/or born preterm.
- Close contact with someone who is sick.
- Use tobacco or are exposed to second-hand smoke.
- Use drugs or chronic alcohol use.
- Recently hospitalized.
- Have underlying medical issues, like asthma, chronic obstructive pulmonary disease (COPD), heart disease, diabetes, cystic fibrosis, renal disease, sickle cell disease, asplenia, tuberculosis risk factors, or the flu.
- Are immunocompromised, such as having HIV, receiving chemotherapy or radiation, regularly taking steroids, had a transplant, or have sickle cell disease.
Go to the ER or call 911 if you have severe difficulty breathing, feel dizzy, your heart is racing, or you are vomiting. Call 911 immediately if you see blue discoloration anywhere on your skin, lips, or nails (sign of oxygen deprivation, or cyanosis), experience chest pain, or have any other serious symptoms.
Otherwise, call your doctor or go to an urgent care facility.
Bacterial infections usually get better after a few days of being on antibiotics. However, it is very important to finish the antibiotics as prescribed by your doctor even if you feel better. This keeps symptoms from coming back.
The worse your pneumonia is, the longer symptoms will last. Once the infection is treated, symptoms like a cough and trouble breathing may linger for weeks or even months. This is especially true when your infection is viral.
Don’t use tobacco and try to avoid being around smoke. Make sure you’re drinking a lot of fluid and resting. You should not return to work until you no longer have a fever and trouble breathing.
Since pneumonia is spread by droplets, it is very important to wash your hands for 20 seconds often. If someone you know has pneumonia, they should wear a mask and/or cover their cough (ideally by coughing into their elbow).
Since having the flu increases your risk of getting pneumonia, getting an annual flu shot will help. Getting other recommended vaccines for children and the pneumococcal pneumonia vaccine (Pnemovax) for adults 65 and older and those at increased risk of pneumonia can help.
Dr. Manuelpillai is a board-certified Emergency Medicine physician. She received her undergraduate degree in Health Science Studies from Quinnipiac University (2002). She then went on to graduated from Rosalind Franklin University of Medicine and Sciences/The Chicago Medical School (2007) where she served on the Executive Student Council, as well as was the alternate delegate to the AMA/ISMS-MSS Governing Council and the student representative to the Illinois State Medical Society (ISMS) Education and Health Workforce committee. She completed an internship year with UCLA-Harbor Medical Center's Department of Internal Medicine followed by an emergency medicine residency program at Boston Medical Center (2011) while also serving as the resident representative to the Massachusetts Medical Society (MMS) committee on Student Health & Sports Medicine. She then started working at Saints Medical Center (later Lowell General Hospital/Saints Campus and Main Campus) in Lowell Massachusetts where she served as the Continuous Quality Improvement Director for the emergency medicine group, as well as was the representative for the emergency department on the Sepsis, Stroke and PCI Quality Assurance and Compliance Committees. She joined Buoy Health in 2019. She currently works in multiple emergency departments both in the community and academics, as well as previously worked in multiple urgent care centers. She believes this mix of experiences has given her a unique perspective on the care of acute illnesses.