Ilia Jbankov, FNP-BC
More than three million cases of pneumonia are diagnosed each year in the U.S. About one million of those cases need to be treated in the hospital, and around 50,000 cases become fatal. Pneumonia is the leading infectious cause of death in developed countries.
What Is Pneumonia?
Pneumonia is an infection of one or both of your lungs. Pneumonia is caused by different types of microbes including viruses, bacteria, or fungi. Pneumonia causes fluid to build up in the air sacs—also known as alveoli—of the lungs, which can make breathing difficult. The severity of pneumonia can vary, including infection of a small part of one lung in some people to affecting both lungs in others.
Symptoms of pneumonia may include:
- Productive cough (wet cough)
- Green, yellow, or rusty sputum
- Chest discomfort or chest pain
- Changes in breathing including trouble breathing, rapid breathing, or shortness of breath
- Fever, chills, and sweats
- Rapid heart rate
- Fatigue and weakness
- Body aches and malaise
- Change in skin color
- Altered mental status or confusion
What Are the Risk Factors?
Anyone can get pneumonia regardless of age, gender, or health status, but there are some risk factors that may increase your risk of developing pneumonia.
Age: The young and the elderly are at higher risk for severe pneumonia. Pneumonia is the leading cause of death for children under 5 years old around the world. People 65 years of age and older are at higher risk of developing pneumonia and dying from it than younger adults.
Health conditions: Individuals with weakened immune systems, such as those living with HIV or cancer, as well as those with genetic conditions, such as sickle cell disease or cystic fibrosis, are more likely to develop pneumonia. Certain common health conditions such as asthma, allergies, diabetes, COPD, heart disease, sleep apnea, poor nutrition, and acid reflux also increase the likelihood of getting sick from pneumonia. Pneumonia can occur more frequently after a surgery, when using certain medications, or after an injury because your body’s immune system may be weaker than normal.
Other risk factors: Drinking alcohol, smoking, being exposed to secondhand smoke, and using drugs increases the chances of getting pneumonia. Additionally, smoke or toxic fumes from occupational exposures can increase risk for pneumonia.
People who live in crowded conditions or are hospitalized also have an increased risk of developing pneumonia.
What Types of Pneumonia Are There?
- Bacterial pneumonia is the most common type of pneumonia. It is usually caused by bacteria that live in the back of the nose and in the throat. In healthy people, these bacteria do not cause any harm. However, when the immune system is compromised, the bacteria may enter the lungs and cause pneumonia. Pneumonia can be a complication of an upper respiratory infection.
- Viral pneumonia is the second most common type of pneumonia and accounts for about one third of all pneumonia cases. While the majority of viral pneumonia infections in adults are caused by influenza viruses; other viruses such as parainfluenza, adenovirus, and the recently emerging SARS-CoV-2 coronavirus are among other causes. With viral pneumonia, the illness usually starts off as a common cold or flu, but later the virus can descend into the lungs causing pneumonia.
- Fungal pneumonia may occur when fungal or mold spores are inhaled. The spores may settle in the respiratory system and invade the lung tissues, leading to infection. Fungal pneumonia primarily affects people with immune deficiencies due to HIV, chemotherapy, and organ transplant. However, different types of fungi found in soil, decomposing leaves and wood, and bat or bird droppings can cause pneumonia, even in healthy individuals with well-functioning immune systems. People in certain occupations, such as farmers, landscapers, and construction workers, are at increased risk of developing fungal pneumonia as they may be more likely to come in contact with different kinds of fungal spores.
Evaluation and Treatment
If you think you are experiencing symptoms of pneumonia, seek immediate medical care. Pneumonia is a progressive condition, meaning it can worsen with time and cause more harm to the lungs, other organs, and the whole body if not diagnosed and treated early. Without early medical attention, pneumonia can lead to worsening symptoms, complications, the need for hospitalization, and longer recovery time.
A healthcare provider will usually ask about your symptoms, check your vital signs, and perform a physical exam. Your healthcare provider may order a chest x-ray if pneumonia is suspected. Additional tests may include COVID-19 tests, influenza tests, blood tests, or a sputum test.
Treatment usually includes rest, hydration, and medications that treat symptoms of pneumonia such as cough, fever, headache, nasal congestion, etc. For bacterial pneumonia, your healthcare provider may prescribe an antibiotic which needs to be taken as directed.
Viral and fungal pneumonia in an otherwise healthy person in stable condition can usually be treated with rest, hydration, and medicines for symptoms. But in some instances, an anti-viral or anti-fungal medicine may be ordered by a doctor.
If symptoms are more severe, then pneumonia may need to be treated in a hospital with appropriate medications, oxygen therapy, and possibly a ventilator machine under close medical supervision.
What can we do to prevent pneumonia?
Steps anyone can take to prevent pneumonia include:
- Maintaining good personal hygiene and frequent handwashing will help minimize contact with pathogens that cause pneumonia.
- Avoiding smoking and alcohol will help to keep lungs and the immune system working properly.
- Keeping chronic health conditions such as asthma or diabetes under good control will also help prevent pneumonia.
- Getting vaccinated. Annual flu shots help to prevent pneumonia caused by the flu virus. Additionally, pneumococcal vaccines PCV13 and PPSV23, recommended for certain age groups, build immunity against some of the most common microbes responsible for pneumonia.
- Staying active. Regular physical activity, good nutrition, healthy sleeping, and controlling emotional stress should never be underestimated. These healthy habits can go a long way in preventing pneumonia and many other health problems.
American Thoracic Society, “Top 20 Pneumonia Facts—2019,” https://www.thoracic.org/patients/patient-resources/resources/top-pneumonia-facts.pdf
Peter Crosta, “What you should know about pneumonia,” MedicalNewsToday, November 27, 2017, https://www.medicalnewstoday.com/articles/151632
Winchester Hospital, “Risk Factors for Pneumonia,” https://www.winchesterhospital.org/health-library/article?id=20036
Zab Mosenifar, “Viral Pneumonia,” Medscape, January 22, 2020, https://emedicine.medscape.com/article/300455
Justina Gamache, “Bacterial Pneumonia,” Medscape, September 30, 2020, https://emedicine.medscape.com/article/300157
Johns Hopkins Medicine, “Pneumonia,” https://www.hopkinsmedicine.org/health/conditions-and-diseases/pneumonia
Brunilda Nazario, “Types of Pneumonia,” WebMD, April 8, 2020, https://www.webmd.com/lung/pneumonia-types
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Centers for Disease Control and Prevention, “Fungal pneumonia: a silent epidemic,” December 2012, https://www.cdc.gov/fungal/pdf/cocci-fact-sheet-sw-us-508c.pdf
Michael Joseph Bono, “Mycoplasmal Pneumonia Treatment & Management,” December 28, 2018, https://emedicine.medscape.com/article/1941994-treatment