Pneumonia and its management

Pneumonia (pronounced: noo-mow-nyuh) is an infection of the lungs. When someone has pneumonia, lung tissue can fill with pus and other fluid, which makes it difficult for oxygen in the lung’s air sacs to reach the bloodstream. With pneumonia, a person may have difficulty breathing and have a cough and fever; occasionally, chest or abdominal pain and vomiting are symptoms, too.

Pneumonia is commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Influenza H1N1 (swine flu) can also become a significant cause of pneumonia. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such asStreptococcus pneumoniae can cause pneumonia, too. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.

You may have heard the terms “double pneumonia” or “walking pneumonia.” Double pneumonia simply means that the infection is in both lungs. It’s common for pneumonia to affect both lungs, so don’t worry if your doctor says this is what you have — it doesn’t mean you’re twice as sick.

Walking pneumonia refers to pneumonia that is mild enough that you may not even know you have it. Walking pneumonia, which has also been called atypical pneumonia because it’s different from the typical bacterial pneumonia, is common in teens and is often caused by a tiny microorganism known as Mycoplasma pneumoniae. Like the typical bacterial pneumonia, walking pneumonia also can be treated with antibiotics.

Signs and Symptoms

There are many symptoms of pneumonia, and some of them, like a cough or a sore throat, are associated with many other common infections. Often, people get pneumonia after they’ve had an upper respiratory tract infection like a cold.

Symptoms of pneumonia can include:

  • fever
  • chills
  • cough
  • unusually rapid breathing
  • wheezing
  • difficulty breathing
  • chest or abdominal pain
  • loss of appetite
  • exhaustion
  • vomiting

The symptoms of pneumonia vary from person to person, and few people get all of them.

When pneumonia is caused by bacteria, the person tends to become sick quickly and develops a high fever and has difficulty breathing. When it’s caused by a virus, symptoms generally appear more gradually and may be less severe.

A person’s symptoms can help the doctor identify the type of pneumonia. Mycoplasma pneumoniae, for example, often causes headaches and sore throats in addition to the symptoms listed above.

How Can We Prevent Pneumonia?

The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received additional vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria. People who have diseases that affect their immune system (like diabetes, HIV infection, or cancer), are 65 or older, or are in other high-risk groups should receive a pneumococcal vaccination.

People with immune system problems also may receive antibiotics to prevent pneumonia that can be caused by organisms they’re especially susceptible to. In some cases, antiviral medication might be used to prevent viral pneumonia or to lessen its effects.

Flu vaccination is also recommended since pneumonia often occurs as a complication of the flu. In addition to the standard flu vaccine, the newer H1N1 (swine flu) vaccine is also recommended. You can contact your doctor’s office to see when these vaccines are available.

Because pneumonia is often caused by contagious germs, a good way to prevent it is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils; wash your hands frequently with warm, soapy water; and avoid touching used tissues and paper towels.

You also can stay strong and help avoid some of the illnesses that might lead to pneumonia by eating as healthily as possible, getting a minimum of 8 to 10 hours of sleep a night, and avoiding smoking.

How Is Pneumonia Treated?

If a doctor suspects pneumonia, he or she will perform a physical exam and might order a chest X-ray and blood tests. People with bacterial or atypical pneumonia will probably be given antibiotics to take at home. A doctor also will recommend getting lots of rest and drinking plenty of fluids.

Some people with pneumonia need to be hospitalized to get better — usually babies, young kids, and people older than 65. However, hospital care may be needed for a teen who:

  • already has immune system problems
  • has cystic fibrosis
  • is dangerously dehydrated or is vomiting a lot and can’t keep fluids and medicine down
  • has had pneumonia frequently
  • has skin that’s blue or pale in color, which reflects a lack of oxygen

When pneumonia patients are hospitalized, treatment might include intravenous (IV) antibiotics (delivered through a needle inserted into a vein) and respiratory therapy (breathing treatments).

Antiviral medications approved for adults and teens can reduce the severity of flu infections if taken in the first 1 to 2 days after symptoms begin. They’re usually prescribed for teens who have certain underlying illnesses such as asthma or who have pneumonia or breathing difficulty. If you have been exposed to either type of influenza and you begin to develop symptoms of pneumonia, call a doctor.

How Can We Feel Better?

If your doctor has prescribed medicine, be sure to follow the directions carefully.

You may feel better in a room with a humidifier, which increases the moisture in the air and soothes irritated lungs. Make sure you drink plenty of fluids, especially if you have a fever. If you have a fever and feel uncomfortable, ask the doctor whether you can take over-the-counter medicine such as acetaminophen or ibuprofen to bring it down. But don’t take any medicine without checking first with your doctor — a cough suppressant, for example, may not allow your lungs to clear themselves of mucus.

And finally, be sure to rest. This is a good time to sleep, watch TV, read, and lay low.