Pneumonia

What is pneumonia?

Pneumonia is a lung infection that can make you very sick. You may cough, run a fever, and have a hard time breathing. For most people, pneumonia can be treated at home. It often clears up in 2 to 3 weeks with treatment. But older adults, babies, and people with other diseases can become very ill. They may need to be in the hospital.

You can get pneumonia in your daily life, such as at school or work. This is called community-associated pneumonia. You can also get it when you are in a hospital or nursing home. This is called healthcare-associated pneumonia. It may be more severe because you already are ill. This topic focuses on pneumonia you get in your daily life.

What causes pneumonia?

Germs called bacteria or viruses usually cause pneumonia. Pneumonia usually starts when you breathe the germs into your lungs. You may be more likely to get the disease after having a cold or the flu. These illnesses make it harder for your lungs to fight infection, so it is easier to get pneumonia. Having a long-term, or chronic, disease like asthma, heart disease, cancer, or diabetes also makes you more likely to get pneumonia.

What are the symptoms of pneumonia?

Symptoms of pneumonia may include:

  • Cough. You will likely cough up mucus (sputum) from your lungs. Mucus may be rusty or green or tinged with blood.
  • Fever, chills, and sweating.
  • Fast breathing and feeling short of breath.
  • Chest pain that often feels worse when you cough or breathe in.
  • Fast heartbeat.
  • Feeling very tired or very weak.

When you have less severe symptoms, your doctor may call this "walking pneumonia." Older adults may have different, fewer, or milder symptoms. They may not have a fever. Or they may have a cough but not bring up mucus. The main sign of pneumonia in older adults may be a change in how well they think. Confusion or delirium is common. Or, if they already have a lung disease, that disease may get worse. Symptoms caused by viruses are the same as those caused by bacteria. But they may come on slowly and often are not as obvious or as bad.

How is pneumonia diagnosed?

Your doctor will ask you about your symptoms and do a physical exam. He or she may order a chest X-ray and a complete blood count (CBC). This is usually enough for your doctor to know if you have pneumonia. You may need more tests if you have bad symptoms, are an older adult, or have other health problems. In general, the sicker you are, the more tests you may need.

Your doctor may also test mucus from your lungs to find out if bacteria are causing your pneumonia. Finding out what is causing your pneumonia can help your doctor choose the best treatment for you. However, often the organism can't be found and a broad-spectrum antibiotic may be given.

How is pneumonia treated?

Antibiotics are the usual treatment, because the organism may not be found. But if the pneumonia is caused by a virus, antivirals may be given. Sometimes, antibiotics may be used to prevent complications. Antibiotics usually cure pneumonia caused by bacteria. Be sure to take the antibiotics exactly as instructed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Pneumonia can make you feel very sick. But after you take antibiotics, you should start to feel much better, although you will probably not be back to normal for several weeks. Call your doctor if you do not start to feel better after 2 to 3 days of antibiotics. Call your doctor right away if you feel worse.

There are things you can do to feel better during your treatment. Get plenty of rest and sleep, and drink lots of liquids. Do not smoke. If your cough keeps you awake at night, talk to your doctor about using cough medicine. You may need to go to the hospital if you have bad symptoms, a weak immune system, or another serious illness.

How can you prevent pneumonia?

Experts recommend immunization for children and adults. Children get the pneumococcal vaccine as part of their routine shots. Two different types of pneumococcal vaccines are recommended for people ages 65 and older. If you smoke, or you have a long-term health problem, it's a good idea to get a pneumococcal vaccine. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably won't be as sick. You can also get an influenza vaccine to prevent the flu, because sometimes people get pneumonia after having the flu.

You can also lower your chances of getting pneumonia by staying away from people who have the flu, respiratory symptoms, or chickenpox. You may get pneumonia after you have one of these illnesses. Wash your hands often. This helps prevent the spread of viruses and bacteria that may cause pneumonia.

Aspiration Pneumonia: Care Instructions

aspiration pneumonia care instructionAspiration pneumonia is an inflammation of the lungs. It may occur after you breathe in large amounts of foreign material, such as food, liquid, vomit, or mucus.

Aspiration may happen because of a health problem that makes it hard to swallow. These problems include stroke or seizure.

Pneumonia makes it hard to breathe.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

To help with swallowing

  • You may need to do exercises to train your muscles to work together to help you swallow. You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better.
  • You may need to change the foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier.
  • You may need to change how you prepare foods. For example, you may need to add thickeners to some liquids, or puree certain foods in a blender.

To help with pneumonia

  • Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Take your medicines exactly as prescribed. For example, your doctor may have given you medicine that makes breathing easier. Call your doctor if you think you are having a problem with your medicine.
  • Get plenty of rest and sleep. You may feel weak and tired for a while, but your energy level will improve with time.
  • Take care of your cough so you can rest. A cough that brings up mucus from your lungs is common with pneumonia. It is one way your body gets rid of the infection. But if coughing keeps you from resting or causes severe fatigue and chest-wall pain, talk to your doctor. He or she may suggest that you take a medicine to reduce the cough.
  • Use a humidifier to increase the moisture in the air. Dry air makes coughing worse. Follow the instructions for cleaning the machine.
  • Do not smoke, and avoid others' smoke. Smoke will make your cough last longer. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve) to help reduce fever and reduce chest pain caused by coughing. Read and follow all instructions on the label.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.

Call your doctor now or seek immediate medical care if:

  • You have a new or higher fever.
  • You have new or worse trouble breathing.
  • You cough up blood.
  • You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.
  • You are coughing more deeply or more often.

Learning About COPD and How to Prevent Lung Infections

How do lung infections affect COPD?

Lung infections like pneumonia and acute bronchitis are common causes of COPD flare-ups. And people who have COPD are more likely to get these lung infections, especially if they smoke.

When you have COPD, it is important to know the symptoms of pneumonia and acute bronchitis and call your doctor if you have them. Symptoms include:

  • A cough that brings up more mucus than usual.
  • Fever.
  • Shortness of breath.

What can you do to prevent these infections?

Stay healthy

  • Get a flu shot every year.
  • Get a pneumococcal vaccine shot. If you have had one before, ask your doctor whether you need another dose. Two different types of pneumococcal vaccines are recommended for people ages 65 and older.
  • If you must be around people with colds or the flu, wash your hands often.
  • Do not smoke. This is the most important step you can take to prevent more damage to your lungs. If you need help quitting, talk to your doctor about stop-smoking programs and medicines.
  • These can increase your chances of quitting for good.
  • Avoid secondhand smoke, air pollution, and high altitudes. Also avoid cold, dry air and hot, humid air. Stay at home with your windows closed when air pollution is bad.

Exercise and eat well

  • If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 30 minutes on most days of the week.
  • Eat regular, well-balanced meals. Eating right keeps your energy levels up and helps your body fight infection.
  • Get plenty of rest and sleep.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Learning About Hospital-Acquired Pneumonia (HAP)

Hospital-acquired pneumonia (HAP) is pneumonia that you get when you are in a hospital or nursing home. It also can happen to people who have been on a machine to help them breathe (ventilator).

HAP is more serious than pneumonia that people get in daily life. That's because someone with HAP may already have a serious illness. Pneumonia in the hospital is also often caused by different bacteria than the ones that usually cause pneumonia. These other bacteria may be stronger and harder to treat with antibiotics.

What increases your risk?

You're more likely to get HAP if:

  • You have another serious condition, especially another lung disease, such as COPD.
  • You don't eat enough healthy foods.
  • You have a weak immune system.
  • You've been in the hospital.
  • You took antibiotics recently.
  • You are age 55 or older.

What are the symptoms?

Symptoms of HAP include:

  • A fever.
  • Trouble breathing.
  • A cough with mucus.
  • Feeling very tired or very weak.
  • Symptoms may start 2 days or more after you go into the hospital or nursing home. They may also start shortly after being sent home.

How is it diagnosed?

It's important to diagnose HAP quickly. If your doctor thinks that you have it, you will have a chest X-ray. Your doctor may also look at a sample of your mucus and blood.

How is it treated?

Most types of HAP are treated with an antibiotic that kills many types of bacteria. This may be done before your doctor knows which type of bacteria caused your infection. Your antibiotic may be changed after tests show which bacteria you have.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Pneumococcal Conjugate Vaccine for Children: Care Instructions

The pneumococcal shot (PCV13) protects against a type of bacteria that causes pneumonia, meningitis, blood infections (sepsis), and ear infections.

All children need four doses—one at age 2 months, one at 4 months, one at 6 months, and one at 12 to 15 months. If your child does not get the shots in this time frame, ask your doctor about a schedule for catch-up shots.

The shot may cause pain or swelling in the area where the shot is given. It may cause your child to feel sleepy or not feel like eating or cause a fever. These reactions may last 1 to 2 days.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

Give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever or for pain at the shot area. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.

Do not give a child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your child's skin.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child has a seizure.
  • Your child has symptoms of a severe allergic reaction. These may include:
    • Sudden raised, red areas (hives) all over the body.
    • Swelling of the throat, mouth, lips, or tongue.
    • Trouble breathing.
    • Passing out (losing consciousness). Or your child may feel very lightheaded or suddenly feel weak, confused, or restless.

Call your doctor now or seek immediate medical care if:

  • Your child has symptoms of an allergic reaction, such as:
    • A rash or hives (raised, red areas on the skin).
    • Itching.
    • Swelling.
    • Belly pain, nausea, or vomiting.
  • Your child has a high fever.
  • Your child cries for 3 hours or more within 2 to 3 days after getting the shot.

Watch closely for changes in your child's health, and be sure to contact your doctor if your child has any problems.

Pneumococcal Polysaccharide Vaccine: Care Instructions

The pneumococcal polysaccharide vaccine (PPSV) can prevent some of the serious complications of pneumonia. This includes infection in the bloodstream (bacteremia) or throughout the body (septicemia).

PPSV is recommended for people ages 65 years and older. People ages 2 to 64 who have a long-term illness should also get the vaccine. This includes people with diabetes, heart disease, liver disease, or lung disease. PPSV can also help people who have a weakened immune system. This includes cancer patients and people who don't have a spleen. The immune system helps your body fight infection and other illnesses.

PPSV is given as a shot. It's usually given in the arm. Healthy older adults get the shot once. Other people may need to have a second dose. The shot may cause pain and redness at the site. It may also cause a mild fever for a short time.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), if your arm is sore after the shot. Be safe with medicines. Read and follow all instructions on the label.

Give acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to your child for pain or fussiness after the shot. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.

Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have a seizure.
  • You have symptoms of a severe allergic reaction. These may include:
    • Sudden raised, red areas (hives) all over the body.
    • Swelling of the throat, mouth, lips, or tongue.
    • Trouble breathing.
    • Passing out (losing consciousness). Or you may feel very lightheaded or suddenly feel weak, confused, or restless.

Call your doctor now or seek immediate medical care if:

  • You have symptoms of an allergic reaction, such as:
    • A rash or hives (raised, red areas on the skin).
    • Itching.
    • Swelling.
    • Belly pain, nausea, or vomiting.
  • You have a high fever.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Pneumonia: Self Care

Pneumonia may be mild or very severe. It may take a few weeks to a few months to recover fully from pneumonia, depending on how sick you were and whether your overall health is good. Watch this short video to learn more on how to self care.