Pneumonia

A common lung infection, pneumonia affects millions of people every year. Bacteria, fungi or viruses can cause pneumonia. The infection, which can range from mild to life-threatening, causes inflammation in one or both of your lungs. The air sacs in your lungs can also fill with fluid or pus. As a result, it may become harder to breathe.

Pneumonia shares some symptoms with the common cold and influenza, so it can be easy to confuse the infections. But pneumonia can be life-threatening, so getting medical care is critical. Some symptoms that may indicate pneumonia include:

• Chest pain
• Congestion
• Coughing up bloody, green or yellow mucus or spit
• Difficulty breathing
• Fever of 102°F or higher

Pneumonia isn’t contagious, but the bacteria, fungi or viruses that cause it are. Bacteria and viruses that float in the air are the most common causes of pneumonia. Cases of pneumonia caused by fungi are less common and usually affect people with weakened immune systems.

• Bacterial pneumonia. These infections are typically the most severe. You’re more likely to develop this type of pneumonia if you’ve had a cold or the flu. It can also lead to ear infections, meningitis and sinus infections.
• Fungal pneumonia. Soil and bird droppings contain the fungi that cause this type of pneumonia. People with chronic health problems or a weakened immune system are most at risk.
• Viral pneumonia. Viral pneumonia is usually mild and clears up on its own. It typically develops when you have another respiratory infection like a cold, influenza or respiratory syncytial virus (RSV). Pneumonia caused by COVID-19 can be more severe.

Exposure to the bacteria, fungi or viruses that lead to pneumonia can occur in a variety of ways. Our providers will categorize your type of pneumonia by where you were exposed.

• Aspiration pneumonia. If you get food, liquid, spit or vomit in your lungs and can’t cough it up, pneumonia can develop.
• Community-acquired pneumonia (CAP). You can encounter the bacteria, fungi or viruses that cause pneumonia in your daily life.
• Hospital-acquired pneumonia (HAP). Being in the hospital for an illness or a procedure can expose you to pneumonia. HAP usually resists treatment, so it is often more serious than CAP. As a result, HAP can make you sicker.
• Healthcare-acquired pneumonia (HCAP). You can pick up this type of pneumonia during an extended stay, long-term care or outpatient clinic. Like HAP, these cases usually resist treatment.
• Ventilator-associated pneumonia (VAP). You are at risk for VAP if you need a respirator or breathing machine.

Pneumonia can affect anyone. But some people are at greater risk for developing an infection. You are at a higher risk of pneumonia if you:

• Are over 65 or under 2
• Are pregnant
• Have a chronic heart or lung condition like asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis or emphysema
• Have a weakened immune system
• Are in a hospital or long-term care environment
• Have a neurological condition that makes swallowing difficult, like dementia or Parkinson’s disease
• Smoke or vape

Pneumonia shares many symptoms with the common cold and influenza. But you can also develop different symptoms based on the type of pneumonia you have.

Bacterial pneumonia symptoms. Signs of bacterial pneumonia may appear slowly or suddenly. They include:

• Abdominal pain from coughing or deep breathing
• Bluish lips, nails and skin
• Chest pain
• Confusion or altered mental stage (especially in people 65 and older)
• Cough with bloody, green or yellow mucus
• Fatigue
• High fever (up to 105°F)
• Loss of appetite
• Rapid breathing
• Rapid heart rate
• Shortness of breath
• Sweating or chills

Viral pneumonia symptoms. Signs of viral pneumonia usually emerge over many days. Viral pneumonia produces many of the same symptoms as bacterial pneumonia, but you may also experience:

• Dry cough
• Extreme fatigue
• Headache
• Muscle pain
• Weakness

Fungal pneumonia symptoms. Fungal pneumonia shares symptoms with bacterial pneumonia and other respiratory illnesses. But signs can also include:

• Coughing up blood
• Hypersensitivity to allergens
• Joint pain

Symptoms in adults and children

Children and older adults can experience different symptoms of pneumonia.

Symptoms in children. Babies and young children may not show signs of pneumonia. If they do show symptoms, those can include:

• Chills or sweating/flushed skin
• Cough
• Crying more than usual
• Difficulty breathing
• Difficulty feeding
• Fever
• Fewer wet diapers
• Fussiness or restlessness
• Grunting while breathing
• Less energy
• Loss of appetite
• Pale skin
• Vomiting

Symptoms in adults over 65. Pneumonia symptoms like coughing and shortness of breath may be less noticeable in older adults. However, they may show these signs:

• Fatigue
• Low appetite
• Sudden change in mental state
• Worsening of ongoing health conditions

To diagnose your condition, our providers will first perform a physical exam. They will use a stethoscope to examine your lungs, listening for the bubbling and cracking sounds that come with pneumonia.

If they hear those sounds, they may recommend any of the following additional tests and further workup:

• Arterial blood gas test. Our providers use a sample of your blood to measure your blood-oxygen level. This test shows how well your lungs work.
• Blood test. Our providers will test a sample of your blood to determine whether your infection is bacterial, fungal or viral.
• Bronchoscopy. Using a bronchoscope (a thin tube with a light on the end), our providers can examine the inside of your lungs. They may collect a tissue or fluid sample for further testing.
• Imaging. Chest CT scans or X-rays of your lungs can reveal any signs of pneumonia.
• Pleural fluid culture. Our providers use a thin needle to collect a fluid sample from your lungs. Laboratory staff test it to determine the cause of your infection.
• Pulse oximetry. A pulse oximeter (a small clip attached to your finger or toe) measures your blood-oxygen level to determine how well your lungs work.
• Sputum test. By coughing or spitting into a container, you provide a sample that laboratory staff can test to determine the cause of your infection.

Our expert providers will work with you to determine the best treatment for your pneumonia. Their recommendations will depend on the cause of your infection. If they can’t identify the underlying cause of your pneumonia, our providers will suggest therapies to help manage and reduce your symptoms.

Possible treatment options include:

• Antibiotics. Providers prescribe antibiotics to treat bacterial pneumonia.
• Antifungal medication. Special medication taken by mouth can clear up an infection caused by fungi.
• Antiviral medication. Most cases of viral pneumonia get better on their own.
• Cough suppressants. Over-the-counter cough medicine can control — but not eliminate — your cough. Cough suppressants help you rest but encourage coughing to remove mucus and fluid from your lungs.
• Draining fluid. Fluid in your lungs makes it difficult to breathe. Our providers can use a catheter (a long, thin tube) to drain fluid from your lungs and chest wall.
• Drinking plenty of water. Drinking enough liquids can thin out the mucus in your lungs, making it easier to cough it up.
• Fever reducers/pain relievers. Over-the-counter medications can reduce your fever and discomfort.
• IV fluids. Delivering fluids directly into your veins can prevent dehydration caused by sweating and fever.
• Oxygen therapy. To help you breathe, our providers may deliver oxygen through a mask on your face or a tube in your nose.
• Using a humidifier. Running a humidifier or taking a hot shower can make it easier for you to breathe.

Most cases of pneumonia respond well to treatment. However, serious complications can occur. Children, older adults, people with chronic conditions and those with weakened immune systems are at greater risk. These additional complications include:

• Acute respiratory distress. This syndrome is a severe form of respiratory failure. Fluid buildup makes it harder for your lungs to provide enough oxygen in your bloodstream.
• Lung abscesses. Pockets of pus form inside and around your lungs. Our providers can drain them with tubes or surgery.
• Respiratory failure. Your lung function drops to the point where you need a breathing machine or ventilator.
• Sepsis. When an infection gets into your blood, it can potentially cause organ failure.

It’s not always possible to avoid exposure to the bacteria, fungi or viruses that cause pneumonia. Getting vaccinated is the best way to protect yourself. Different vaccines exist for adults, children under 2 and children between 2 and 5.

You can also reduce your pneumonia risk if you practice these healthy behaviors:

• Avoid close contact with people who have contagious conditions like a cold, COVID-19 or influenza
• Avoid excessive alcohol intake
• Avoid secondhand smoke from cigarettes and vape pens
• Don’t share items with people with contagious conditions
• Eat a healthy diet
• Exercise regularly
• Get enough sleep
• Quit smoking
• Seek treatment for existing infections
• Wash your hands (or use alcohol-based sanitizer) before eating or handling food and after you use the bathroom