Pneumonia
Multimedia
Definition
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung.
Community-acquired pneumonia is pneumonia in people who have not recently been in the hospital or another health care facility (nursing home, rehabilitation facility).
See also: Hospital-acquired pneumonia
Alternative Names
Bronchopneumonia; Community-acquired pneumonia
Causes, incidence, and risk factors
Pneumonia is a common illness that affects millions of people each year in the United States. Germs called bacteria, viruses, and fungi may cause pneumonia.
Ways you can get pneumonia include:
Bacteria and viruses living in your nose, sinuses, or mouth may spread to your lungs.
You may breathe some of these germs directly into your lungs.
You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungs (
aspiration pneumonia)
Pneumonia caused by bacteria tends to be the most serious kind. In adults, bacteria are the most common cause of pneumonia.
Many other bacteria can also cause pneumonia.
Viruses are also a common cause of pneumonia, especially in infants and young children.
See also: Respiratory syncytial virus
Risk factors (conditions that increase your chances of getting pneumonia) include:
Cigarette smoking
Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions)
Living in a nursing facility
Recent surgery or trauma
References
Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556.
Niederman M. In the clinic. Community-acquired pneumonia. Ann Intern Med. 2009;151(7).
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.
Torres A, Menéndez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.
Review Date: 5/1/2011
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care. University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bronchopneumonia; Community-acquired pneumonia
Symptoms
The most common symptoms of pneumonia are:
Other symptoms include:
Signs and tests
If you have pneumonia, you may be working hard to breathe, or breathing fast.
The health care provider will hear crackles when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall).
The health care provider will likely order a chest x-ray if pneumonia is suspected.
Some patients may need other tests, including:
References
Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556.
Niederman M. In the clinic. Community-acquired pneumonia. Ann Intern Med. 2009;151(7).
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.
Torres A, Menéndez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.
Review Date: 5/1/2011
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care. University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bronchopneumonia; Community-acquired pneumonia
Treatment
Your doctor must first decide whether you need to be in the hospital. If you are treated in the hospital, you will receive:
It is very important that you are started on antibiotics very soon after you are admitted.
You are more likely to be admitted to the hospital if you:
Have another serious medical problem
Have severe symptoms
Are unable to care for yourself at home, or are unable to eat or drink
Are older than 65 or a young child
Have been taking antibiotics at home and are not getting better
However, many people can be treated at home. If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have viral or bacterial pneumonia, so you may receive antibiotics.
Your doctor may tell you to take antibiotics. Antibiotics help most people with pneumonia get better.
Don't miss any doses. Take the medicine until it is gone, even if you start to feel better.
Do NOT take cough medicine or cold medicine unless your doctor says it is okay. Coughing helps your body get rid of mucus from your lungs.
Breathing warm, moist (wet) air helps loosen the sticky mucus that may make you feel like you are choking. These things may help:
Place a warm, wet washcloth loosely over your nose and mouth.
Fill a humidifier with warm water and breathe in the warm mist.
Coughing helps clear your airways. Take a couple of deep breaths two or three times every hour. Deep breaths will help open up your lungs.
Tap your chest gently a few times a day and lie with your head lower than your chest. This can help bring up mucus from the lungs.
If you smoke any tobacco products, STOP. Do not allow smoking in your home.
Drink plenty of liquids (as long as your health care provider says it is okay):
Drink water, juice, or weak tea
Drink at least 6 to 10 cups a day
Do NOT drink alcohol
Get plenty of rest when you go home. If you have trouble sleeping at night, take naps during the day.
Expectations (prognosis)
With treatment, most patients will improve within 2 weeks. Elderly or very sick patients may need longer treatment.
Those who may be more likely to have complicated pneumonia include:
Your doctor may want to make sure your chest x-ray becomes normal again after you take a course of antibiotics. However, it may take many weeks for your x-ray to clear up.
Complications
Possible complications include:
Calling your health care provider
Call your doctor if you have:
- A cough that brings up bloody or rust-colored mucus
- Breathing (respiratory) symptoms that get worse
- Chest pain that gets worse when you cough or breathe in
- Fast or painful breathing
- Night sweats or unexplained weight loss
- Shortness of breath, shaking chills, or persistent fevers
- Signs of pneumonia and a weak immune system (for example such as with HIV or chemotherapy)
Infants with pneumonia may not have a cough. Call your doctor if your infant makes grunting noises or the area below the rib cage is pulling in during breathing.
References
Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556.
Niederman M. In the clinic. Community-acquired pneumonia. Ann Intern Med. 2009;151(7).
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.
Torres A, Menéndez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.
Review Date: 5/1/2011
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care. University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bronchopneumonia; Community-acquired pneumonia
Prevention
Wash your hands often, especially after:
Blowing your nose
Going to the bathroom
Diapering
Also wash your hands before eating or preparing foods.
Don't smoke. Tobacco damages your lung's ability to ward off infection.
Vaccines may help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other long-term conditions:
- A drug called Synagis (palivizumab) is given to some children younger than 24 months to prevent pneumonia caused by respiratory syncytial virus.
- Flu vaccine prevents pneumonia and other problems caused by the influenza virus. It must be given each year to protect against new virus strains.
- Hib vaccine prevents pneumonia in children from Haemophilus influenzae type b.
- Pneumococcal vaccine (Pneumovax, Prevnar) lowers your chances of getting pneumonia from Streptococcus pneumoniae.
If you have cancer or HIV, talk to your doctor about ways to prevent pneumonia and other infections.
References
Van der Poll T, Opal SM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543-1556.
Niederman M. In the clinic. Community-acquired pneumonia. Ann Intern Med. 2009;151(7).
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.
Torres A, Menéndez R, Wunderink R. Pyogenic bacterial pneumonia and lung abscess. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 32.
Review Date: 5/1/2011
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care. University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/1/2011
Reviewed By: Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care. University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.