Pneumonia

What is pneumonia?

Pneumonia is an inflammation of the lung tissue. It is usually due to infection.

Pneumonia tends to be more serious than bronchitis. (Bronchitis is an inflammation or infection of the large airways - the bronchi.) Sometimes bronchitis and pneumonia occur together which is called broncho-pneumonia.

Are there different types of pneumonia?

Pneumonia is commonly caused by an infection with a bacterium or virus. Other germs such as fungi, yeasts, or protozoa sometimes cause pneumonia.

Rarely, non-infective pneumonia is caused by inhaling poisons or chemicals.

How does pneumonia occur?

You may breathe-in some bacteria, viruses, or other germs. If you are normally healthy, a small number of germs usually doesn't matter as they are trapped in the sputum and are killed by the immune system. Sometimes the germs multiply and cause lung infections. This is more likely to happen if you are already in poor health. For example: if you are frail or elderly; if you have a chest disease; if you have a low immunity to infection with such things as alcohol dependence, AIDS, or another serious illness. However, even healthy people sometimes develop pneumonia.

How serious is pneumonia?

• If you were previously well. With treatment, you are likely to make a full recovery. However, some bacteria, viruses, and other germs are more serious than others. Some people become very ill and require hospital admission. Occasionally, some people who were previously well die from pneumonia.
• If you are already in poor health. You are more likely to become seriously ill with pneumonia. Pneumonia is a common cause of death in people who are already in poor health. For example, people in the late or terminal stages of a cancer.

What are the symptoms of pneumonia?

Typical symptoms are cough, fever, sweats, shivers, being off food, and feeling generally unwell. Headaches, and aches and pains are common. You usually make more sputum which may become yellow/green, and is sometimes bloodstained.

You may become breathless, breathe fast, and develop a 'tight chest'. A sharp pain in the side of the chest may develop if the infection involves the pleura. (This is the membrane between the lung and the chest wall.) A doctor may hear 'crackles' in the chest when listening with a stethoscope.

What is the treatment for pneumonia?

Treatment at home
Treatment at home may be fine if you are normally healthy and the pneumonia is not too severe.

• Antibiotics are prescribed when pneumonia is suspected. Bacterial infection is the common cause of pneumonia and antibiotics kill bacteria. Antibiotic treatment usually works well, and you can expect to fully recover. Symptoms settle over a few days if the treatment is working. You may feel tired for a week or so after the infection has cleared.
• Have lots to drink to avoid dehydration.
• Take regular paracetamol or ibuprofen to ease fever and pain.
• You may need stronger painkillers if chest pain develops due to an inflamed pleura (pleurisy).
• Let a doctor know if symptoms do not improve over the next two days.

Hospital treatment
Hospital admission may be advised if you have severe pneumonia, or if symptoms do not quickly improve after you start antibiotic treatment. Also, if you are already in poor health, you are more likely to be treated in hospital.

• A chest X-ray may be taken to confirm the diagnosis and the extent of the infection.
• Blood tests and sputum tests may be taken to find which bacterium is causing the pneumonia. This helps to decide which antibiotic is best to use. Sometimes the bacterium that is causing the pneumonia is 'resistant' to the first antibiotic. A switch to another antibiotic is sometimes needed.
• Sometimes oxygen and other supportive treatments are needed if you have severe pneumonia.

Can pneumonia be prevented?

The following may prevent some cases.

• Do not smoke. Cigarette smoke damages the lining of the airways and makes the lungs more prone to infection.
• Immunisation.
  • Pneumococcal immunisation. The pneumoccocus is a common cause of bacterial pneumonia.
  • Influenza immunisation - the annual 'flu jab'.
  These immunisations are advised if you are at greater risk of developing these infections. There are separate leaflets about these immunisations which give further details.

What if pneumonia recurs?

If you are normally well, but then develop recurrent bouts of pneumonia, it may be the first sign of a problem of your lung or immune system. Some tests may be advised if pneumonia recurs for no apparent reason.

© EMIS and PIP 2006   Updated: February 2006   PRODIGY Validated