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Understanding pneumonia: causes, treatment, & prevention

Understanding pneumonia: causes, treatment, & prevention

Optum Perks Author

By Optum Perks Author

What is pneumonia?

Pneumonia can be a confusing topic. With many types and causes, it’s often mistaken for a virus, when in fact, the term “pneumonia” is a broad sweeping generalization for a lung infection. The air sacs in the lungs, called alveoli, become inflamed, fill with fluid or pus, and cause difficulty breathing and a painful cough.

In the United States, over 1 million people are hospitalized with pneumonia every year, with approximately 50,000 dying yearly from the illness. Pneumonia is the most common reason for hospitalization of children and the second most common reason for adults — childbirth being the most common.

Symptoms of pneumonia

Pneumonia symptoms compared to those of a cold or flu but last longer and range in severity depending on health, age, and cause of infection. Symptoms include:

  • Chest pain or shortness of breath
  • Painful cough, which may produce phlegm
  • Fatigue, tiredness
  • Fever, sweating, chills
  • Loss of appetite, nausea, vomiting, diarrhea
  • Headache

For children under five, additional signs to watch for include wheezing and rapid breathing. Infants may not have apparent symptoms but could have difficulty eating, vomit, or lack energy.

Adults over 65 can have additional symptoms, including altered mental state or confusion and a lower-than-average body temperature.

What causes pneumonia?   

Viruses, bacteria, and fungi all cause pneumonia. Viruses that cause pneumonia include many of the same viruses that cause other respiratory infections including:

  • Influenza
  • RSV
  • Rhinovirus
  • Coronavirus

Viral pneumonia is generally less severe than bacterial pneumonia, though people who have it are also at risk for developing bacterial pneumonia due to an already weakened immune system.

Bacterial pneumonia usually occurs when the body is in a weakened state, such as having undergone surgery, a viral infection, or an impaired immune system from smoking, poor nutrition, or alcohol use. It often affects just one lobe (side) of the lungs.

Fungal pneumonia is caused by inhalation of spores from fungi found in soil or bird droppings in parts of the world, especially in the southwestern United States.

Pneumonia is further categorized according to the means of acquiring the infection.

  • Community-acquired pneumonia refers to an infection caught in communities where people live and not in a hospital. It can be viral, bacterial, or fungal.
  • Hospital-acquired pneumonia is as it sounds – pneumonia developed while in the hospital. Patients on ventilators or in the ICU are susceptible to this type of infection. This type of pneumonia is dangerous because the bacteria causing it might be resistant to antibiotics.
  • Health care-acquired pneumonia occurs in people who reside in long-term care facilities like nursing homes or assisted living or who receive care in outpatient clinics, including chemotherapy or kidney dialysis centers. It may also be antibiotic-resistant.
  • Aspiration pneumonia is bacterial pneumonia developed after inhaling food, drink, saliva, or vomit into your lungs. People with difficulty swallowing, such as coma patients or those sedated for other reasons like excessive use of alcohol or drugs, are at risk for this type of infection.

Note: “Walking pneumonia” is a common term for pneumonia that isn’t severe enough to require bed rest or hospitalization.

Is pneumonia contagious?   

Viral and bacterial pneumonia are contagious. Germs spread via inhalation of airborne droplets from breathing, coughing, or sneezing, or through touching contaminated surfaces. Other types of pneumonia, like fungal and aspirational pneumonia, are not contagious.

How is pneumonia diagnosed?   

Since treatment is dependent on an accurate diagnosis of pneumonia type, diagnosis can involve many tests. After listening to your lungs with a stethoscope for abnormal sounds during a chest exam, a doctor might order one of the following tests:

  • A chest x-ray to show whether and where inflammation is present in the lungs
  • A blood culture to confirm an infection and identify the cause
  • A sputum (mucus) culture collected via a cough to identify the cause
  • A pulse oximetry measures the level of oxygen in your blood
  • Fluid samples taken from the pleural space in the chest via a needle placed between the ribs to help identify the cause of the infection
  • A bronchoscopy using a camera attached to a tube to view affected tissue
  • A CT scan for a more detailed image of the lungs

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How is pneumonia treated?   

Medication is the first course of treatment for pneumonia, though the type of medication depends on the cause of the infection. Your doctor will decide which medication is best for you.

Antibiotics such as azithromycin, clarithromycin, doxycycline, or amoxicillin can treat bacterial infections.

Viral pneumonia will not respond to antibiotics though if influenza is a suspected cause, antivirals like Tamiflu or Relenza might help.

Fungal pneumonia could be treated with fluconazole, Sporanox, Ancobon, or Nizoral.

If medication is unable to control the infection, hospitalization may be necessary. In the hospital, pneumonia patients receive oxygen and respiratory therapy to assist with breathing and oxygen levels and IV treatment.

Pneumonia complications   

Additional complications may arise if medication is not effective, especially in high-risk groups such as children, the elderly, or those with compromised immune systems. Those with chronic conditions may find their conditions worsen. In the most severe cases, complications may include:

  • Pleural effusion: A fluid build-up between the layers of tissue lining the lungs and the chest cavity could become infected and need to be drained surgically or via a chest tube
  • Lung abscess: If pus forms within a cavity in the lung, an abscess occurs. Generally, they can be treated with antibiotics but also might need surgical removal or drainage
  • Bacteremia: Bacteria entering the bloodstream is extremely dangerous because it can spread the infection to other organs, cause septic shock, or even organ failure
  • Acute respiratory distress syndrome: Fluid in the lungs prevents full expansion, so a person struggles to breathe. If a lung scars or becomes stiff, one or both lungs may collapse. This syndrome could result in blood clots, multiple organ failure, or death

How do I prevent pneumonia?   

Thankfully, several vaccines can help prevent certain types of pneumonia or its causes, like the flu. The CDC recommends that everyone ages six months and older get vaccinated, while there are separate pneumonia vaccines available for adults over 65.

Practicing self-care is also effective at preventing pneumonia, just as it does other illnesses. Maintaining a healthy diet, practicing good hygiene, not smoking, getting appropriate rest, and exercising will result in a strong immune system.

Key takeaways

  • Symptoms of pneumonia are similar to those of other upper respiratory infections
  • Proper diagnosis of the cause is critical for effective treatment. Bacterial, viral, and fungal pneumonia require specific medications to treat the origin of the infection
  • Serious complications, including death, could result from ineffective treatment
  • Vaccines are available to prevent certain types of pneumonia

Talk to your doctor if you believe you have pneumonia symptoms or have questions about vaccines and prevention.