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What Is Pneumonia?

Pneumonia is a common lung infection caused by bacterial, viral, and fungal infections. With pneumonia, the air sacs fill with fluid or pus and can cause mild to life-threatening symptoms such as shortness of breath, cough, fever, chest pain, and fatigue. Pneumonia is diagnosed through a physical exam and lab and imaging tests. Treatment varies, depending on the cause and severity of symptoms.

Pneumonia can occur at any age, but children, older adults, and people with weakened immune systems are most vulnerable. In the United States, over 120 million children under age 5 are diagnosed with pneumonia, and about 1.5 million adults seek medical care at a hospital due to pneumonia every year.

There are several different types of pneumonia, which are classified based on the pathogen (germ) that caused the infection.

Bacterial: Various bacteria species can cause pneumonia; Streptococcus pneumoniae is the most common pneumonia-associated bacteria in the U.S.

Viral: Viruses that affect the respiratory tract, such as influenza or respiratory syncytial virus (RSV), can lead to pneumonia.

Fungal: Fungi, such as pneumocystis pneumonia (PCP), can cause pneumonia in people with chronic health conditions and weakened immune systems.

Walking: A form of pneumonia caused by the Mycoplasma pneumoniae bacteria that is usually mild enough that you can continue your day-to-day activities.

Aspiration: Occurs when mouth secretions, stomach contents, or food are inhaled into the lungs rather than swallowed.

Healthcare providers also type pneumonia based on where the infection was acquired:

Community-acquired pneumonia: Develops outside of a hospital or healthcare setting, usually due to a bacterial, viral, or fungal infection.

Hospital-acquired pneumonia: Develops during hospitalization and can be more serious than other lung infections because germs commonly found in hospital settings are often more treatment-resistant.

Pneumonia symptoms range in severity from mild to life-threatening. Young children, older adults, and immunocompromised people have a higher risk of developing more serious symptoms and complications.

Common pneumonia symptoms can include:

Less common pneumonia symptoms may include:

Headache

Muscle aches and pains

Extreme fatigue

Nausea

Vomiting

Diarrhea

Some older adults and people with weakened immune systems may have atypical symptoms, such as a low body temperature rather than a fever. Many older adults may have sudden changes in mental awareness and become confused.

Infants and young children may have additional pneumonia symptoms, such as:

Bluish-colored skin and lips

Rapid breathing

Grunting

Widened nostrils and inward pulling of rib muscles when breathing

Irritability or fussiness

Pneumonia is usually caused by pathogens such as bacteria, viruses, and fungi. It can also occur when liquid or food is aspirated (inhaled) rather than swallowed. As the body's immune system fights the germs, the lungs become inflamed, causing the tiny air sacs (alveoli) to fill with fluid or pus.

Many types of bacteria can cause pneumonia, with Streptococcus pneumoniae being the most common bacteria associated with pneumonia in the United States. Viruses that affect your respiratory tract, such as influenza, respiratory syncytial virus (RSV), or the common cold, are the most common cause of viral pneumonia. Fungi, such as Pneumocystis jirovecii, can cause pneumonia, especially in immunocompromised people.

Risk Factors

Pneumonia can affect anyone, but certain risk factors can increase your chances of developing it:

Age: Infants and children ages two and younger and older adults (65 and older) are more vulnerable to pneumonia.

Environment: The risk of pneumonia is higher for those who work or live in crowded places, such as homeless shelters, prisons, nursing homes, or dorms.

Occupation: People exposed to chemical fumes and dust and those who work in an environment involving animal exposure (e.G., meat processing center, veterinary clinic) are at a higher risk.

Weakened immune system: Immunocompromised people, such as those with HIV/AIDS or undergoing chemotherapy, are more likely to develop pneumonia.

Hospitalization: Getting medical care in a hospital can raise the risk of hospital-acquired pneumonia, especially if you are sedated or unconscious and unable to move around or require a ventilator to help you breathe.

Smoking: Over time, smoking damages the lungs, increasing your risk of pneumonia.

Other medical conditions: Lung diseases and medical conditions that affect your ability to cough or swallow can increase your pneumonia risk.

Pneumonia can be challenging to diagnose because the symptoms resemble those caused by influenza or the common cold. A healthcare provider will ask about your medical history and symptoms to diagnose pneumonia. They may ask about recent travel, exposure to sick people and animals, and whether you've recently had an illness.

During the physical exam, your healthcare provider will look for signs and symptoms of pneumonia and use a stethoscope to listen for crackling, popping, or rumbling sounds in your lungs when you breathe.

Diagnostic tests may be ordered to confirm a pneumonia diagnosis, such as:

Chest X-ray: Takes pictures of the lungs to look for signs of inflammation or fluid buildup in and around your lungs.

Blood tests: To confirm an infection and determine the type of germ-causing pneumonia.

Pulse oximetry: Measures the oxygen level in your blood, which may be lower with pneumonia.

Sputum culture: A sample of mucus from the lungs is collected when you cough and analyzed in a laboratory to identify the pathogen causing your pneumonia.

Additional diagnostic tests may be ordered if you are at high risk for pneumonia complications or are hospitalized. These include:

Computerized tomography (CT) scan: Provides detailed images of the lungs and surrounding structures to look for pus-filled spots (abscesses) and other complications.

Bronchoscopy: A thin, flexible tube is passed through the nose or mouth to collect a sample of lung tissue (biopsy) or fluid for analysis.

Arterial blood gas: Measures the amount of oxygen in blood taken from an artery, which provides more accurate results than pulse oximetry.

Pleural fluid culture: A small amount of fluid is removed from tissues surrounding the lungs and sent to the lab to identify the pathogen causing pneumonia.

The goal of treatment for pneumonia is to relieve symptoms, cure the infection, and prevent complications. Treatment approaches vary, depending on what's causing pneumonia, the severity of your symptoms, and your overall health.

Medications

The type of medication prescribed to treat pneumonia depends on whether bacteria, a virus, or a fungus caused the infection.

Antibiotics are prescribed to treat bacterial pneumonia. You should feel better within a few days of antibiotic treatment. You must take the full course to eliminate the infection. If you stop taking antibiotics too soon, the infection could return and be harder to treat.

Antiviral medicines are often prescribed to treat viral pneumonia. These medicines don't work for every virus, so rest and symptom management may be all you need for your body to fight off the infection.

Antifungal medicines are prescribed to treat fungal pneumonia.

Over-the-counter pain relievers such as Tylenol (acetaminophen) and Advil (ibuprofen) can help relieve pain and discomfort and reduce your fever.

At-Home Management

Most people with pneumonia can safely manage symptoms and recover at home. If you have a mild case of pneumonia, a healthcare provider may prescribe medication and recommend the following:

Get lots of rest to give your body a chance to recover and recuperate

Drink plenty of fluids to help break up mucus in your lungs

Drink warm beverages, take hot showers or baths, and use a humidifier to keep your airways open

Avoid exposure to lung irritants, such as cigarette smoke, chemicals, wood smoke, and allergens (e.G., pollen, dust) while your lungs heal

Hospitalization

If your infection is serious or you develop complications of pneumonia (e.G., lung abscess) you may be hospitalized for treatment. Hospital treatments for severe pneumonia can include:

Oxygen therapy: Helps increase oxygen levels in your blood if you have trouble breathing.

IV fluids and medicines: Medications (e.G., antibiotics) and fluids may be administered intravenously (IV).

Mechanical ventilation: If you are having trouble breathing, you may require a ventilator to help you breathe.

Surgery: If part of your lung is seriously infected or damaged, you may need surgery to remove the damaged parts and prevent pneumonia from returning.

Healthy lifestyle choices can lower your risk of infection and help prevent pneumonia. Here's how:

Get vaccinated: Vaccines that protect against the most common causes of pneumonia, such as influenza, COVID-19, and pneumococcus bacteria, can help prevent certain types of pneumonia and lower your risk of complications.

Good hygiene: Wash your hands frequently with soap and water to kill germs and avoid touching your face in public spaces.

Don't smoke: Smoking damages the lungs and weakens the immune system, making it harder to fight off infections.

Stay healthy: Eat a balanced, nutritious diet, exercise regularly, and get enough sleep to help keep your immune system strong.

Manage chronic conditions: If you have a chronic condition such as heart disease, diabetes, or COPD, follow your treatment plan to manage the condition.

People with certain health conditions are at a greater risk of developing pneumonia and experiencing complications. Common comorbid conditions associated with a higher risk of pneumonia include:

Obesity

Diabetes

High blood pressure

Cardiovascular disease

Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema

Alcohol use disorder

Malnutrition

If you have symptoms of pneumonia, see a healthcare provider. Getting an early diagnosis and starting treatment can help prevent complications and help you feel better sooner. Along with following your treatment plan, resting and staying hydrated are important to your recovery. Most people recover within 1-2 weeks, but it may be several weeks before your energy levels return to normal.

Visit your healthcare provider for follow-up care, especially if your symptoms are not improving. They may suggest additional treatments or therapies, such as physical therapy to regain strength or pulmonary rehabilitation to help your lungs recover. Making lifestyle changes, such as quitting smoking, staying up-to-date on vaccinations, and managing chronic conditions, can help reduce the risk of future infections and improve your overall health.

Lung Disease

Increasing level of pollution has made breathing in urban areas very difficult, raising the incidence of respiratory problems. Out of the world's top 20 cities with polluted air, 13 belong to India and according to the World health Organisation (WHO) report published in 2011, lung diseases rank 2ndin the list of top 20 causes of death. Naturally, lung disease is a big health issue that needs to be addressed. Here are some facts about lung disease you should know about.

To understand the condition of your lungs, you need to first understand how the lungs function. Lungs are soft organs present on both right and left side of the chest. They are protected by a had covering called the ribcage. Each lung is made of sections called lobes. The main function of the lungs is to make oxygen available for purifying blood and to and eliminate carbondioxide from impure blood or deoxygenated blood. So when you breathe, air travels down your windpipe (trachea). The windpipe bifurcates with each branch entering each of the lungs. Into the lungs, the windpipe is further branched to tubes called bronchioles that end in small sacs called alveoli, where the inhaled air reaches for delivering oxygen.

A lung disease or disorder occurs in the various structures of lungs and disrupts its functioning. It can vary from a mild common cold to life-threatening conditions like pneumonia and cancer. Lung disease can be caused by infections, inflammation, obstruction of airways, decreased lung function, problems related to pulmonary circulation, etc. Smoking, infections, air pollution, genetics, exposure to asbestos, etc. Can cause various lung diseases.

Types

The common as well as rare types of lung disease include -

Causes

'In any form of lung disease mainly the breathing gets affected,' says Dr Animesh Arya, Senior Consultant, Respiratory Medicine, Delhi based Sri Balaji Action Medical Institute. Here are some common forms of lung diseases he explains.

1. Asthma:It is the most common lung disease triggered by allergies, infections and pollutants that harm the airways and cause inflammation.

2. Acute bronchitis: Bronchitis is the inflammation of the air passage. Acute bronchitis is caused by viral or bacterial respiratory infections.

3. Chronic Obstructive Pulmonary Disease (COPD): It a group of diseases that causes breathing difficulties and interfere with the exhalation process of breathing.

4. Chronic bronchitis: It is a type of COPD caused mainly due to smoking.

5. Emphysema: It is a COPD caused by environmental factors and may also be triggered by allergens or organisms that cause diseases like pneumonia and tuberculosis.

Apart from these common forms of lung diseases, other rare lung diseases include:

6. Cystic fibrosis: It is rare lung disease caused by genetic mutation that results in excess mucus production causing blockage of airways.

7. Acute respiratory distress syndrome (ARDS): It is a medical emergency caused as a result of lung injury due to a severe illness.

8. Lung cancer: It can affect any part of the lung. It is mainly caused due to smoking. Here are 10 common symptoms of lung cancer you need to know.

9. Interstitial lung disease: This is a group of diseases affecting the interstitium, a thin lining separating the air sacs.

Symptoms

'Bronchitis, asthma, COPD, lung infections and pulmonary fibrosis have similar symptoms even though they are very different in nature,' says Dr Arya. He lists a few common symptoms of lung diseases:

Difficulty in breathing

Chronic cough

Being short of breath easily after any strenuous activity

Excess mucus production

Coughing up blood due to inflammation in the lining of the respiratory tract

Chest pain

Air hunger which indicates lack of oxygen and also can cause fatigue

Diagnosis

In most cases, chronic cough, chest pain and breathing difficulties necessitate a lung function test. But your doctor might first take a look at the results of your blood test that may indicate whether you have any kind of lung infection. Otherwise, based on your symptoms your doctor might recommend the following lung function tests for you, as explained by Dr Arya.

Imaging tests: A chest X ray, CT scan or nuclear lung scanning can be done to reveal any kind of structural abnormality of the lungs and the chest. With the help of an Xray, the doctor will be able to detect lung tumors, infections like pneumonia, emphysema, interstitial lung disease. It also helps identification of fluid accumulation around the lungs (pulmonary edema).

Lung Volume measurement or spirometry: This test will determine how much air your lungs can hold. A device called spirometer is used in the test to record and analyse the volume of air inhaled and exhaled. The test is repeated after administering a bronchodilator which opens up the airways.

Diffusing capacity measurement: This test determines how well oxygen is transferred from the air sacs (alveoli) to the bloodstream.

Maximal Voluntary Ventilation: The maximum capacity a person can breathe is checked in this test.

Lung biopsy: In case interstitial lung disease is suspected, the doctor may suggest a lung biopsy where a tissue from the lung is obtained using procedures like bronchoscopy for investigation.

Treatment

'If any of the above mentioned symptoms persist for a long time, it is better to consult a doctor immediately for diagnosis,' says Dr Arya. The management of lung disease depends on the type of lung disease you're diagnosed with but largely medication is the main treatment option for lung disease patients.

Asthma and COPD patients may require bronchodialtors and inhalers for relieving asthma symptoms and opening up the airways. Read more about medicines for asthma

Expectorants may be prescribed in case of chronic productive cough to loosen the mucus and facilitate easy expulsion

Corticosteroids are given for reducing inflammation and swelling of the lung tissue

Patients with extreme shortness of breath are managed with oxygen therapy, where the prescribed level of oxygen is delivered through a mask

Antibiotics like azithromycin may be prescribed for patients diagnosed with interstitial lung disease. Lung Infections are also treated with antibiotics

There are some thoracic surgical interventions in which the lung volume or contraction and expansion of the diaphragm can be improved for better lung function

Lung transplantation is the last option for patients with end stage lung disease

'However additional measures like lifestyle management are also needed,' says Dr Arya. These measures not only help you protect lung function but also prevent lung disease. Here are some tips he offers for better management and prevention of lung disease.

If you are a smoker, quit smoking and if not, avoid smokers as far as possible.

Identify things that you are allergic to and avoid them. Some common allergens include animal dander, dust, and aerosols.

Contrary to popular belief, exercise helps with lung diseases. Exercising for even half an hour daily can increase your lung capacity.

Manage your weight as being obese puts more stress on your heart and lungs.

It is important is to take your medication on time every day.

Lastly, get as much rest as possible.

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