Pneumonia is an inflammatory illness of the lung(s). Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection, however every year, more than 60,000 Americans still die of pneumonia.
Pneumonia is defined as an inflammatory condition of the lung affecting primarily the microscopic air sacs known as alveoli. It is usually caused by infection with viruses or bacteria and less commonly other microorganisms, certain drugs and other conditions such as autoimmune diseases. Typical symptoms include a cough, chest pain, fever, and difficulty breathing.
Symptoms associated with pneumonia include:
Other possible symptoms are:
Symptoms of pneumonia need immediate medical evaluation.
Diagnostic tools include x-rays and examination of the sputum. Treatment depends on the cause of pneumonia; bacterial pneumonia is treated with antibiotics. People with infectious pneumonia often have a cough producing greenish or yellow sputum, or phlegm and a high fever that may be accompanied by shaking chills. Shortness of breath is also common, as is pleuritic chest pain, a sharp or stabbing pain, either experienced during deep breaths or coughs or worsened by them. People with pneumonia may cough up blood, experience headaches, or develop sweaty and clammy skin.
Most cases of pneumonia can be treated without hospitalization. Typically, oral antibiotics, rest, fluids, and home care are sufficient for complete resolution. However, people with pneumonia who are having trouble breathing, people with other medical problems, and the elderly may need more advanced treatment.
An important test for pneumonia in unclear situations is a chest x-ray. Chest x-rays can reveal areas of opacity (seen as white) which represent consolidation. Pneumonia is not always seen on x-rays, either because the disease is only in its initial stages, or because it involves a part of the lung not easily seen by x-rays.
Chronic obstructive pulmonary disease (COPD) or asthma can present with a polyphonic wheeze, similar to that of pneumonia. Pulmonary edema can be mistaken for pneumonia due to its ability to show a third heart sound and present with an abnormal ECG. Other diseases to be taken into consideration include bronchiectasis, lung cancer and pulmonary emboli.
Hospital-acquired pneumonia, also called nosocomial pneumonia, is pneumonia acquired during or after hospitalization for another illness or procedure with onset at least 72 hrs after admission. The causes, microbiology, treatment and prognosis are different from those of community-acquired pneumonia. Up to 5% of patients admitted to a hospital for other causes subsequently develop pneumonia.
In general, pneumonia is not contagious, but the upper respiratory viruses that lead to it are.
For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition. See your doctor if you have difficulty breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you're coughing up pus.
It's especially important that people in these high-risk groups see a doctor:
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