Pneumonia is a general term for a range of acute infections that attack the tissues lining the air spacesthe alveoliof one or both lungs. The tissues become inflamed, making it difficult for oxygen to reach the bloodstream, impairing breathing. The inflammation that pneumonia causes may be limited to a single area (lobar pneumonia) or may occur in patches throughout the lungs (bronchopneumonia).
Pneumonia can strike people from infancy through old age, though those over 65 are at higher risk. Until the development of antibiotics, pneumonia caused by bacterial infections was the leading cause of death in the United States. It is the sixth most frequent cause of death, but in developing countries the mortality rate from bacterial pneumonia can be much higher, particularly among young children.
Symptoms of pneumonia can range from very mild to severein fact, the illness can be so mild that some people may not know they have it. Infants and the elderly are at the greatest risk of developing serious complications from pneumonia. Healthy adults usually can be cured within two weeks, though aggressive medical treatment may be required.
One of the more serious forms of infection is hospital-acquired pneumonia, which strikes a patient who has been hospitalized for some other condition. It occurs most frequently in patients in intensive care units and/or those who are on ventilators. Though less common than pneumonia that develops outside a hospital (called community-acquired pneumonia), it is the second most common cause of infections acquired in hospitals and has mortality rates as high as 50 percent.
Symptoms of Pneumonia
- Fever (over 100°F, may reach 105°F)
- Chest pain
- Pain in the ear
- Lump in the neck
- Cough, sometimes with bloody sputum; this cough may last as long as six weeks after the initial infection has cleared
- Increased respiratory rate
- Chest pain on inhalation and shortness of breath
- Nausea and vomiting
- Rapid pulse, rapid breathing
- Weakness and fatigue
- Bluish or gray color of the lips and fingernails
- Muscle pain, sore throat and headache
- Nasal congestion
- In severe cases extreme breathing difficulty, blue tinge to fingernails, lips, or other skin areas, mental confusion
- Decreased activity
What Causes Pneumonia?
Pneumonia has many causes, but viral or bacterial infections are the most commonoften as a complication of a lingering cold, or a bout with the flu or bronchitis. Nearly half of community-acquired pneumonia cases are believed to be viral, about 30 percent are bacterial, and roughly 20 percent are thought to be caused by mycoplasmas (organisms that have both viral and bacterial characteristics). However, in 40 to 60 percent of cases, the specific agent causing the infection isn’t identified. Most cases of hospital-acquired pneumonia are bacterial infections.
Pneumococcal pneumonia, the most common form of bacterial pneumonia in adults over 30, is caused by Streptococcus pneumoniae. This bacterium is found in the throats of many healthy people. When body defenses are weakened—by illness, old age, or impaired immunity, for example—the bacteria can work their way into the lungs and multiply. An estimated 150,000 to 570,000 cases of pneumococcal pneumonia are diagnosed in the United States each year, and they account for most pneumonia-related deaths. Fortunately, a vaccine is available to help prevent pneumococcal pneumonia.
Both bacterial and viral pneumonia can strike year-round, but the autumn and winter months, when colds and influenza proliferate, are major times for the disease, in part because people spend more time indoors, where bacteria and viruses can spread rapidly from one person to another.
Other risk factors for developing community-acquired pneumonia include smoking, recent surgery, and the use of chemotherapy or other immunosuppressive medications. Being in a nursing home or other long-term care facility can also put you at high risk.
Medical conditions that can increase the risk for developing pneumonia include sickle-cell anemia, heart disease, asthma or other chronic lung diseases such as emphysema, poorly controlled diabetes mellitus, alcoholism, chronic kidney disease, and many types of malignancies. In many people with AIDs, pneumonia caused by Pneumocystis carinii, an organism believed to be a fungus, is a common cause of pneumonia.
What If You Do Nothing?
Most cases of viral pneumonia are relatively mild and clear up within one to two weeks. In fact, if the infection develops slowly, you may be unaware that you have pneumonia—a condition known as walking pneumonia.
Bacterial pneumonia, on the other hand, is more serious. Left untreated, it can lead to scarring of lung tissue or the infection can spread to other vital organs. The earlier a diagnosis is made and treatment started, the less damage will be done to the lungs. Recovery may take anywhere from 10 days to three weeks.
Vaccines for Adults and Children
Many people are surprised to hear that a vaccine is available to protect adults against strains of the pneumococcal bacteria, which are responsible for most cases of bacterial pneumonia in this country. That may be one reason why only about 45 percent of those who should get the shot, do.
Unlike flu shots, which must be given each year to cope with the newest strains of virus, a single pneumonia vaccination confers immunity for many years. But the Centers for Disease Control (CDC) recommends a booster dose five or more years after the first dose. As with the flu shot, the vaccine has few side effects, usually nothing more than a sore arm.
Anyone who is age 65 or older should get the shot, as well as anyone over age two who is at high risk for serious or life-threatening complications from pneumonia (such as people with chronic kidney disease, diabetes, heart disease, and other disorders that may lower resistance to infection). The vaccine does not protect against viral pneumonia or the type of pneumonia (Pneumocystis carinii) that people with AIDS are prone to develop.
If you’re 65 or older or in a high-risk group, talk to your physician about getting the pneumonia shot if you haven’t had it, or if your previous shot was more than five years ago. (Medicare, by the way, covers the cost of the shot.)
The CDC also recommends that a recently-approved children’s vaccine be administered to all children under the age of 5. A child may need as many as three doses of the vaccine as well as a booster shot.
Children ages two to five who are at high risk of contracting pneumococcal illnesses, such as those with HIV infection or chronic illness, may be advised to receive single doses of the older and new vaccines
Home Remedies for Pneumonia
Pneumonia, whether bacterial or viral, should be diagnosed and treated by a physician. In either case, though, you can do certain things to help ease symptoms and speed your recovery.
- Get plenty of rest. Rest is necessary until the fever and shortness of breath subside.
- Lower your fever and reduce pain. Over-the-counter pain relievers—aspirin, ibuprofen, naproxen, or acetaminophen—will help do both when taken according to label directions.
- Take an over-the-counter cough suppressant. Look for a product containing dextromethorphan if you have a dry, painful, and persistent cough. Don’t use a suppressant if you are coughing up sputum. Suppressing the cough may encourage mucus accumulation in the lungs, which can lead to serious complications.
- Loosen lung secretions. Inhale steam, use a humidifier, take hot showers, and drink at least eight glasses a day of water or other nonalcoholic, noncaffeinated fluids to make lung secretions easier to cough up and expel.
- Get some relief from chest pain. Use a heating pad on a low setting and place it over your chest for 10-minute intervals.
- Get a flu shot. An annual flu vaccination may reduce your risk since pneumonia is a common complication of severe flu among those in high-risk groups.
- Don’t smoke. Tobacco byproducts weaken your ability to battle infection.
- If you’re at high risk, get immunized. If you’re over 65, contact your physician for a pneumococcal pneumonia vaccine. Other candidates for pneumonia vaccine are people who have heart, lung, or kidney disease, have a weakened immune system, or are alcoholics. The vaccine provides long-term protection.
- Anew vaccine is now available for use in children. If you have a child under age 5, check with your doctor.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician whenever you have symptoms of pneumonia.
Call for an ambulance if you experience severe difficulty in breathing or if you develop a blue tinge to your skin.
What Your Doctor Will Do
After reviewing your symptoms and examining you, your physician may take a chest x-ray to confirm the diagnosis. If the pneumonia is bacterial, antibiotics may be prescribed. Cases of viral pneumonia are generally treated with medications to relieve the primary symptoms. Depending on the severity of your pneumonia and your age, hospitalization may be recommended.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media