Not Just Another Disease: What We Get Wrong About Pneumonia

India has the highest burden of childhood pneumonia than any other country in the world. Learn all about this deadly disease, including its causes, risk factors, symptoms, complications, prevention and management.

What is pneumonia?

Pneumonia is a respiratory infection that affects your lungs and causes the balloon-like sacs in your lungs (called alveoli) to get inflamed and fill up with pus.

How is pneumonia caused?

In most cases, pneumonia is caused by bacteria, although viruses and other organisms can also be responsible. Different types of pneumonia include:
  • Community-acquired pneumonia: This is the most common type. It’s seen in people who aren’t hospitalised or in a long-term care facility, and the infection is spread by droplets
  • Hospital-acquired or nosocomial pneumonia: These infections usually develop during a hospital stay or after 2 days of being hospitalised. People on ventilators are at the highest risk of developing this.
  • Pneumonia in an immunocompromised host: This is seen in people who are immunocompromised (e.g., organ transplant patients, those living with HIV/AIDS)
  • Healthcare-acquired pneumonia: This is seen in people living in nursing homes or long-term care residence

Who’s at risk for developing pneumonia?

Children below the age of 2 years and people over 65 years are more susceptible to the disease. You’re also at a higher risk if:
  • Smoke or consume tobacco regularly
  • You’ve recently had the flu or some upper respiratory tract infection
  • You have a pre-existing lung disease such as asthma, COPD
  • drink alcohol regularly
  • You’re on glucocorticoid therapy
  • You are immunocompromised (eg. organ transplant patients, those living with HIV/AIDS)

What are the symptoms of pneumonia?

Most commonly you will experience:
  • High fever with chills or shivering
  • Cough, which may be dry and painful at first, is followed by the production of foul-smelling sputum. Sometimes, the sputum can be tinged with blood as well
  • Chest pain that gets worse when coughing
  • Generalised fatigue
  • Body pain
  • Loss of appetite
  • Headache
  • Confusion

How is pneumonia diagnosed?

Your doctor can give you a positive diagnosis based on your symptoms and the clinical findings. They’ll take your medical history in detail and do a physical examination by placing a stethoscope over your chest and back to listen to your breath sounds. Additionally, you’ll be asked to get:
  • Blood and urine examination: These include general blood and urine testing to help pinpoint the exact cause. You can also be asked to get a blood and urine culture to confirm the presence of bacteria, check which antibiotics the bacteria is sensitive to, and decide the course of treatment based on the findings
  • Chest X-ray: An X-ray is essential for confirming the diagnosis, follow-up, and detecting any complications
  • Sputum testing: In some cases, analysis of your sputum can be helpful in detecting the causative organism
  • Pleural fluid testing: In cases of serious infections, your doctor can insert a needle into the space around the lungs and remove the fluid to test it for bacteria and other parameters
  • HIV testing: Your doctor can recommend getting tested for HIV in some cases since pneumonia is common in undiagnosed cases of HIV/AIDS
  • CT scan: This is reserved for more severe cases and if you’re suffering from complications

Can pneumonia go away on its own?

Pneumonia is a serious infection that doesn’t usually resolve and requires medical attention.

How is pneumonia treated?

The most important parameters of treatment are oxygen, antibiotics and fluids.
  • Oxygen: In case you’re having difficulty breathing or your oxygen saturation levels are less than 94%, your doctor can connect you to an oxygen mask or nasal cannula
  • Antibiotics: Based on the findings of diagnostic tests, your doctor will prescribe you, antibiotics which can be taken orally or given through your veins in cases of severe infection. You must finish the antibiotic course as per your doctor’s instructions to recover quickly and avoid complications
  • Fluids: It’s important to keep yourself well hydrated and drink plenty of liquids. In severe infections, your doctor can put you on intravenous fluids as well to avoid dehydration and collapse
  • Additional medications can include paracetamol for fever and chest pain, cough syrup to ease cough and sore throat, and antihistamines to provide relief from your other symptoms.

What are the complications of pneumonia?

While it usually resolves after prompt treatment with antibiotics, sometimes it can lead to complications such as:
  • Parapneumonic effusion, which is the build-up of fluid around the lungs
  • Lung abscess, or the formation of a pus-filled cavity in the lung
  • Empyema, or the formation of pockets of pus around the lungs
  • Pneumothorax or lung collapse
  • Respiratory distress
  • Bacteremia occurs when the infection gets into the bloodstream and affects other organs such as the heart, liver, brain

How can I prevent pneumonia?

You can minimise your risk by:
  • Giving up smoking
  • Getting an influenza and pneumococcal vaccination, especially if you’re a high-risk patient
  • Getting your child vaccinated according to the schedule, especially against measles, whooping cough, and H. influenzae type b
  • Building a strong immune system with a healthy diet, regular exercise and getting adequate sleep daily
  • Ensuring good hygiene
Dr. Aditi

Dr. Aditi

An MBBS and a medical reviewer with a penchant for healthcare articles and blogs. Read her contributions and writings about various healthcare topics.

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