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Alternative Names Return to topBronchopneumonia; Community-acquired pneumonia
Definition Return to top
Pneumonia is an infection of the lungs. Many different organisms can cause it, including bacteria, viruses, and fungi.Pneumonia can range from mild to severe, and can even be deadly. The severity depends on the type of organism causing pneumonia, as well as your age and underlying health.
Causes Return to top
Pneumonia is a common illness that affects millions of people each year in the United States.
Bacterial pneumonias tend to be the most serious and, in adults, the most common cause of pneumonia. The most common pneumonia-causing bacterium in adults is Streptococcus pneumoniae (pneumococcus).
Respiratory viruses are the most common causes of pneumonia in young children, peaking between the ages of 2 and 3. By school age, the bacterium Mycoplasma pneumoniae becomes more common.
In some people, particularly the elderly and those who are debilitated, bacterial pneumonia may follow influenza or even a common cold.
People who have trouble swallowing are at risk of aspiration pneumonia. In this condition, food, liquid, or saliva accidentally goes into the airways. It is more common in people who have had a stroke, Parkinson's disease, or previous throat surgery.
It is often harder to treat pneumonia in people who are in a hospital, or a nursing facility.
Symptoms Return to top
The main symptoms of pneumonia are:
Exams and Tests Return to top
If you have pneumonia, you may be working hard to breathe, or may be breathing fast.
Crackles are heard when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall).
The health care provider will likely order a chest x-ray if pneumonia is suspected.
Some patients may need other tests, including:
Treatment Return to top
If the cause is bacterial, the doctor will try to cure the infection with antibiotics. If the cause is viral, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication. It may be difficult to distinguish between viral and bacterial pneumonia, so you may receive antibiotics.
Patients with mild pneumonia who are otherwise healthy are usually treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).
Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following:
Many people can be treated at home with antibiotics. If you have an underlying chronic disease, severe symptoms, or low oxygen levels, you will likely require hospitalization for intravenous antibiotics and oxygen therapy. Infants and the elderly are more commonly admitted for treatment of pneumonia.
You can take these steps at home:
When in the hospital, respiratory treatments to remove secretions may be necessary. Occasionally, steroid medications may be used to reduce wheezing if there is an underlying lung disease.
Outlook (Prognosis) Return to top
With treatment, most patients will improve within 2 weeks. Elderly or debilitated patients may need treatment for longer.
Your doctor will want to make sure your chest x-ray becomes normal again after you take a course of antibiotics.
Possible Complications Return to top
Empyema or lung abscesses are infrequent, but serious, complications of pneumonia. They occur when pockets of pus form around or inside the lung. These may sometimes require surgical drainage.
When to Contact a Medical Professional Return to top
Call your doctor if you have:
Infants with pneumonia may not have a cough. Call your doctor if your infant makes grunting noises or the area below the rib cage is retracting while breathing.
Prevention Return to top
Vaccines can help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other chronic conditions:
Taking deep breaths may help prevent pneumonia if you are in the hospital -- for example, while recovering from surgery. Often, a breathing device will be given to you to assist in deep breathing.
If you have cancer or HIV, you should talk to your doctor about additional ways to prevent pneumonia.
References Return to top
Limper AH. Overview of Pneumonia. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 97.
Lutfiyya MN, Henley E, Chang LF, Reyburn SW. Diagnosis and treatment of community-acquired pneumonia. Am Fam Physician. 2006;73:442-450.
Hemilä H, Louhiala P. Vitamin C for preventing and treating pneumonia. Cochrane Database Syst Rev. 2007;Jan 24(1):CD005532.
Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents -- United States, 2008. Pediatrics. 2008;121:219-220.
Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2007;120:783-790.
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.Update Date: 4/14/2008 Updated by: Andrew Schriber, MD, FCCP, Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.