Symptoms of Pneumonia: Know the Facts
Pneumonia is a respiratory condition that is caused by an infection of one or both lungs. This is an illness that affects more than a million people each year in the United States. Various bacteria, viruses, and fungi may cause pneumonia. Bacterial pneumonia is the most common type of pneumonia in adults and the most common type of bacteria is Streptococcus pneumoniae (pneumococcus). Chemical burns or physical injury to the lungs can also produce pneumonia.
For individuals that are otherwise healthy and younger than 65, the symptoms of bacterial pneumonia usually come on suddenly caused by inflammation in the tiny air sacs of the lung, called alveoli, or when the lungs fill with fluid (consolidation). Symptoms often start during or after an upper respiratory infection, such as the flu or a cold.
In children and young adults, the primary cause is viral. Viral pneumonia caused by the influenza virus may be severe and sometimes fatal. The virus invades the lungs and multiplies; however, there are almost no physical signs of the lung tissue becoming filled with fluid. Because of this, the symptoms of viral pneumonia may come on slowly and often are not as obvious or as bad.
Most of the time, your nose and airways filter germs out of the air as you breathe. This typically keeps your lungs from becoming infected. However, sometimes germs can find a way to enter the lungs and cause infections. The lungs are a great place for bacteria and viruses to grow because they are warm, dark and moist. Once inside the lungs, germs can multiply rather rapidly.
What Are the Symptoms of Pneumonia?
Pneumonia symptoms can range from mild to severe and are dependent on the type of pneumonia you have, your age and your general health. The elderly, infants, and people with other diseases are at a greater risk of becoming very ill and may need to be in the hospital.
The most common symptoms of pneumonia are:
- Cough – A prolonged cough is often a good indicator to seek medical care.
- Productive- sputum/mucus coughed up may be yellow, greenish or even bloody.
- Non-productive- a dry, racking cough which may irritate the throat.
- Fever – mild or high (as high as 105°F)
- Shaking and chills
- Shortness of breath or shallow/rapid breathing
- Muscle aches and malaise (generally feeling bad)
- Enlarged lymph nodes, particularly in the neck
- Chest pain – Sharp/stabbing pain that gets worse when taking a deep breath or when coughing. The chest also may be sore when it is touched or pressed because of coughing.
Additional symptoms may include:
- Nausea and vomiting – particularly with newborns and infants
- Excessive sweating and clammy skin
- Loss of appetite
- Low energy and fatigue
- Confusion – especially with the elderly and with high fevers
Symptoms also can vary, depending on whether your pneumonia is bacterial, viral or fungal.
In bacterial pneumonia, your temperature may be 102° F and over. This type of infection and high fever causes chills, difficulty breathing and a rapid pulse rate. Lips and nailbeds may become blanched (white) or have a bluish color. This is due to the lack of oxygen in the blood. A person may also appear to be confused or delirious due to an elevated body temperature.
The bacteria causes symptoms by initiating an immune response in the lungs. The small blood vessels in the lungs (capillaries) become leaky, and fluid seeps into the alveoli (air-filled sacs). This results in a less functional area for oxygen-carbon dioxide exchange. The person becomes oxygen deprived, while retaining potentially damaging carbon dioxide. Their breathing becomes faster and faster, while they are trying to bring in more oxygen and get rid of the extra carbon dioxide.
Mucus production increases and the leaky capillaries may make the mucus look slightly bloody. If mucus plugs form, they actually decrease the efficiency of gas exchange in the lung even more. The alveoli continue to fill with fluid and debris from the large number of white blood cells being produced to fight the infection.
Consolidation is a feature of bacterial pneumonia. This occurs when the alveoli, which are normally hollow air spaces within the lung, become solid, due to fluid and debris.
Although viral pneumonia does occur, viruses more commonly play a part in weakening the lungs. This then allows a secondary infection of pneumonia caused by bacteria. The initial symptoms of viral pneumonia are the same as influenza symptoms: headache, muscle pain, and weakness, runny nose, decreased appetite, and low-grade fever, usually followed by respiratory congestion and cough. However, within 12 to 36 hours, there is increased difficulty breathing due to the cough becoming worse and producing a small amount of mucus.
Fungal pneumonia can develop very rapidly and may be fatal, but it usually occurs in hospitalized persons who, because of impaired immunity, have a decreased resistance to infection. Contaminated dusts, when inhaled by healthy individuals, can sometimes cause fungal lung diseases.
Fungal infections such as coccidioidomycosis and histoplasmosis should be considered, particularly if the patient was recently exposed to excavations, backyard swimming pools, old sheds and barns, or dust storms. Other fungal and protozoan parasites (such as Pneumocystis carinii) are common in patients receiving immunosuppressive drugs or in patients with cancer, AIDS, or other chronic diseases. Pneumocystis carinii pneumonia has been one of the major causes of death among AIDS patients.
Risk Factors Associated with Pneumonia
There are various factors that can increase your risk of both contracting pneumonia and having complications associated with it. These risk factors include:
- Age 65 years old and over
- Children under the age of two
- Having a weakened immune system from medication of disease
- Chronic diseases such as diabetes, asthma, COPD, heart disease
- Difficulty swallowing
- Individuals living in a confined space: Nursing home, dorms and prisons
- Individuals requiring regular ventilator support
- Tobacco use
Treatment for Pneumonia
People diagnosed with bacterial pneumonia will need to take an antibiotic to help eliminate the infection from the body. The antibiotic your doctor chooses depends on your age, any chronic medical conditions, tobacco and alcohol use, and other medications that you may be taking. It is important that you tell your doctor about any allergies or reactions to any medicines you have taken previously, and bring a list of all of your current medicines with you.
Antibiotics are not effective against viral pneumonia. Depending upon the type of virus that causes pneumonia, antiviral medications can provide benefit when started early in the course of the disease. For example, the medications oseltamivir (Tamiflu) and zanamivir (Relenza) are used to treat influenza virus infections. Antifungal agents are used to treat most fungal pneumonias.
Take your medicine as directed and make sure that you take the entire course of any medications your doctor prescribed for you. If you stop taking your medication too soon, your lungs may continue to harbor germs that can multiply and cause your pneumonia to progress. Medicines such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) help to reduce fever and may also help to alleviate some of your body aches and pains.
Lastly, stay hydrated. This helps the body fight pneumonia. Drink plenty of fluids, especially water, to help loosen mucus in your lungs. You may prefer warm liquids. These can be comforting and aid in mobilization (breaking up) and expectoration (coughing out) of secretions. Coughing helps clear infection in the lungs. Your doctor may give you deep breathing exercises to help with this. Avoid cigarette or other tobacco smoke while recovering from pneumonia. Smoking will decrease the body’s ability to fight infection and it prolongs the healing process.
Finally, it is very important to get plenty of rest. Don’t go back to school or work until after your temperature returns to normal and you stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Pneumonia can recur, so it’s better not to jump back into your routine until you are fully recovered.