What Causes Pneumonia?

Many different germs and other things can cause pneumonia. There are five main causes of pneumonia:

 Bacteria  Other infectious agents, such as fungi—

including pneumocystis
 Viruses
 Various chemicals
 Mycoplasma
If you have viral pneumonia, you also are at risk of getting bacterial pneumonia.

Types of Pneumonia

Bacterial Pneumonia

Bacterial pneumonia can attack anyone, at any age. It can occur on its own or develop after you've had a cold or
the flu. People at greatest risk for bacterial pneumonia include people recovering from surgery, people with
respiratory diseases or viral infections and people who have weakened immune systems.

If your body's defenses are weakened—by illness, old age, malnutrition, or impaired immunity—the pneumonia
bacteria, which can live in healthy throats, can multiply and work their way into the lungs. The infection can quickly
spread through the bloodstream and invade the entire body.

Dozens of different types of bacteria can cause pneumonia:

 The most common type of bacterial pneumonia is pneumococcal pneumonia, affecting over 900,000
Americans every year. Children under the age of 5 and adults over 65 have a recommendation to receive
a pneumococcal vaccination to help protect them against the Streptococcus (pneumococcus) bacteria.

 Atypical pneumonia is caused by bacteria such as Legionella pneumophila, Mycoplasma pneumoniae,

and Chlamydophila pneumoniae.

 Other bacteria that can cause pneumonia

include Staphylococcus aureus, Moraxella catarrhalis, Streptococcuspyogenes, Neisseria meningitidis, Klebsiell
a pneumoniae, and Haemophilus influenzae.

Viral Pneumonia

Most respiratory viruses attack the upper respiratory tract, but some cause pneumonia, especially in children. Most
of these pneumonias are not serious and last a short time but others can be severe.

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 lung tissue becoming filled with fluid. This pneumonia is
most serious in people who have pre-existing heart or lung disease and pregnant women.

In extreme cases, the patient has a desperate need for air and extreme breathlessness. Viral pneumonias may be
complicated by an invasion of bacteria, with all the typical symptoms of bacterial pneumonia.

Mycoplasma Pneumonia

Mycoplasma are the smallest free-living agents of disease. They are not classified as to whether they are bacteria or
viruses, but they have traits of both.

Mycoplasma usually cause a mild form of pneumonia but may be severe with certain symptoms lasting a long time.
They affect all age groups but occur most often in older children and young adults.
Other Types of Pneumonia

Tuberculosis (TB) rarely can cause pneumonia (tuberculosis pneumonia). It is a very serious lung infection and
extremely dangerous unless treated early.

Pneumocystis jiroveci pneumonia, which is caused by a fungus, is sometimes seen in people whose immune system is
impaired (due to HIV infection or certain medications that suppress the immune system).

Various special pneumonias are caused by the inhalation of food, liquid, gases or dust.

Pneumonia Symptoms, Causes, and Risk Factors

Anyone can get pneumonia. It's commonly a complication of a respiratory infection—especially the flu—but there are
more than 30 different causes of the illness. Older adults, children and people with chronic disease, including COPD
and asthma, are at high risk for pneumonia.

What Are the Symptoms of Pneumonia?

Pneumonia symptoms can vary from mild to severe, depending on the type of pneumonia you have, your age and
health.

The most common symptoms of pneumonia are:

 Cough (with some pneumonias you may cough  Shaking chills

up greenish or yellow mucus, or even bloody
 Shortness of breath, which may only occur
mucus)
when you climb stairs
 Fever, which may be mild or high
Additional symptoms include:

 Sharp or stabbing chest pain that gets worse  Excessive sweating and clammy skin
when you breathe deeply or cough
 Loss of appetite, low energy, and fatigue
 Headache
 Confusion, especially in older people
Symptoms also can vary, depending on whether your pneumonia is bacterial or viral.

 In bacterial pneumonia, your temperature may rise as high as 105 degrees F. This pneumonia can cause
profuse sweating, and rapidly increased breathing and pulse rate. Lips and nailbeds may have a bluish color
due to lack of oxygen in the blood. A patient's mental state may be confused or delirious.

 The initial symptoms of viral pneumonia are the same as influenza symptoms: fever, a dry cough, headache,
muscle pain, and weakness. Within 12 to 36 hours, there is increasing breathlessness; the cough becomes
worse and produces a small amount of mucus. There may be a high fever and there may be blueness of the
lips.
 What Causes Pneumonia?

Many different germs can cause pneumonia. There are five main causes of pneumonia:

 Bacteria  Other infectious agents, such as fungi

 Viruses  Pneumonia may also be caused by inhaling

various chemicals and environmental agents
 Mycoplasmas
If you have viral pneumonia, you also are at risk of getting bacterial pneumonia.

Understanding the cause of pneumonia is important because pneumonia treatment depends on its cause. Learn more
about what causes pneumonia.

What Are Risk Factors?

Anyone can get pneumonia, but some people are at a higher risk than others.

Risk factors (that increase your chances of getting pneumonia) include:

 Cigarette smoking  Other serious illnesses, such as heart disease,

liver cirrhosis, or diabetes
 Recent viral respiratory infection—a cold,
laryngitis, influenza, etc.  Living in a nursing facility

 Difficulty swallowing (due to stroke, dementia,
Parkinson's disease, or other neurological
conditions), which can lead to aspiration
(breathing in a foreign object)
 Chronic lung disease such
as COPD, bronchiectasis, or cystic fibrosis
 Cerebral palsy
 Impaired consciousness (loss of brain function
due to dementia, stroke, or other neurologic
conditions)
 Recent surgery or trauma
 Having a weakened immune system due to
illness, certain medications, and autoimmune
disorders

Diagnosing and Treating Pneumonia

Many treatments for pneumonia are available. Treatment depends on the cause of your pneumonia, how severe your
symptoms are, your age and overall health. Most healthy people recover from pneumonia in one to three weeks, but
pneumonia can be life-threatening.

How Is Pneumonia Diagnosed?

 Physical exam: Your doctor will listen to your lungs with a stethoscope. If you have pneumonia, your lungs
may make crackling, bubbling, and rumbling sounds when you inhale. You also may be wheezing, and it may
be hard to hear sounds of breathing in some areas of your chest.

 Chest X-ray (if your doctor suspects pneumonia).

 Some patients may need other tests, including:

 o Blood test to check white blood cell collected from you after a deep cough)
count and to try to know the germ causing your symptoms.
which may be in your blood as well.
o Pleural fluid culture if there is fluid in
o Arterial blood gases to see if enough the space surrounding the lungs.
oxygen is getting into your blood from
o Pulse oximetry to measure how much
the lungs.
oxygen is moving through your
o CT (or CAT) scan of the chest to get a bloodstream, done by simply
better view of the lungs. attaching a small clip to your finger for
a brief time.
o Sputum tests to look for the organism
(that can detect in the mucus
o Bronchoscopy, a procedure used to look into the lungs' airways, which would be performed if you are
hospitalized and antibiotics are not working well.

How Is Pneumonia Treated?

Treatment for pneumonia depends on the type of pneumonia you have and how severe it is, and if you have other
chronic diseases. The goals of treatment are to cure the infection and prevent complications.

Most people can be treated at home by following these steps:

 Drink plenty of fluids to help loosen secretions rest you need, ask your doctor about steps you
and bring up phlegm. can take to get relief.

 Get lots of rest. Have someone else do  Control your fever with aspirin, nonsteroidal
household chores. anti-inflammatory drugs (NSAIDs, such as
ibuprofen or naproxen), or acetaminophen.
 Do not take cough medicines without first
DO NOT give aspirin to children.
talking to your doctor. Coughing is one way
your body works to get rid of an infection. If  Make sure you take antibiotics as prescribed.
your cough is preventing you from getting the
If your pneumonia becomes so severe that you are treated in the hospital, you may receive fluids and antibiotics in
your veins, oxygen therapy, and possibly breathing treatments. You are more likely to be admitted to the hospital if
you:

 Have another serious medical problem.  Are older than 65 or a young child.

 Have severe symptoms.  Have been taking antibiotics at home and are
not getting better.
 Are unable to care for yourself at home, or are
unable to eat or drink.

Viral Pneumonia: Typical antibiotics will not work for viral pneumonia; sometimes, however, your doctor may use
antiviral medication. Viral pneumonia usually improves in one to three weeks.

Bacterial Pneumonia: Patients with mild pneumonia who are otherwise healthy are sometimes treated with oral
macrolide antibiotics (azithromycin, clarithromycin, or erythromycin). Patients with other serious illnesses, such as
heart disease, chronic obstructive pulmonary disease (which includes chronic bronchitis and emphysema), kidney
disease, or diabetes are often given more powerful or higher dose antibiotics.
In addition to antibiotics, treatment includes: proper diet and oxygen to increase oxygen in the blood when needed.
In some patients, medication to ease chest pain and to provide relief from a violent cough may be necessary.

Mycoplasma Pneumonia: These are pneumonias caused by germs intermediate between viruses and bacteria. These
are frequently mild, but occasionally can be severe and prolonged.

Recovering from Pneumonia

A healthy young person may feel back to normal within a week of recovery from pneumonia. For middle-aged or
older people, it may be weeks before they regain their usual strength and feeling of well-being.

A person recovering from mycoplasma pneumonia may be weak for an extended period of time. Adequate rest is
important to maintain progress toward full recovery and to avoid relapse. Don't rush recovery!

If you have taken antibiotics, your doctor will want to make sure your chest X-ray becomes normal again after you
finish the whole prescription. It may take many weeks for your X-ray to clear up.

Possible Pneumonia Complications

People who may be more likely to have complications from pneumonia include:

 Older adults or very young children.

 People whose immune system does not work well.

 People with other, serious medical problems such as diabetes or cirrhosis of the liver.

Possible complications include:

 Respiratory failure, which requires a breathing machine or ventilator.

 Sepsis, a condition in which there is uncontrolled inflammation in the body, which may lead to widespread
organ failure.

 Acute respiratory distress syndrome (ARDS), a severe form of respiratory failure.

 Lung abscesses - these are infrequent, but serious, complications of pneumonia. They occur when pockets of
pus form inside or around the lung. These may sometimes need to be drained with surgery.

Preventing Pneumonia

Can Pneumonia Be Prevented?

Yes. You can reduce your risk of getting pneumonia by following a few simple steps. Here's how:

Get Vaccinated

 Get a flu shot every year to prevent seasonal influenza. The flu is a common cause of pneumonia,
so preventing the flu is a good way to prevent pneumonia.

 Children younger than 5 and adults 65 and older should get vaccinated against pneumococcal pneumonia, a
common form of bacterial pneumonia. The pneumococcal vaccine is also recommended for all children and
adults who are at increased risk of pneumococcal disease due to other health conditions. There are two types
of pneumococcal vaccine. Talk to your healthcare provider to find out if one of them is right for you.
  There are several other vaccines that can prevent infections by bacteria and viruses that may lead to
pneumonia, including pertussis, chicken pox and measles. Please talk to your doctor about whether you and
your children are up to date on your vaccines and to determine if any of these vaccines are appropriate for
you.

Wash Your Hands

Wash your hands frequently, especially after blowing your nose, going to the bathroom, diapering, and before eating
or preparing foods.

Don't Smoke

Tobacco damages your lung's ability to fight off infection, and smokers have been found to be at higher risk of getting
pneumonia. Smokers are considered one of the high risk groups that are encouraged to get the pneumococcal
vaccine.

Be Aware of Your General Health

 Since pneumonia often follows respiratory infections, be aware of any symptoms that linger more than a few
days.

 Good health habits—a healthy diet, rest, regular exercise, etc.—help you from getting sick from viruses and
respiratory illnesses. They also help promote fast recovery when you do get a cold, the flu or other
respiratory illness.

If you have children, talk to their doctor about:

 Hib vaccine, which prevents pneumonia in children from Haemophilus influenza type b

 A drug called Synagis (palivizumab), which is given to some children younger than 24 months to prevent
pneumonia caused by respiratory syncytial virus (RSV).

If you have cancer or HIV, talk to your doctor about additional ways to prevent pneumonia and other infections.