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Pneumonia

Pneumonia is an inflammation of your lungs, usually caused by an infection of your lung tissue by one of many different germs (micro-organisms).

Animation – How pneumonia occurs

About pneumonia

If you have pneumonia, the infection causes the air sacs (alveoli) and smaller airways in your lungs to become inflamed. Your lungs can't work properly and aren’t able to get enough oxygen from the air into your blood. Pneumonia is caused by micro-organisms which include bacteria, viruses and fungi. Most infections occur in the autumn or winter and around one in four people with pneumonia are admitted to hospital.

If you have been infected at home or at work, it’s referred to as 'community-acquired' pneumonia. If you have been infected in hospital, it’s known as ‘hospital-acquired’ pneumonia.

Symptoms of pneumonia

If you have pneumonia, you will feel unwell and have symptoms that may be similar to flu or a chest infection. If you have pneumonia caused by the Streptococcus pneumoniae bacterium (the most common cause), it can start suddenly and rapidly get worse.

Symptoms of pneumonia may include:

  • a cough – this may be dry at first and then becomes a green/yellow or rust-coloured and smelly phlegm
  • a fever
  • breathlessness or faster breathing
  • pain in your chest
  • shivering and night sweats
  • loss of appetite
  • confusion and unsteadiness, especially if you’re over 65
  • muscle aches and pains

These symptoms aren't always caused by pneumonia, but if you have any then you should visit your GP. If your symptoms are severe, then seek urgent medical attention. Sometimes pneumonia can make it difficult to breathe in enough oxygen, which can be very dangerous. If your lips or the skin under your fingernails become bluish, call 999 immediately.

Complications of pneumonia

Complications of pneumonia are more common in older people and those with diabetes. They may include:

  • a build-up of fluid around your lungs (a pleural effusion)
  • severe breathing difficulties
  • an abscess in your lung
  • blood poisoning (septicaemia) as the infection spreads to other parts of your body

If you’re being treated at home and develop complications, you may be admitted to hospital.

Causes of pneumonia

It isn't always possible to identify the particular micro-organism that causes your pneumonia.

The germs may be present in your body for some time before you become ill. Alternatively, you may breathe in droplets that are in the air from other people coughing and sneezing.

The most common cause of pneumonia is bacteria, especially S.pneumoniae. An infection caused by this organism is known as pneumococcal pneumonia. Another common cause of bacterial pneumonia is Haemophilus influenzae type b (Hib).The bacteria Staphylococcus aureus may cause pneumonia in hospitals. The bacteria Mycoplasma pneumoniae causes epidemics every four years, mostly affecting children and young people. More rarely, the bacteria Legionella pneumophilia (which lives in all types of water), causes Legionnaire's disease, a severe form of pneumonia.

Other less common causes of pneumonia include:

  • viruses, including the influenza (flu) virus and chicken pox virus
  • inhaling substances, for example pollution, chemicals, smoke or vomit

You’re more at risk of pneumonia if you:

  • are in poor health
  • are over 65 or very young
  • smoke (smoking damages your lungs, making you more prone to infection)
  • have long-term heart or lung problems, liver or kidney disease
  • have diabetes
  • drink too much alcohol
  • have cancer or leukaemia, or are undergoing chemotherapy
  • have a weakened immune system, for example if you have HIV/AIDS

Diagnosis of pneumonia

Your GP will ask about your symptoms and examine you. He or she will tap on your chest and listen to how your breath sounds with a stethoscope.

Other tests you may have include:

  • a chest X-ray to find out where the infection is and how severe it is
  • measuring the amount of oxygen in your blood using a device that clips onto your finger
  • blood tests
  • a phlegm sample to send to a laboratory for testing
  • a urine sample

Treatment of pneumonia

Medicines

The type of antibiotic that your GP prescribes depends on what type of bacteria has caused your pneumonia. If your GP isn't sure which type has caused the pneumonia, he or she may give you an antibiotic that covers a range of bacteria.

You will usually need to take the antibiotics for approximately five to seven days. If you’re not feeling better within 48 hours after starting the antibiotics, it’s important to tell your GP. This is because the bacteria causing the infection may be resistant to the antibiotics. Your GP may then prescribe a different type of antibiotic.

The antibiotics won’t work if your pneumonia is caused by a virus because antibiotics only fight bacteria, not viruses. Your body’s immune system will create antibodies to destroy the virus.

Hospital treatment

If you’re very ill, your GP may decide to refer you to hospital.

You may be given antibiotics through a drip. As you get better, you may be able to come off the drip and take antibiotic tablets.

If you’re very ill in hospital, you might need to have oxygen to help your breathing or may even need help to breathe with a ventilator – an artificial breathing machine.

Self-help

If you have pneumonia you should:

If you’re resting in bed, turn over at least once every hour while you’re awake. To help clear any phlegm that has settled in your lungs, breathe deeply five to 10 times, followed by a few strong coughs.

If you have a fever you can take paracetamol, or for a child, a children’s paracetamol (eg Calpol). Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

After your treatment

Most people begin to feel better within three to five days after treatment, especially if treated quickly. However, pneumonia can make you feel very tired for up to six weeks afterwards. This may even be for longer if you were in hospital, are older or have another condition affecting your health. In some cases, it can take several months before you feel like you have fully recovered.

At first, you may find it hard to walk without getting out of breath. But as you recover, your energy and lung function should return to normal.

After six weeks, you will probably have a check up with your GP and possibly a follow-up X-ray, especially if you’re a smoker.
 

Prevention of pneumonia

Pneumonia isn’t as contagious as illnesses such as flu but you can pick it up through infected people coughing and sneezing around you. It’s important to wash your hands regularly and to use a tissue when you cough or sneeze and bin it immediately.

Stopping smoking will also reduce your risk of pneumonia.

Vaccines

Your GP may recommend you getting vaccinated against pneumonia and flu if you’re at risk.

There are two vaccines that can help prevent pneumonia caused by S.pneumoniae infection.

  • Pneumococcal polysaccharide vaccine (PPV). This is for anyone at high risk, or over 65, and protects against 23 strains.
  • Pneumococcal conjugate vaccine (PCV). This is for children under the age of two, with the first dose given at two months old, and protects against 13 strains.

Children also receive HiB vaccines to protect them as part of the childhood immunisation schedule.

If you’re at risk, you can get vaccinated at your local GP surgery. Alternatively, vaccines are available from private clinics and some pharmacists. You should also consider having an influenza vaccination too, as pneumonia can develop as a complication of flu.

Animation - How bacterial vaccines work

 

Produced by Rebecca Canvin, Bupa Health Information Team, April 2013.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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