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Pneumonia


Expert reviewer, Dr Richard Russell, Respiratory Consultant
Next review due February 2024

Pneumonia is an inflammation of the lung tissues, usually caused by an infection. Most people recover well from pneumonia. But it can be a very serious condition needing medical attention and sometimes admission to hospital.

Pneumonia causes

Pneumonia is usually caused by either a bacterial infection or a viral infection. The bacteria or virus can get into your lungs and cause the alveoli (tiny air sacs) and smaller airways to become inflamed and filled with fluid. This makes it harder for your lungs to work properly.

Anyone of any age can get pneumonia. But you’re at greater risk of getting pneumonia or getting it more severely if you:

  • are over 65 or under two years of age
  • smoke (smoking damages your lungs which makes you more prone to infection)
  • have long-term lung problems such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis or cystic fibrosis
  • have other health conditions such as diabetes or a heart, liver or kidney condition
  • regularly drink alcohol
  • have a weakened immune system (for example, if you have HIV/AIDS or are undergoing chemotherapy)

You’re also more likely to get pneumonia if you’re in hospital for other reasons. If you develop pneumonia while you’re in hospital, it’s called hospital-acquired pneumonia.

It’s also possible to get pneumonia from inhaling small amounts of liquid or material from your stomach or mouth and throat into your lungs. This can damage the lungs and cause infection. This is known as aspiration pneumonia. It’s more likely to happen if you’re unconscious or if you have a condition that causes swallowing difficulties.

Pneumonia symptoms

If you have pneumonia, you’ll probably feel unwell and have symptoms like flu.

Common symptoms of pneumonia include:

  • a cough – this may be dry or you may cough up sputum which can be green–yellow, rust-coloured or even bloodstained
  • a fever and you might also sweat and shiver
  • breathlessness
  • pain in your chest, which is worse when you take a deep breath (pleurisy)
  • loss of appetite
  • muscle aches and pains

Your symptoms may come on gradually, but sometimes the symptoms of pneumonia start suddenly and rapidly get worse.

Symptoms of pneumonia may vary depending on your age and other medical problems. An older person with pneumonia may just seem generally unwell and off their food. They may also be confused and more prone to falls. A young child with pneumonia may be restless and irritable, perhaps with abdominal (tummy) pain.

These symptoms aren't always caused by pneumonia, but if you have them and feel very unwell, contact your GP. If your symptoms are severe (for example, you’re feeling very short of breath or coughing up blood), seek urgent medical attention.

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Diagnosis of pneumonia

Your GP will often be able to diagnose whether or not you have pneumonia by asking about your symptoms and examining you. They might count how fast you’re breathing and tap on your chest to see how it sounds. They may use a stethoscope to see if they can hear any crackly noises in your lungs.

Your GP may also take your blood pressure, pulse rate and temperature. Sometimes, they may measure the amount of oxygen in your blood, using a simple device that clips to your finger. They might also ask you some questions to check if you’re experiencing any confusion.

Based on your age, symptoms and their examination, your GP will decide whether you should be admitted to hospital or can be treated at home.

In some cases, you may also need other tests including:

  • a chest X-ray
  • blood tests
  • a sputum sample to send to a laboratory for testing

Self-help for pneumonia

If you have pneumonia, there are things you can do to help yourself while you recover. You should:

  • stop smoking
  • drink plenty of fluids – enough to keep hydrated
  • get plenty of rest

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 or are in pain, you can take an over-the-counter painkiller such as paracetamol or ibuprofen. Make sure you also take any prescribed medications as directed by your doctor.

Pneumonia treatment

Medicines

The main treatment for bacterial pneumonia is a course of antibiotics. Your GP will advise you to start this as soon as possible. A type of penicillin is often used to treat pneumonia, so it’s vital that you tell your GP if you’re allergic to penicillin. If you can’t have penicillin, there are other effective antibiotics that your GP can offer you instead.

You’ll usually need to take the antibiotics for five days to start with. If you’re not feeling better within three days after starting the antibiotics or you start feeling much worse, it’s important to tell your GP. They may ask you to take antibiotics for a few more days, prescribe a different antibiotic or arrange further tests or a specialist review.

If you have viral pneumonia, antibiotics won’t work because they act against bacteria not viruses. Viral pneumonia is mainly treated with supportive therapy as described in our self-help section. But there are some antiviral medicines your doctor may prescribe if you’re at high risk of complications.

Hospital treatment

If your symptoms are severe or you don’t get better at home with initial treatment, your GP may advise you to go to hospital.

In hospital, your doctor may recommend that you have two antibiotics rather than one. You may be given these directly into a vein with a drip (intravenously, IV). In some areas it may be possible for nurses to come to your house to give you IV antibiotics. Your GP will tell you if this is an option for you.

While you’re in hospital, your doctor will monitor how much oxygen your body is getting. You’ll probably be offered oxygen to help your breathing. If you have very severe pneumonia, you may need help with your breathing using a ventilator (an artificial breathing machine).

Recovering from pneumonia

Most people who have pneumonia recover well, but it can take weeks or months to feel completely back to normal. How quickly you get better depends on how severe your pneumonia was, your age and your general health. Most people can expect that by:

  • one week, their temperature should be back to normal
  • four weeks, they shouldn’t have much chest pain or be producing as much sputum
  • six weeks, their cough will be much better and they won’t feel so breathless
  • three months, most of their symptoms will have gone but they may still feel tired a lot
  • six months, they’ll be back to normal

It’s important to see your GP if your symptoms get worse rather than better.

If you’re still experiencing symptoms after six weeks or you’re at higher risk (for example, you smoke), your doctor may suggest a follow-up X-ray. This is to make sure the infection has gone. Depending on the results of the X-ray, you may need to see your GP.

If you’ve had pneumonia, you may be concerned that it might happen again. There’s no real reason why a healthy person who has had pneumonia will be more likely to get it again. However, there are some health conditions that make you more prone to developing pneumonia. For more information, see our section on causes of pneumonia.

Complications of pneumonia

Most people with pneumonia recover well and return to good health. However, pneumonia can sometimes lead to complications. These include the following.

  • A build-up of fluid around your lungs is called a pleural effusion. This might make you feel breathless. It might go away on its own with antibiotic treatment but can sometimes need hospital treatment.
  • Severe breathing difficulties can develop as a result of severe inflammation in your lungs. You may need to go on a ventilator if your breathing is severely affected.
  • An abscess (collection of pus) in your lung might require treatment in hospital to drain it.
  • Septicaemia (blood poisoning) is an infection that can spread to other parts of your body and may be fatal if not treated straight away.

Prevention of pneumonia

If you smoke, stopping will reduce your risk of getting pneumonia. It will also reduce the chance of those around you (for example, your children) getting pneumonia. There’s a lot of advice available to help you quit – speak to your pharmacist or contact your GP surgery for advice.

Your GP may recommend you have a vaccination (jab) against pneumonia and flu if you’re at risk. There are two vaccines that can help prevent pneumonia caused by infection with a bacterium called Streptococcus pneumoniae.

  • Pneumococcal polysaccharide vaccine (PPV) is given to anyone aged over 65. It is also given to children over the age of two and at high risk. It protects against 23 strains of the bacterium.
  • Pneumococcal conjugate vaccine (PCV) is for children under the age of two. The first dose is given at around three months old and protects against 13 strains of the bacterium.

If you’re at risk, you can get vaccinated at your GP surgery. Vaccines are also available from private clinics and some pharmacists. You should also consider having a flu jab because pneumonia can develop as a complication of flu.

Frequently asked questions about pneumonia



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Related information

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  • Reviewed by Pippa Coulter, Freelance Health Editor, February 2021
    Expert reviewer, Dr Richard Russell, Respiratory Consultant
    Next review due February 2024

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