Pneumonia: When to Seek Urgent Medical Care

Pneumonia is a serious lung disease that kills thousands of people every year and sends many more to the hospital. It is a common lung infection caused by bacteria, a virus or fungi. The infection causes inflammation in either one or both lungs. The alveoli, or air sacs, fill with fluid making it extremely difficult to breathe. When lungs are impaired it’s difficult to get oxygen into the bloodstream. When there is too little oxygen in the blood, the cells in your body cannot operate properly.

Anybody of any age can contract pneumonia. In adults, approximately 5-11 people out of every 1,000 get pneumonia each year in the UK. The disease is more serious for infants, older adults (65 years or older), and young children. Other people affected are those who suffer from chronic health issues,and those with a weak immune system.

Your chances of recovery are the greatest if you are young, it is caught early on, you have a strong immune system, it has not spread and your are not suffering from other illnesses. Most people, once treated, usually recover within one to three weeks. The elderly and those with other illnesses may need may take a longer period of time.

How It Affects The Lungs

The disease affects the lobe of the lung, referred to as lobar pneumonia, and if spots appear throughout both lungs it’s known as bronchial pneumonia. Another term for both lungs being affected is double pneumonia.

Causes Of Pneumonia

It can be caused by bacteria, a virus or fungi or due to chemical exposure. The most common causes are as follows:

Bacterial Pneumonia

When bacteria enters the lungs from the throat which usually happens when the immune system is weakened in some way. In many cases, this happens when someone suffers from an upper respiratory infection which can cause damage to the lungs, allowing bacteria to enter the area. Bacterial pneumonia is caused by a bacteria known as either pneumococcus or streptococcus pneumoniae.

Legionnaires Disease, which most people have heard of but haven’t a clue what it is, is caused by a bacteria called Legionella Pneumophila. This is often found in poor air conditioning units in buildings such as hospitals and/or hotels. This bacteria thrives in air conditioning units, as they are moist and warm, and if present can cause an outbreak of the disease. Usually this pneumonia is not severe and can be easily treated with antibiotics.

Legionnaires Disease came about from an epidemic in 1976 when 29 American Legion members mysteriously died after staying at the same hotel.

Viral Pneumonia

Viral pneumonia is caused by viral organisms that are similar to viruses that cause the common cold. It is a common complexity of various illnesses such as colds, influenza, herpes, measles and chickenpox. In most cases, viral pneumonia is milder than bacterial pneumonia and doesn’t last for a very long period of time.

Mycroplasma Pneumonia

This form of pneumonia is caused by a micro-organism of the same name. It is spread by coming in close contact with and infected person and is more prominent among young adults. In some cases, some people can contract this pneumonia and never show any symptoms. If someone is in good health, this form of pneumonia is not as severe as normal pneumonia and there are rarely any complications.

Aspiration Pneumonia

This happens when bacteria enters the lungs from either the mouth or stomach during vomiting. It’s usually common amongst alcoholics.

Pneumocystis Carinii Pneumonia (P.C.P.)

This is caused by a micro-organism that harmlessly live in normal lungs. It can develop as a secondary infection in those who have weakened immune systems caused by cancer or HIV. In many cases, it is the first sign of illness for people with HIV.

The Symptoms of Pneumonia

Bacterial and viral pneumonia are very similar and last approximately for two weeks. Some the common symptoms may be:

  • Fever
  • Severe shaking and chills
  • Severe coughing that increases over time and is accompanied by phlegm.
  • Shortness of breath
  • Severe chest pains or tightness
  • Fatigue and tiredness
  • Loss of appetite
  • Muscle aches and pains

If you feel you might have pneumonia and have a persistent cough, you should consult with your doctor as soon as possible.

How Do Doctors Diagnose Pneumonia

Your doctor will listen to your breathing through a stethoscope. If he or she suspects pneumonia, they will request a chest X-ray to see how severe the condition is.

It they discover a severe level, they will take samples of your phlegm for examination. Your doctor will try to grow the organism to find out what type of pneumonia you are suffering from.

If it is discovered you have bacterial pneumonia, your doctor will treat you with antibiotics. If you have viral pneumonia, it will usually get better on its own. Whether bacterial or viral, you should get plenty of bed rest, use a painkiller or antibiotic to alleviate your aches, pains and fever and drink plenty of water or juice daily.

Chest X-Ray Findings

When your doctor orders a chest X-ray to check for pneumonia, there are certain patterns and abnormalities they look for. The findings on the X-ray help determine if you likely have pneumonia and how severe it may be.

Typically, bacterial pneumonia shows up as a dense opacity or consolidation in one or more lobes of the lung. This means that area of the lung looks whitish or opaque rather than black which is the normal appearance of air-filled lungs on X-ray.

The consolidation tends to have an airspace pattern, meaning it appears as if the airspaces inside the lung have become solid or filled with fluid and pus from the infectious process.

In contrast, viral pneumonias often appear as more hazy airspace opacities with ill-defined borders. The lung abnormalities may be more widespread through both lungs rather than localized to one area.

For example, in COVID-19 pneumonia, chest X-rays commonly show bilateral patchy infiltrates in both lungs. However, X-rays are not always abnormal early in the course of viral pneumonias.

Blood Tests for Pneumonia

Along with imaging studies, your doctor may order certain blood tests if pneumonia is suspected. Some common tests include:

White Blood Cell Count (WBC): This measures the level of white blood cells, which increase when you have an infection as your body tries to fight it off. High WBC levels support a diagnosis of bacterial pneumonia.

Procalcitonin: This biomarker tends to be elevated with bacterial infections but stays low in viral illnesses. High procalcitonin levels suggest bacterial, rather than viral, pneumonia.

Inflammatory Markers: Tests like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) detect inflammation in the body caused by infections like pneumonia.

However, it’s important to note that while abnormal bloodwork raises suspicion for pneumonia, normal results don’t rule it out either. Lab tests are often used together with symptoms and imaging to diagnose pneumonia accurately.

When Is Hospitalisation Needed?

Most cases of pneumonia can be treated at home with oral antibiotics, plenty of rest, and increased fluid intake. However, there are certain situations where hospitalisation is recommended:

  • Severe difficulty breathing or low oxygen levels
  • You are elderly or have chronic illnesses that increase pneumonia risks
  • You appear dehydrated or cannot maintain adequate oral intake
  • You have high fevers or severe symptoms that indicate a more serious case
  • You live alone without support at home during recovery
  • You have complications like lung abscesses or pleural effusion (fluid around the lungs)

If admitted to the hospital, you may need IV antibiotics, respiratory treatments, oxygen therapy, or even ventilator support until your pneumonia improves. With proper medical care, most cases of pneumonia can be treated successfully.

Who Is At Risk Of Contracting Pneumonia

Anyone can contract pneumonia, however it is more common amongst the elderly, if you suffer from alcoholism, suffer from a heart condition, lung disease, asthma or diabetes. If you smoke, suffer from a weak immune system or had your spleen removed.

If Diagnosed With Severe Pneumonia

There is a good chance that you will be hospitalised for treatment. This may include additional oxygen to improve your breathing, physiotherapy to clear out mucus and antibiotics administered directly into your veins.

Are There Complications?

For those who are under a year of age, are elderly or suffer from a weakened immune system, it can be fatal. However, most people will suffer from a feeling of tiredness for some period of time but will fully recover.

Can I Prevent Pneumonia?

As pneumonia can be brought about by the flu and you are at high risk (list above), ask your doctor about getting a flue shot. Other ways to prevent pneumonia, do not smoke as smokers run a higher risk than non-smokers.

There is a vaccine available to protect against pneumococcus pneumonia infection. This is the most common form of pneumonia. The vaccine is highly recommended for those who suffer from heart or lung problems.

Further Advice

If you are worried about Pneumonia, contact your GP. Further help and advice can be found on the British Lung Foundation website. They also have a free helpline on 03000 030 555. Lines are open 9am to 5pm, Monday to Friday.

Photo “Pneumonia” by Anthony Cunningham for Zoom Health

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