Pneumonia is one of the leading causes of death worldwide, but proper treatment can greatly improve outcomes for most patients. We speak to a Mediclinic pulmonologist about the symptoms, causes and best treatment for different types of pneumonia.
‘Pneumonia is an infection in the tissues of the lungs that causes inflammation of the airspaces in the lungs. This stops the lungs from functioning properly,’ explains Dr Ismail Hassan, a pulmonologist at Mediclinic Heart Hospital in Pretoria.
What are the symptoms?
Sometimes the only symptom may be rapid breathing. When pneumonia is present in the lower part of the lungs, often no breathing problems may be present but rather fever, abdominal pain or vomiting, says Dr Hassan. ‘If the pneumonia is bacterial, the infected person becomes sick relatively quickly and is prone to developing a high fever and rapid breathing,’ he adds.
Pneumonia symptoms can vary from mild to severe, depending on the type of pneumonia (bacterial or viral), and the patient’s age and health status.
The most common symptoms are:
- Coughing (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
- Fever, which may be low grade or high grade
- Shaking chills (rigors)
- Shortness of breath, which may only occur on exertion
Other symptoms include:
- Sharp or stabbing chest pain that gets worse when you breathe in deeply or cough (known as pleuritic chest pain)
- Excessive sweating, cold and clammy skin
- Low blood pressure
- Confusion, especially in older people
Types and causes of pneumonia
Pneumonia can be broken down into 7 types:
- Aspiration pneumonia results when food, drink, vomit, secretions or other foreign material is inhaled or aspirated into the airway.
- Bacterial pneumonia is most commonly caused by streptococcus bacteria (pneumococcus), but other bacteria can cause it too.
- Viral pneumonia is caused by certain viruses – often those responsible for common colds and flu or common childhood infections such as chicken pox.
- Community-acquired pneumonia is caused by certain strains of bacteria that are present in the community.
- Nosocomial pneumonia is caused by certain strains of bacteria that are prevalent in a hospital setting.
- Healthcare-associated pneumonia is caused by certain strains of bacteria that are found in old-age homes, dialysis units and other specialist facilities.
- Ventilator-associated pneumonia (VAP) is caused by certain strains of bacteria present in patients who are being ventilated in an ICU.
How is pneumonia treated?
In the management of pneumonia, chest X-rays are an important investigation.
‘Antibiotic medications are the treatment of choice for pneumonia caused by a bacterial infection,’ says Dr Hassan. ‘Severe pneumonia will require hospitalisation and oxygen treatment with other medications such as corticosteroids and bronchodilators if needed.’
- Physiotherapists play an important role in helping patients with pneumonia to recover.
- Patients should have a chest X-ray and consultation with a health care provider six weeks later from the onset of symptoms.
- Non-resolving pneumonia will need a referral to a pulmonologist.
- Annual vaccinations (pneumococcal and influenza) are recommended in high-risk individuals and can be given simultaneously.
- Precautions should be taken at mass gatherings to limit infection in high-risk individuals.
Who is most at risk of getting pneumonia?
‘Pneumonia is generally more serious when it affects older adults, infants and young children, those with chronic medical conditions, or those with weakened immune function,’ Dr Hassan explains. He adds that those at most risk include:
- People who lead poor lifestyles (drinking, smoking or eating poorly)
- Infants and children under 5 years of age
- Elderly people above the age of 65
- People with swallowing or coughing problems
- People with chronic disease such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), sickle cell anaemia, multiple myeloma, asthma, heart disease, diabetes or cancer patients on chemotherapy.
If you or a loved one displays any of the above symptoms, see a GP who will refer you to an appropriate specialist. If the symptoms are severe, the patient should be taken to an emergency unit for immediate care.