Symptoms, Diagnosis and Treatment

What Are the Symptoms of Pneumonia?

The most common symptoms of pneumonia are:

  • Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
  • Fever, which may be mild or high
  • Shaking chills
  • Shortness of breath, which may only occur when you climb stairs

Additional symptoms include:

  • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
  • Headache
  • Excessive sweating and clammy skin
  • Loss of appetite, low energy, and fatigue
  • 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 causes 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 is a high fever and there may be blueness of the lips.

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:
    • CBC blood test to check white blood cell count
    • Arterial blood gases to see if enough oxygen is getting into your blood from the lungs
    • CT (or CAT) scan of the chest  to see how the lungs are functioning
    • Sputum tests to look for the organism (that can detected by studying your spit) causing your symptoms
    • Pleural fluid culture if there is fluid in the space surrounding the lungs
    • Pulse oximetry to measure how much oxygen is moving through your bloodstream, done by simply attaching a small clip to your finger for a brief time
    • 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 and bring up phlegm.
  • Get lots of rest. Have someone else do household chores.
  • Do not take cough medicines without first talking to your doctor. Cough medicines may make it harder for your body to cough up the extra sputum.
  • Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.

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
  • Have severe symptoms
  • Are unable to care for yourself at home, or are unable to eat or drink
  • Are older than 65 or a young child
  • Have been taking antibiotics at home and are not getting better

Viral Pneumonia

Typical antibiotics will not work for viral pneumonia; sometimes, however, your doctor may use antiviral medication.  Viral pneumonia usually improves in 1 to 3 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, or 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 violent cough may be necessary.

Recovery

A healthy young person may lead a normal life within a week of recovery from pneumonia. For middle-aged 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!