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Diagnosing and Treating Pneumonia

Top 5 Questions for Your Doctor

See 5 important questions to ask your healthcare provider about pneumonia.

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Many treatments for pneumonia are available. Treatment depends on the cause of your pneumonia, how severe your symptoms are, your age and overall health. Most healthy people recover from pneumonia in 1 to 3 weeks, but pneumonia can be life-threatening.

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:
    • Blood test to check white blood cell count and to try to know the germ which may be in your blood as well
    • Arterial blood gases to see if enough oxygen is getting into your blood from the lungs
    • CT (or CAT) scan of the chest to get a better view of the lungs
    • Sputum tests to look for the organism (that can detected in the mucus collected from you after a deep cough) 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. Coughing is one way your body works to get rid of an infection. If your cough is preventing you from getting the rest you need, ask your doctor about steps you can take to get relief.
  • Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.
  • Make sure you take antibiotics as prescribed

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 (which includes chronic bronchitis and 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 feel back to normal within a week of recovery from pneumonia. For middle-aged or older 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!

If you have taken antibiotics, your doctor may want to make sure your chest X-ray becomes normal again after you finish the whole prescription. It may take many weeks for your X-ray to clear up.

Possible Complications

People who may be more likely to have complications from pneumonia include:

  • Older adults or very young children
  • People whose immune system does not work well
  • People with other, serious medical problems such as diabetes or cirrhosis of the liver

Possible complications include:

  • Respiratory failure, which requires a breathing machine or ventilator
  • Sepsis, a condition in which there is uncontrolled inflammation in the body, which may lead to widespread organ failure
  • Acute respiratory distress syndrome (ARDS), a severe form of respiratory failure
  • Lung abscesses - these are infrequent, but serious, complications of pneumonia. They occur when pockets of pus form inside or around the lung. These may sometimes need to be drained with surgery.


    Approved by Scientific and Medical Editorial Review Panel. Last reviewed October 6, 2016.

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