Pneumonia - Definitive Guide

Pneumonia is not a single disease symptom, but a group of symptoms causing inflammation of one or both lungs. In pneumonia there is a decrease in the amount of oxygen that blood can absorb from air breathed into the lung.

It is usually caused by infection with bacteria, viruses, fungi, or parasites. 

Pneumonia causes the air sacs in the lungs to fill with pus and fluid making breathing difficult. It can range in severity from mild to life-threatening and is most dangerous for babies and young children, people over 65, and those with weakened immune systems or chronic health conditions. 

Common symptoms of pneumonia include: 

• cough— this may be dry, or you may cough up thick mucus (phlegm) which may be green, brown, yellow, or blood-stained
• difficulty breathing and shortness of breath
• fever
• fast heart rate
• sweating
• chills
• feeling generally unwell
• loss of appetite
• chest pain, especially when coughing or breathing

Less common symptoms of pneumonia include: 

• headaches
• fatigue
• coughing up blood
• nausea (feeling sick)
• vomiting (being sick)
• diarrhoea
• wheezing (noisy breathing with a whistling or rattling sound) 
• muscle and joint pain
• low body temperature (more common in people over 65) 
• confusion (particularly in people over 65)

Most pneumonia are caused by bacteria, but it may also be caused by viruses like RSV, coronavirus. These types of pneumonia are known as community-acquired pneumonia as they are passed from person to person in the community. 

Some other types of pneumonia include: 

• hospital-acquired pneumonia is a type of pneumonia that develops in hospital while being treated for another condition. It is often severe due to the presence of stronger, drug-resistant bacteria in hospitals and hospitalised patients being unwell and less able to fight infections. Hospital-acquired pneumonia is particularly common in patients on ventilators (breathing machines) in intensive care. 

• fungal pneumonia develops from breathing in fungal spores in the environment. It normally affects people with weakened immunity such as children under 2, adults over 65, and people with long-term health conditions such as HIV or having treatment for cancer. 

• aspiration pneumonia occurs when a foreign substance such as chemicals, food, or vomit is breathed into the lungs instead of being swallowed. This causes infection and inflammation. 

Is pneumonia contagious? 

Viral and bacterial pneumonia are contagious (can be spread from person to person). Pneumonia is spread by: 

• coughing and sneezing

• touching objects that someone with pneumonia has used such as cups, eating utensils, and tissues
• not washing your hands regularly

Fungal pneumonia and aspiration pneumonia are not contagious.

Pneumonia is a serious condition and can be life-threatening. 

If you have symptoms of pneumonia you must see a doctor as soon as possible. 

Call an ambulance or go straight to hospital if you have any of the following symptoms: 

• Difficulty breathing
• Coughing up blood
• Blue lips or blue-tinged skin
• Confusion
• Drowsiness
• Cold, clammy, pale, or blotchy skin
• A rash that doesn’t fade when you press a glass against it 
• Peeing less than usual or not peeing at all
• Collapse 

Treatment for pneumonia will depend on the type of pneumonia you have, how severe the infection is, your age, and general health. 

Bacterial pneumonia is treated with antibiotics. 

Viral pneumonia may be treated with antivirals, but usually, your body will fight the infection by itself. 

Mild pneumonia  can normally be treated at home with: 

• antibiotics (if you have bacterial pneumonia) 

• rest

• drinking plenty of fluids
• Painkillers such as ibuprofen or paracetamol can help to reduce pain and fever. Always read the patient information leaflet of any medication carefully, and check with your doctor or pharmacist that they are safe for you to take. 

If your symptoms are getting worse, or there is no improvement after 3 days of taking antibiotics, make an appointment with a doctor. 

Symptoms of pneumonia normally start to improve after about a week, and gradually resolve over the next couple of months. You may still feel tired for a few months after having pneumonia. 

Always finish your course of antibiotics even if you feel better. Stopping your antibiotics early can mean the infection isn’t fully treated. This means it may come back and be harder to treat next time. 

Some things you can do to help prevent pneumonia include:

• wash your hands frequently especially after coughing, blowing your nose, and before eating or preparing food. 

• stop smoking. Smoking damages your lungs and makes it harder for you to recover from pneumonia. If you need help quitting smoking, talk to your GP. 
• a flu vaccine or pneumococcal vaccination may be recommended to help prevent pneumonia. Talk to your doctor about whether this is a good option for you.

If you have severe pneumonia you will need to be treated in hospital. Your doctor will decide on the best course of action for you depending on your age, general health, and symptoms.

NHS: Overview. Pneumonia June 30th 2019 (Accessed October 5th 2022)  

GP Notebook: Pneumonia February 2020 (Accessed October 5th 2022)  

 National Institute for Health and Care Excellence: Scenario- Community-acquired pneumonia June 2021 (Accessed October 5th 2022)  

John Hopkins Medicine: Pneumonia 2022  (Accessed October 5th 2022)  

NIH: How are different types of pneumonia classified? August 9th 2018 (Accessed October 5th 2022)  

NIH: Bacterial Pneumonia December 28th 2021  (Accessed October 5th 2022)  

NIH: Pneumonia Pathology April 12th 2022  (Accessed October 5th 2022)  

American Lung Association: Pneumonia Treatment and Recovery August 16th 2021 (Accessed October 5th 2022)  

NHS: Treatment. Pneumonia June 30th 2019  (Accessed October 5th 2022)