Pneumonia Symptoms, Causes, Treatments, & More

• Pneumonia is a lung infection that causes fluid buildup in the lungs.
• Pneumonia can happen to anyone and is highly contagious, but it is treatable.
• Those over the age of 65 are at a higher risk of contracting pneumonia and experiencing more severe symptoms.

Pneumonia is a respiratory infection that may range from a mild to severe illness. This condition may impact anyone, though it is more likely to affect people who are older, have certain chronic health problems, or have a weakened immune system.

Ahead, we’ll look at the symptoms of this common illness, possible and serious complications, and what pneumonia cases can be treated at home with prescription and/​or over the counter medications and which ones require treatment in inpatient health care settings.

Pneumonia is a common lung infection. It occurs when there’s inflammation and/​or fluid buildup in air sacs in the lungs caused by a bacterial, fungal, or viral infection. The lungs sit inside the chest cavity, and along with the upper airways and other parts of the respiratory system, they make it possible to breathe. Treating this condition depends on what caused the condition, which is why an accurate diagnosis is so important.

Pneumonia can occur in anyone and ranges from mild to life-threatening. However, the risk of developing pneumonia or experiencing more severe symptoms is more likely in:

• Children
• Those over the age of 65
• Those with weak immune systems due to conditions such as Type 2 Diabetes, HIV, cancer, or smoking.

Pneumonia can occur in one or both lungs and is treatable, but it should be treated immediately to prevent further complications, such as lung abscesses.

There are several types of pneumonia, including bacterial, viral, fungal, and aspiration pneumonia.

• Bacterial pneumonia: The result of a bacterial infection, often caused by Streptococcus pneumoniae bacteria. It’s typically the most common form of pneumonia and often requires a hospital stay.
• Viral pneumonia: The result of respiratory viruses similar to those that cause other conditions such as COVID-19, respiratory syncytial virus (RSV), a common cold or the flu. Viral pneumonia often has milder symptoms and resolves on its own, but it’s still important to monitor and treat.
• Fungal pneumonia: This type of pneumonia is caused by fungal spores such as Cryptococcus, Pneumocystis jirovecii, and Coccidioides. It is less common and usually only affects those with compromised immune systems.
• Aspiration pneumonia: The result of food and liquid being inhaled into the lungs. Like fungal pneumonia, this is a less common form of pneumonia.
• Walking pneumonia: This isn’t a medical term, but it does refer to cases of pneumonia that are incredibly mild and can allow a person to continue daily activities without an issue. Sometimes, it’s also referred to as atypical pneumonia.
• Nosocomial pneumonia: This refers to pneumonia acquired in a hospital after 48 hours of admission that wasn’t present before arrival. This type is considered very common in senior patients, with the most common causes being the bacteria MRSA (methicillin-resistant staph aureus) and aerobic gram-negative bacilli.

Depending on the type of pneumonia, symptoms of pneumonia can vary and range from mild to more serious. Pneumonia is highly contagious, with the exception of fungal pneumonia (fungal infections do not pass from person to person the same way bacteria or viral infections do).

Bacterial Pneumonia Symptoms

• Tiredness (fatigue)
• Cough with phlegm or thick mucus
• Changes in body temperature, usually a high fever though older adults or those with a weakened immune system may have a lower than normal temperature
• Rapid breathing or rapid heart rate
• Shortness of breath
• Sweating or chills
• Chest and/​or abdominal pain
• Loss of appetite
• Confusion or altered mental state

Bacterial pneumonia symptoms usually occur in four stages:

• Stage 1 — Congestion: Early symptoms of infection may include coughing and fatigue 
• Stage 2 — Red Hepatization: Usually occurs 2 or 3 days after your initial symptoms. The lungs may appear red on imaging due to the build-up of red blood cells and other immune cells in the lungs.
• Stage 3 — Gray Hepatization: Usually occurs 4 to 6 days after the onset of pneumonia symptoms. During this stage, your lungs may appear gray on imaging due to avascularization or a decrease in visible lung blood vessels. Your symptoms may persist for 4 to 8 days.
• Stage 4 — Resolution: Airways begin to return to normal and symptoms ease

Viral Pneumonia Symptoms

• Dry cough
• Trouble breathing/​shortness of breath
• Changes in body temperature
• Fatigue
• Muscle pain
• Headache

Symptoms of fungal, aspiration, and walking pneumonia are similar to those of bacterial or viral pneumonia, making them difficult to distinguish. It’s worth noting that aspiration pneumonia may also include foul-smelling breath or coughing up phlegm that contains mucus or blood. Additionally, walking pneumonia symptoms are often extremely mild compared to other types.

Milder symptoms may go away after one to two weeks, but more severe cases can lead to respiratory failure, sepsis, and meningitis. If you are experiencing worsening pneumonia symptoms after three weeks, visit your provider to ensure your case is not growing severe. 

Causes

Pneumonia can be caused by bacterial, viral, or fungal infections. Bacterial and viral pneumonia are the two most common types.

Bacterial and viral infections are often characterized by where the infection was contracted e.g. the hospital, their community, etc. Bacterial or viral pneumonia infections are commonly called by the names below:

• Hospital-acquired pneumonia: this occurs when you obtain a virus or infection while in the hospital, usually while being treated for a different medical condition. 
• Ventilator-acquired pneumonia: this results from receiving the infection from a ventilator.
• Community-acquired pneumonia: this occurs when you pick up a virus or infection while not in the hospital and is the most common category of pneumonia. 

Risk Factors

Risk factors for pneumonia include:

• Age: Children and older adults (those over the age of 65) are at a higher risk of pneumonia.
• Smoking: Those who smoke often have weaker lungs and are more susceptible to lung infections.
• Chronic health conditions: People with chronic obstructive pulmonary disease (COPD) or lung disease are at higher risk for pneumonia.
• Weakened immune system: Those with weakened immune systems due to one of the previous risk factors, other health conditions such as HIV/AIDS, or those undergoing chemotherapy, are also at a higher risk of pneumonia.

If a doctor suspects pneumonia, they will usually prescribe antibiotics first.

Given that pneumonia symptoms can be similar to those of the flu and that pneumonia can result from other viruses, the doctor will ask about your medical history and do a focused physical exam, including listening to your chest with a stethoscope.

If your doctor suspects you could have pneumonia, they will run a few tests to confirm the diagnosis, including:

• Blood Tests (to check for infection and determine what is causing it)
• Chest X‑ray (to look for the location of the infection)
• Pulse Oximetry (to measure the oxygen in your blood)
• Sputum Test (to measure the extent of infection through a mucus sample)

For those over the age of 65 or who have other health complications, a doctor may run additional tests if you’re diagnosed with pneumonia. These can include a CT scan or bronchoscopy if the pneumonia isn’t healing.

Pneumonia is curable, but some complications can arise if left untreated, including:

• Respiratory failure
• Sepsis
• Meningitis
• Long-term lung damage
• Increased risk of future infections

If you suspect that you have pneumonia, contact a healthcare provider immediately. 

The best way to prevent pneumonia, especially bacterial pneumonia, is through vaccination. Specific pneumococcal vaccines, such as Pnemovax23 and Prevnar13, can help protect against bacteria such as Streptococcus pneumonia.

Additionally, getting vaccines that protect against other viruses, such as the flu vaccination and COVID-19 vaccine, can help prevent infections that might turn into pneumonia.

Children younger than age five should receive the full pneumococcal vaccination series, and everyone should stay current with vaccines that prevent other infections that can lead to pneumonia.

Additionally, you can help prevent pneumonia by washing your hands and staying away from those infected. If you smoke, quitting can help increase your lung’s chances of being able to fight off infection.

Note: For more information surrounding routine vaccines and how to stay up-to-date with your immunizations, visit this resource.

Treatment will depend on the type of pneumonia and the cause of the infection. 

Bacterial Pneumonia Treatment

If you have bacterial pneumonia, antibiotics will likely be prescribed. You must take all of the antibiotics, even if you begin to feel better, to ensure that you have eliminated the entire infection, lowering the risk of it returning.

Viral Pneumonia Treatment

If you have viral pneumonia, your provider will monitor your symptoms to determine severity. They will likely advise you to isolate and treat the virus at home (at-home treatments referenced below). If the symptoms persist, an antiviral may be prescribed to combat the virus.

At-Home Pneumonia Treatments

In many cases, pneumonia symptoms can be treated at home alongside the prescribed medications from your provider. Some ways to treat pneumonia at home include:

• Taking aspirin or NSAIDs to help treat your fever
• Using breathing treatments, such as a nebulizing mask that delivers liquid directly to the lungs, if your healthcare provider prescribes one
• Drinking plenty of beverages
• Using a humidifier, steamy baths, or warm beverages to help open your air passages
• Getting plenty of rest
• Not smoking and considering quitting if you smoke tobacco products regularly

Signs Pneumonia is Improving

As you continue to treat at home, some signs that your pneumonia is improving include:

• Breathing becomes easier
• Less mucus production
• Coughing lessens or goes away entirely
• Your fever lifts
• Your chest feels lighter

If your breathing or other symptoms worsen, contact your healthcare provider immediately.

While pneumonia can often be treated at home, you will want to seek medical attention if pneumonia symptoms grow serious, including:

• Difficulty breathing
• Chest pain
• Fever of 102℉ or higher.

If you have trouble breathing, persistent coughing, or a fever that lasts more than two days, contact your primary care provider as soon as possible.

While pneumonia can affect all age groups, seniors are at particular risk for pneumonia. This occurs primarily because your immune system begins to wane around the age of 65, a condition known as functionally immunocompromised. As a result, you may have: 

• A weakened immune system
• A higher likelihood of contracting pneumonia at a hospital due to extended medical stays
• Other chronic health problems, such as heart disease or diabetes, that make you more susceptible to pneumonia

Additionally, seniors are at a higher risk of pneumonia symptoms getting worse or lasting longer, which can lead to more severe cases of the illness. If you suspect you have symptoms of pneumonia, see your doctor immediately to help treat the illness before it worsens.