2. Pneumonia
• lung inflammation caused by bacterial or viral infection, in
which the air sacs fill with pus and may become solid.
Inflammation may affect both lungs ( double pneumonia )
or only one ( single pneumonia ).
• Most people get better in 2 to 4 weeks, but babies, older
people, and people with heart or lung conditions are at
risk of getting seriously ill and may need treatment in
hospital.
3. What is the main cause of pneumonia?
• Pneumonia is mostly spread when people infected cough,
sneeze or talk, sending respiratory droplets into the air.
These droplets can then be inhaled by close contacts.
Less often, you can get pneumonia from touching an
object or surface that has the germ on it and then
touching your nose or mouth.
4. What is the main cause of pneumonia?
• BACTERIA
• The most common type of bacterial pneumonia is called pneumococcal
pneumonia. Pneumococcal pneumonia is caused by the Streptococcus
pneumoniae germ that normally lives in the upper respiratory tract.
• VIRUS
• Viruses that infect the upper respiratory tract may also cause pneumonia.
SARS-CoV-2, the virus that causes COVID-19, and the influenza virus are
the most common cause of viral pneumonia in adults. Respiratory syncytial
virus (RSV) is the most common cause of viral pneumonia in young children.
Most viral pneumonias are not serious and last a shorter time than bacterial
pneumonia.
5. What is the main cause of pneumonia?
• FUNGI
• Pneumocystis pneumoniais a serious fungal infection
caused by Pneumocystis jirovecii. It occurs in people who
have weak immune systems due to HIV/AIDS or the long-
term use of medicines that suppress their immune
systems, such as those used to treat cancer or manage
organ transplants.
6. Stages of pneumonia
• Stage 1 (congestion) occurs within 24 hours of infection. Many
bacteria are present in the lungs but few white blood cells are
available to fight the infection. The lungs may look red from
increased blood flow and swelling of the lung tissue.
• Stage 2 (red hepatization) occurs after 48 to 72 hours and lasts
for about 2 to 4 days. The affected lung becomes more dry,
granular and airless and resembles the consistency of liver. Red
cells, white cells, bacteria and cellular debris can clog the lung
airways.
7. Stages of pneumonia
• Stage 3 (grey hepatization) occurs on day 4 to 6 and continues for 4 to 8
days. The lung looks grey or yellow in color but still has the consistency of
liver. Fibrin, hemosiderin and red blood cells break down and lead to a more
fluid-like exudate. Macrophages, a type of large white blood cell, start to form.
• Stage 4 (resolution) is the final recovery stage and occurs during days 8 to
10. Fluids and breakdown products from cell destruction are reabsorbed.
Macrophages (large white blood cells) are present and help to clear white
blood cells (neutrophils) and leftover debris. You may cough up this debris.
The airways and air sacs (alveoli) return to normal lung function. Any
remaining lung swelling may lead to chronic lung disease (such as airway
narrowing or pleural adhesions).
8. Pneumonia classification
• Community-acquired pneumonia
• Community-acquired pneumonia is an infection that is acquired outside of the healthcare
system, including hospitals, nursing homes, outpatient clinics, or any other healthcare facility.
• Community-acquired pneumonia is the most common type of pneumonia and generally
presents as an acute infection, with symptoms appearing over the course of hours or days.
• Streptococcus pneumonia is the leading cause of community-acquired pneumonia and is
responsible for 20% to 60% of all cases. Haemophilus influenza, Staphylococcus aureus,
Legionella pneumophila, Mycoplasma pneumonia, and several viruses are also leading
causes of community-acquired pneumonia.
9. Pneumonia classification
• Hospital-acquired pneumonia
• Hospital-acquired pneumonia is a lung infection that is obtained during a
hospital stay. This form of pneumonia can be serious because oftentimes the
patient, by nature of being in the hospital in the first place, is in an immune-
weakened state due to illness or traumatic injury. As a result, the patient is
often more susceptible to infection.
• The bacteria responsible for this type of pneumonia are often resistant to
first-line antibiotics, which can further complicate treatment regimens.
• These infections can occur through inhalation of airborne organisms or
contact with contaminated healthcare workers.
10. Pneumonia classification
• Healthcare-acquired pneumonia
• Similarly, healthcare-acquired pneumonia is an infection obtained during a visit to an
outpatient clinic, nursing home, or long-term care facility. This type of pneumonia commonly
occurs in patients with chronic kidney disease.
• Patients with chronic kidney disease often have weakened immune systems and are more
susceptible to bacterial infection. In addition, patients must often undergo kidney dialysis,
which requires frequent contact with the healthcare system.
• Patients and their caregivers must practice exceptional hygiene and thoroughly clean all
medical equipment. Given these precautions, dialysis patients are still at increased risk for
infection just by the nature of the procedure and the potential for direct exposure to
pathogens.
11. Pneumonia classification
• Ventilator-associated pneumonia (VAP)
• If you need to be on a respirator or breathing machine to
help you breathe in the hospital (usually in the ICU),
you’re at risk for ventilator-associated pneumonia (VAP).
The same types of bacteria as community-acquired
pneumonia, as well as the drug-resistant kinds that cause
hospital-acquired pneumonia, cause VAP.
12. Pneumonia classification
• Aspiration pneumonia
• Aspiration is when solid food, liquids, spit or vomit go
down your trachea (windpipe) and into your lungs. If you
can’t cough these up, your lungs can get infected.
13. What’s the difference between viral and bacterial
pneumonia?
• Bacterial pneumonia tends to be more common and more
severe than viral pneumonia. It’s more likely to require a
hospital stay. Providers treat bacterial pneumonia with
antibiotics. Viral pneumonia causes flu-like symptoms and
is more likely to resolve on its own. You usually don’t need
specific treatment for viral pneumonia.
14. Symptoms of bacterial pneumonia
• Symptoms of bacterial pneumonia can develop gradually or suddenly. Symptoms include:
• High fever (up to 105 F or 40.55 C).
• Cough with yellow, green or bloody mucus.
• Tiredness (fatigue).
• Rapid breathing.
• Shortness of breath.
• Rapid heart rate.
• Sweating or chills.
• Chest pain and/or abdominal pain, especially with coughing or deep breathing.
• Loss of appetite.
• Bluish skin, lips or nails (cyanosis).
• Confusion or altered mental state.
15. Symptoms of viral pneumonia
• Symptoms of viral pneumonia usually develop over
several days. You might have symptoms similar to
bacterial pneumonia or you might additionally have:
• Dry cough.
• Headache.
• Muscle pain.
• Extreme tiredness or weakness.
16. What tests will be done to diagnose pneumonia?
• Imaging: Your provider can use chest X-ray or CT scan to take pictures of
your lungs to look for signs of infection.
• Blood tests: Your provider can use a blood test to help determine what kind of
infection is causing your pneumonia.
• Sputum test: You’re asked to cough and then spit into a container to collect a
sample for a lab to examine. The lab will look for signs of an infection and try
to determine what’s causing it.
• Pulse oximetry: A sensor measures the amount of oxygen in your blood to
give your provider an idea of how well your lungs are working.
• Pleural fluid culture: Your provider uses a thin needle to take a sample of fluid
from around your lungs. The sample is sent to a lab to help determine what’s
causing the infection.
17. How is pneumonia treated?
• Some treatments may include:
• Antibiotics: Antibiotics treat bacterial pneumonia. They can’t treat a virus but a provider may
prescribe them if you have a bacterial infection at the same time as a virus.
• Antifungal medications: Antifungals can treat pneumonia caused by a fungal infection.
• Antiviral medications: Viral pneumonia usually isn’t treated with medication and can go away
on its own. A provider may prescribe antivirals such as oseltamivir (Tamiflu®), zanamivir
(Relenza®) or peramivir (Rapivab®) to reduce how long you’re sick and how sick you get
from a virus.
• Oxygen therapy: If you’re not getting enough oxygen, a provider may give you extra oxygen
through a tube in your nose or a mask on your face.
• IV fluids: Fluids delivered directly to your vein (IV) treat or prevent dehydration.
• Draining of fluids: If you have a lot of fluid between your lungs and chest wall (pleural
effusion), a provider may drain it. This is done with a catheter or surgery.
18. Vaccines for pneumonia
• Pneumococcal vaccines: Pneumovax23® and Prevnar13® protect against
pneumonia bacteria. They’re each recommended for certain age groups or
those with increased risk for pneumonia. Ask your healthcare provider which
vaccine would be appropriate for you or your loved ones.
• Vaccinations against viruses: As certain viruses can lead to pneumonia,
getting vaccinated against COVID-19 and the flu can help reduce your risk of
getting pneumonia.
• Childhood vaccinations: If you have children, ask their healthcare provider
about other vaccines they should get. Several childhood vaccines help
prevent infections caused by the bacteria and viruses that can lead to
pneumonia.
19. References
• American Lung Association. Pneumonia. (https://www.lung.org/lung-health-and-diseases/lung-disease-
lookup/pneumonia/) Accessed 11/15/2022.
• American Thoracic Society. What is Pneumonia? (https://www.thoracic.org/patients/patient-
resources/resources/what-is-pneumonia.pdf%29) Accessed 11/15/2022.
• Mace SE. Pneumonia. In: Tenenbein M, Macias CG, Sharieff GQ, Yamamoto LG, Schafermeyer R, eds.
Strange and Schafermeyer's Pediatric Emergency Medicine, 5e. McGraw Hill; 2019
• http://www.nlm.nih.gov/medlineplus/ency/article/000146.htm
• http://www.nlm.nih.gov/medlineplus/ency/article/000145.htm