Pneumonia is a chest infection that is caused by various organisms that are present in the environment. The infection causes inflammation in the air sacs (alveoli), leading to difficulty breathing, fever, cough, and chest pain. The severity of Pneumonia can range from mild to life-threatening, especially in people with weakened immune systems, infants and the elderly.

Causes of Pneumonia

  • Bacteria – most common cause is Streptococcus pneumoniae. Other bacteria, such as Mycoplasma pneumoniae and Legionella pneumophila, can also cause pneumonia.
  • Viruses – Influenza, COVID-19, and respiratory syncytial virus (RSV).
  • Fungi – people with weakened immune systems, are more susceptible for fungal pneumonia.

Symptoms of Pneumonia

  • Cough with mucus or sputum, usually discolored, ranging from yellow to green.
  • Fever with or without chills
  • Shortness of breath
  • Chest pain when breathing or coughing
  • Fatigue and weakness
  • Confusion (especially in older adults)
  • In severe cases, there is low oxygenation level, low blood pressure, increase heart rate and alter level of consciousness.

Diagnosis

A detailed history and examination are the initial part of the assessment. The doctor then will order some investigation:

  • Radiological investigation from a simple chest Xray to CT scan of the chest to check the involvement of the lungs and any complication like pleural effusion.
  • Blood tests to identify the infection
  • Sputum analysis to determine the causative organism.
  • Invasive procedure, Bronchoscopy is sometime performed to survey the airway and collect BAL (bronchoalveolar lavage), sample from the lung. And send for analysis.

Treatment

It depends on the cause and the severity of the condition. Mild Pneumonia can be managed as outpatient with oral medications. In moderate to severe cases iv medications and hospitalization may be required.

  • Bacterial pneumonia – Treated with antibiotics.
  • Viral pneumonia / Covid-19 – antiviral medications and supportive care.
  • Fungal pneumonia – antifungal drugs.

Other supportive treatments are given together to good hydration, pain management, cough suppressant, nebulizers and oxygen therapy (for severe cases) help recovery.

Prevention

Vaccination against some common causative agents are available to help prevent infection.

  • Prevnar-13 (PCV13) and PPSV23 vaccines for bacterial pneumonia caused by Streptococcus pneumoniae
  • Flu vaccine against Influenza-related pneumonia
  • COVID-19 vaccines, against COVID-19 and its strains.
  • RSV pneumonia (Respiratory Syncytial Virus) – Prevented in high-risk groups with the RSV vaccine.

Pneumonias That Vaccines Cannot Prevent:

  • Atypical bacterial pneumonia is caused by different organisms.
  • Fungal pneumonia

Other Preventive Measures

To lower the risk, extra measures like maintaining proper cleanliness, abstaining from smoking, boosting immunity, and treating chronic illnesses are crucial.