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Pneumonia is a serious infection and/or inflammation of your lungs. The air sacs in the lungs fill with pus and other liquid. Oxygen has trouble reaching your blood. If there is too little oxygen in your blood, your body cells can't work properly. Because of this and spreading infection through the body pneumonia can cause death.
Pneumonia can have over 30 different causes.


Until 1936, pneumonia was the No.1 cause of death in the U.S. Since then, the use of antibiotics brought it under control. In 2003, pneumonia and influenza combined ranked as the seventh leading cause of death.1

Pneumonia affects your lungs in two ways. Lobar pneumonia affects a section (lobe) of a lung. Bronchial pneumonia (or bronchopneumonia) affects patches throughout both lungs.

CAUSES OF PNEUMONIA

Pneumonia is not a single disease. It can have over 30 different causes. There are five main causes of pneumonia:

• Bacteria

• Viruses

• Mycoplasmas

• Other infectious agents, such as fungi -- including pneumocystis

• Various chemicals

BACTERIAL PNEUMONIA

Bacterial pneumonia can attack anyone from infants through the elderly. Alcoholics, the debilitated, post-operative patients, people with respiratory diseases or viral infections and people who have weakened immune systems are at greater risk.

Pneumonia bacteria are present in some healthy throats. When body defenses are weakened in some way, by illness, old age, malnutrition, general debility or impaired immunity, the bacteria can multiply and cause serious damage. Usually, when a person's resistance is lowered, bacteria work their way into the lungs and inflame the air sacs.

The tissue of part of a lobe of the lung, an entire lobe, or even most of the lung's five lobes becomes completely filled with liquid (this is called "consolidation"). The infection quickly spreads through the bloodstream and the whole body is invaded.

The organism streptococcus pneumoniae is the most common cause of bacterial pneumonia. It is one form of pneumonia for which a vaccine is available.

Symptoms: The onset of bacterial pneumonia can vary from gradual to sudden. In the most severe cases, the patient may experience shaking chills, chattering teeth, severe chest pain, and a cough that produces rust-colored or greenish mucus.

A person's temperature may rise as high as 105 degrees F. The patient sweats profusely, and breathing and pulse rate increase rapidly. Lips and nailbeds may have a bluish color due to lack of oxygen in the blood. A patient's mental state may be confused or delirious.

VIRAL PNEUMONIA

Half of all pneumonias are believed to be caused by viruses. More and more viruses are being identified as the cause of respiratory infection, and though most attack the upper respiratory tract, some produce pneumonia, especially in children. Most of these pneumonias are not serious and last a short time but some may be.

Infection with the influenza virus may be severe and occasionally fatal. The virus invades the lungs and multiplies, but there are almost no physical signs of lung tissue becoming filled with fluid. It finds many of its victims among those who have pre-existing heart or lung disease or are pregnant.

Symptoms: The initial symptoms of viral pneumonia are the same as influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness. Within 12 to 36 hours, there is increasing breathlessness; the cough becomes worse and produces a small amount of mucus. There is a high fever and there may be blueness of the lips.

In extreme cases, the patient has a desperate need for air and extreme breathlessness. Viral pneumonias may be complicated by an invasion of bacteria, with all the typical symptoms of bacterial pneumonia.

MYCOPLASMA PNEUMONIA

Because of its somewhat different symptoms and physical signs, and because the course of the illness differed from classical pneumococcal pneumonia, mycoplasma pneumonia was once believed to be caused by one or more undiscovered viruses and was called "primary atypical pneumonia."

Identified during World War II, mycoplasmas are the smallest free-living agents of disease in humankind, unclassified as to whether bacteria or viruses, but having characteristics of both. They generally cause a mild and widespread pneumonia. They affect all age groups, occurring most frequently in older children and young adults. The death rate is low, even in untreated cases.

Symptoms: The most prominent symptom of mycoplasma pneumonia is a cough that tends to come in violent attacks, but produces only sparse whitish mucus. Chills and fever are early symptoms, and some patients experience nausea or vomiting. Patients may experience profound weakness that lasts for a long time.

OTHER KINDS OF PNEUMONIA

Pneumocystis carinii pneumonia (PCP) is caused by an organism believed to be a fungus. PCP may be the first sign of illness in many persons with AIDS.

PCP can be successfully treated in many cases. It may recur a few months later, but treatment can help to prevent or delay its recurrence.

Other less common pneumonias may be quite serious and are occurring more often. Various special pneumonias are caused by the inhalation of food, liquid, gases or dust, and by fungi. Foreign bodies or a bronchial obstruction such as a tumor may promote the occurrence of pneumonia, although they are not causes of pneumonia.

Rickettsia (also considered an organism somewhere between viruses and bacteria) cause Rocky Mountain spotted fever, Q fever, typhus and psittacosis, diseases that may have mild or severe effects on the lungs. Tuberculosis pneumonia is a very serious lung infection and extremely dangerous unless treated early.


TREATING PNEUMONIA

If you develop pneumonia, your chances of a fast recovery are greatest under certain conditions: if you're young, if your pneumonia is caught early, if your defenses against disease are working well, if the infection hasn't spread, and if you're not suffering from other illnesses.

In the young and healthy, early treatment with antibiotics can cure bacterial pneumonia, speed recovery from mycoplasma pneumonia, and a certain percentage of rickettsia cases. There is not yet a general treatment for viral pneumonia, although antiviral drugs are used for certain kinds. Most people can be treated at home.

The drugs used to fight pneumonia are determined by the germ causing the pneumonia and the judgment of the doctor. After a patient's temperature returns to normal, medication must be continued according to the doctor's instructions, otherwise the pneumonia may recur. Relapses can be far more serious than the first attack.

Besides antibiotics, patients are given supportive treatment: 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.

The vigorous young person may lead a normal life within a week of recovery from pneumonia. For the middle-aged, however, weeks may elapse before they regain their accustomed strength, vigor, 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. Remember, don't rush recovery!


PREVENTING PNEUMONIA IS POSSIBLE

Because pneumonia is a common complication of influenza (flu), getting a flu shot every fall is good pneumonia prevention.

A vaccine is also available to help fight pneumococcal pneumonia, one type of bacterial pneumonia. Your doctor can help you decide if you, or a member of your family, need the vaccine against pneumococcal pneumonia. It is usually given only to people at high risk of getting the disease and its life-threatening complications.

The greatest risk of pneumococcal pneumonia is usually among people who:
Have chronic illnesses such as lung disease, heart disease, kidney disorders, sickle cell anemia, or diabetes.
Are recovering from severe illness
Are in nursing homes or other chronic care facilities
Are age 65 or older

If you are at risk, ask your doctor for the vaccine.

Ask your doctor about any revaccination recommendations. The vaccine is not recommended for pregnant women or children under age two.

Since pneumonia often follows ordinary respiratory infections, the most important preventive measure is to be alert to any symptoms of respiratory trouble that linger more than a few days. Good health habits, proper diet and hygiene, rest, regular exercise, etc., increase resistance to all respiratory illnesses. They also help promote fast recovery when illness does occur.


IF YOU HAVE SYMPTOMS OF PNEUMONIA

Call your doctor immediately. Even with the many effective antibiotics, early diagnosis and treatment are important.

Follow your doctor's advice. In serious cases, your doctor may advise a hospital stay. Or recovery at home may be possible.

Continue to take the medicine your doctor prescribes until told you may stop. This will help prevent recurrence of pneumonia and relapse.

Remember, even though pneumonia can be treated, it is an extremely serious illness. Don't wait, get treatment early.

Sources:
1. National Center for Health Statistics. National Vital Statistics Report. Deaths: Leading Causes for Mortality 2002. Vol. 53(17), 2005
© 2007 American Lung Association®. All rights reserved

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