Pneumonia—Adult

(Community-acquired Pneumonia; CAP; Bronchopneumonia)

Pronounced: Noo-MO-NEE-yah

Definition

Pneumonia is an infection deep in the small airways and air sacs of the lungs. The infection will make the air sacs swell and fill with fluid or pus. This causes intense coughing and can make it difficult to breathe.

Development of Pneumonia in the Air Sacs of the Lungs

pneumonia lung fluid
Copyright © Nucleus Medical Media, Inc.

Types of pneumonia include:

  • Community-acquired—infection is picked up outside of a medical setting; most common type
  • Hospital-acquired pneumonia—infection is picked up while in a hospital
  • Aspiration—happens when something, such as food, liquid, saliva, or vomit is inhaled into the lungs

This article will focus on community-acquired pneumonia.

Causes    TOP

Pneumonia is caused by a germ in the air that you breathe. Germs that most often cause community-acquired pneumonia include:

  • Viruses—such as flu or cold viruses
  • Bacteria
  • Fungus—more likely to happen in people with other health issues or immune system problems

Risk Factors    TOP

Pneumonia is more common in older adults. Other factors that may increase the chances of pneumonia:

  • Living in crowded living conditions such as dormitories or nursing homes
  • Smoking
  • Being underweight
  • Regular contact with children
  • Frequent visits to doctor's office
  • Alcohol use disorder or drug abuse

Health conditions that may increase the risk of community-acquired pneumonia include:

Other environmental factors include:

  • Coming in contact with droppings or dust from:
    • Bats or birds
    • Rabbits
    • Farm animals
  • Recent stay in cruise or hotel
  • Flu is present in your community

Symptoms    TOP

Pneumonia may cause:

  • Cough
  • Shortness of breath
  • Chest pain
  • Increased mucus production
  • Fever and chills
  • Weakness

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may suspect pneumonia based on your symptoms and lung sounds.

Pictures of the lungs can show that pneumonia is present. Pictures may be taken with:

Your doctor may need to know the exact germ that is causing the problem. This step may be needed if there is a severe infection. The germ can be tested through:

  • Blood tests and/or cultures
  • Sputum (fluid you cough up) culture
  • Urine tests

Treatment    TOP

Treatment will be based on what may have caused the pneumonia and your overall health. More support may be needed if there is a severe infection. A hospital stay may be needed if it becomes difficult to breathe.

Medications

Your doctor may advise:

  • Antibiotics—for pneumonia caused by bacteria
  • Antifungal medications—for pneumonia caused by a fungus
  • Antiviral medications—for pneumonia caused viruses such as the flu
  • Over-the-counter medications to reduce fever and discomfort
  • Vitamin C may be advised if you do not get enough in your diet

Oxygen may need to be given for severe infections. This will help to increase the level of oxygen that passes to the blood.

Prevention    TOP

Vaccines may help to prevent certain pneumonia:

  • Flu vaccine—pneumonia may be a complication of the flu, especially people aged 50 years and older
  • Pneumococcal vaccine—protects against pneumonia caused by specific bacteria; recommended for:
    • All adults who are aged 65 years or older
    • Adults of any age who are at high risk of infection or have a suppressed immune system

Steps that may decrease the risk for any respiratory infection include:

  • If you smoke, talk to your doctor about how you can successfully quit. Smoke weakens the lungs' resistance to infection and increases recovery time.
  • Avoid close contact with people who have the cold or flu.
  • Wash your hands often, especially after coming into contact with someone who is sick.
  • Protect yourself on jobs that have risk factors above.
  • Follow your plan for control of any chronic diseases such as asthma and diabetes.

RESOURCES:

American Lung Association
http://www.lung.org
Centers for Disease Control and Prevention
https://www.cdc.gov

CANADIAN RESOURCES:

Public Health Agency of Canada
https://www.canada.ca
The Lung Association
http://www.lung.ca

References:

Blasi F, Aliberti S, Pappalettera M, Tarsia P. 100 years of respiratory medicine: pneumonia. Respir Med. 2007;101(5):875-881.
Community-acquired pneumonia in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 18, 2017. Accessed February 16, 2018.
De Roux A, Marcos MA, Garcia E, et al. Viral community-acquired pneumonia in non-immunocompromised adults. Chest. 2004;125(4):1343-1351.
Immunization schedules. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/schedules/index.html. Updated February 6, 2018. Accessed February 16, 2018.
Niederman MS. Recent advances in community-acquired pneumonia inpatient and outpatient. Chest. 2007;131(4):1205-1215.
Niederman MS. Review of treatment guidelines for community-acquired pneumonia. Am J Med. 2004;117:Suppl 3A:51S-57S.
Pneumonia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/pneumonia. Updated August 2017. Accessed February 16, 2018.
10/21/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Hemilä H, Louhiala P. Vitamin C for preventing and treating pneumonia. Cochrane Database Syst Rev. 2013;8:CD005532.
3/10/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Su VY, Liu CJ, Wang HK, et al. Sleep apnea and risk of pneumonia: A nationwide population-based study. CMAJ. 2014;186(6):415-421.
6/17/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Reissig A, Copetti R, Mathis G, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: A prospective, multicenter diagnostic accuracy study. Chest. 2012;142(4):965-972.
2/3/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis: Rantala A, Jaakkola JJ, Jaakkola MS. Respiratory infections in adults with atopic disease and IgE antibodies to common aeroallergens. PLoS One. 2013;8(7):e68582.
Last reviewed February 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP
Last Updated: 2/3/2015

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