Pneumonia is an infection that inflames the air sacs in one or both lungs, which can fill with fluid or pus. It ranges from mild illness that can be treated at home to a life-threatening condition, particularly for older adults, young children and people with chronic illnesses. Recognizing it early and getting the right vaccines can make a big difference.
Causes
Pneumonia can be caused by:
- Bacteria, most commonly Streptococcus pneumoniae (pneumococcus)
- Viruses, including influenza, RSV and COVID-19
- “Atypical” bacteria, such as Mycoplasma, which often causes milder “walking pneumonia”
- Fungi, mainly in people with weakened immune systems
- Aspiration, when food, drink or stomach contents are breathed into the lungs, more common in people with swallowing difficulties
Symptoms
- Cough, often producing green, yellow or bloody mucus
- Fever, sweating and shaking chills
- Shortness of breath or rapid breathing
- Sharp chest pain that worsens with breathing or coughing
- Fatigue and loss of appetite
- Nausea or vomiting
Older adults may have milder or unusual symptoms, such as confusion, a fall, or a lower-than-normal body temperature, rather than a high fever.
Who is at higher risk
- Adults aged 65 and older
- Children under 2
- People with chronic conditions such as COPD, asthma, heart disease, diabetes, kidney or liver disease
- People with weakened immune systems
- Smokers and people who drink heavily
- People recently in the hospital, especially on a ventilator
- People with swallowing problems after a stroke or with dementia
How pneumonia is diagnosed
A doctor will listen to your lungs, check your oxygen level with a fingertip pulse oximeter and may order:
- A chest X-ray to confirm pneumonia and see how much of the lungs is affected
- Blood tests to look for infection
- Tests for flu, COVID-19 or RSV
- Sputum tests in some cases
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Doctors use scoring tools, such as CURB-65, which considers confusion, kidney function, breathing rate, blood pressure and age 65 or older, to help decide whether you can be treated at home or need hospital care.
Treatment
- Bacterial pneumonia is treated with antibiotics. Healthy adults treated at home usually start to feel better within a few days. Take the full course as prescribed.
- Viral pneumonia does not respond to antibiotics. Antiviral medicines may help for flu or COVID-19, especially when started early.
- Supportive care includes rest, fluids and fever control.
- Hospital care may be needed for low oxygen levels, dehydration, confusion or underlying health problems, and can include oxygen therapy and intravenous antibiotics.
Fatigue and cough can linger for weeks after pneumonia, even after the infection clears. A follow-up chest X-ray may be recommended for some people, such as smokers over 50, to make sure the lungs have cleared.
When to seek urgent care
Call 911 or go to the emergency room if you or a loved one has:
- Severe difficulty breathing
- Bluish lips or fingertips
- Chest pain
- Confusion or extreme drowsiness
- A high fever that will not come down
- An oxygen reading below about 92 percent on a home pulse oximeter, or as advised by your doctor
Vaccines that help prevent pneumonia
Pneumococcal vaccines protect against the most common bacterial cause of pneumonia. CDC guidance recommends a pneumococcal conjugate vaccine for adults aged 50 and older, and for younger adults with certain medical conditions. Options include PCV20 or PCV21 given as a single dose, or PCV15 followed by PPSV23. Children receive pneumococcal vaccines as part of their routine schedule.
Flu vaccine every year, because flu often leads to pneumonia.
COVID-19 vaccine as recommended for your age and health.
RSV vaccine for adults aged 75 and older, and adults aged 50 to 74 at increased risk, as a single dose.
Check with your doctor or pharmacist which vaccines you have had and which you need. Most are covered by insurance and Medicare with no cost-sharing when recommended.
Other ways to lower your risk
- Stop smoking
- Wash your hands regularly
- Manage chronic conditions such as diabetes and COPD
- Practice good oral hygiene, which can reduce aspiration pneumonia in older adults
- Stay active and eat well
The bottom line
Pneumonia can be serious, especially for older adults and people with chronic illness. Watch for cough with fever, chest pain and shortness of breath, and seek urgent care for breathing difficulty or confusion. Pneumococcal, flu, COVID-19 and RSV vaccines are among the best ways to protect yourself.
This article is for general information and does not replace medical advice.