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Pneumonia - Symptoms, Diagnosis and Treatment

Posted Dec 01 2010 2:20pm

Information provided by the American Lung Association

The most common symptoms of pneumonia are:

Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
Fever, which may be mild or high
Shaking chills
Shortness of breath, which may only occur when you climb stairs

Additional symptoms include:

Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
Excessive sweating and clammy skin
Loss of appetite, low energy, and fatigue
Confusion, especially in older people

In bacterial pneumonia, your temperature may rise as high as 105 degrees F. The pneumonia causes profuse sweating, and rapidly increased breathing and pulse rate. 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.

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.

Physical exam: Your doctor will listen to your lungs with a stethoscope. If you have pneumonia, your lungs may make crackling, bubbling, and rumbling sounds when you inhale. You also may be wheezing, and it may be hard to hear sounds of breathing in some areas of your chest.

Chest X-ray (if your doctor suspects pneumonia)

Some patients may need other tests, including:

CBC blood test to check white blood cell count
Arterial blood gases to see if enough oxygen is getting into your blood from the lungs
CT (or CAT) scan of the chest to see how the lungs are functioning
Sputum tests to look for the organism (that can detected by studying your spit) causing your symptoms
Pleural fluid culture if there is fluid in the space surrounding the lungs
Pulse oximetry to measure how much oxygen is moving through your bloodstream, done by simply attaching a small clip to your finger for a brief time
Bronchoscopy, a procedure used to look into the lungs’ airways, which would be performed if you are hospitalized and antibiotics are not working well

Treatment for pneumonia depends on the type of pneumonia you have and how severe it is, and if you have other chronic diseases. The goals of treatment are to cure the infection and prevent complications.

Most people can be treated at home by following these steps:

Drink plenty of fluids to help loosen secretions and bring up phlegm.
Get lots of rest. Have someone else do household chores.
Do not take cough medicines without first talking to your doctor. Cough medicines may make it harder for your body to cough up the extra sputum.
Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.
If your pneumonia becomes so severe that you are treated in the hospital, you may receive fluids and antibiotics in your veins, oxygen therapy, and possibly breathing treatments.

You are more likely to be admitted to the hospital if you:

Have another serious medical problem
Have severe symptoms
Are unable to care for yourself at home, or are unable to eat or drink
Are older than 65 or a young child
Have been taking antibiotics at home and are not getting better

Viral Pneumonia

Typical antibiotics will not work for viral pneumonia; sometimes, however, your doctor may use antiviral medication. Viral pneumonia usually improves in 1 to 3 weeks.

Bacterial Pneumonia

Patients with mild pneumonia who are otherwise healthy are sometimes treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin). Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given more powerful and/or higher dose antibiotics.

In addition to antibiotics, treatment includes: 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.

A healthy young person may lead a normal life within a week of recovery from pneumonia. For middle-aged people, it may be weeks before they regain their usual strength 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. Don’t rush recovery!

American Lung Association
1301 Pennsylvania Ave. NW, Suite 800, Washington, DC 20004
T: 202 785 3355 | F: 202 452 1805 | E:

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