Pneumonia: types, treatment, symptoms, and prevention

Coughs and colds feel inevitable during the colder months. But sometimes, a run-of-the-mill respiratory infection can turn into something worse — pneumonia. Here are the symptoms to look out for and what you can do to lessen your chances of contracting it.

What’s pneumonia?

Pneumonia can be a serious condition — in 2017/18, it accounted for over 135,000 emergency room visits in the country. And, together with influenza, it consistently ranks in the top 10 causes of death in Canada, claiming just under 6,000 lives in 2020.

Despite these grim statistics, most pneumonia cases end in a full recovery. The caveat is that it can take some time. While some feel better within a week or two, others need a month or more to recover.

Are there different types of pneumonia?

Yes. There are three types of pneumonia, categorized by how you acquire the infection.

1. Community-acquired pneumonia (CAP)

CAP applies to everyone who contracts the illness outside of a hospital or healthcare setting — for example, at school. Aspiration pneumonia’s another form of CAP, which occurs when you breathe food or liquid into the lungs.

2. Nosocomial or hospital-acquired pneumonia (HAP)

HAP is the designated name for cases of infection that start while in a hospital or other healthcare setting, like long-term care.

3. Ventilator-associated pneumonia (VAP)

VAP occurs when germs enter a ventilator tube, directing the contaminated air into the patient’s lungs and resulting in pneumonia.

What causes pneumonia?

The causes of pneumonia can be viral, bacterial, or fungal pathogens. Normally, your body has a strong defence system to prevent microorganisms from entering your lungs. However, if your body’s defences are off, or you’re exposed to a large amount of the pathogen (or a very robust one), you’re at risk of infection.

The multiplication of the pathogen inside your lungs sparks a cascade of infection that inflames the air sacs (alveoli) of one or both lungs.

Your body’s immune system responds by directing white blood cells to the area to fight the infection, resulting in swelling in your lung tissue. This causes pus and fluid to build up, making breathing more difficult.

Despite its prevalence, pneumonia isn’t always the cause of a lung infection. Other diseases like bronchiolitis, which is relatively common in small children, or tuberculosis can also be at fault.

What’s the difference between bacterial and viral pneumonia?

The main difference between viral and bacterial pneumonia aren’t in their respective symptoms. Instead, it comes down to how the two are treated. Bacterial pneumonia requires antibiotics, while the viral version is best cured through supportive care and sometimes antivirals. Fungal pneumonia, in turn, is treated with antifungals.

You may also have heard of so-called “walking pneumonia.” This is a common form of bacterial pneumonia caused by mycoplasma bacteria. It’s characterized as “atypical” because it tends to have nonspecific and sometimes misleading symptoms. These can range from mild upper respiratory symptoms to pneumonia.

In severe cases, symptoms of atypical pneumonia can even extend beyond the lungs and include hepatitis or meningitis. In these cases, their causes may be the bacteria legionella or chlamydophila.

Who’s most at risk of getting pneumonia?

Anyone can get pneumonia, but some groups are more likely to contract it and have worse outcomes. These include:

• Children under five
• Adults over 70
• Those with alcohol use disorder (AUD) — these individuals are 10 times more likely to develop pneumonia
• Immunocompromised patients — for example, those with HIV or cancer
• Individuals with health issues — such as asthma, heart disease, or diabetes
• Dementia patients and others with swallowing issues who may be at risk of micro-aspiration. This happens when a small amount of liquid or food gets into the lungs, introducing germs.

What are the symptoms of pneumonia?

Bacterial, viral, and fungal pneumonia can present the same symptoms. These include:

• Cough, often with green, yellow, or blood-tinged mucus
• Rapid breathing or difficulty breathing that worsens with exertion
• Chest pain or abdominal pain (in children), especially when coughing
• Fever
• Loss of appetite
• Fatigue or exhaustion
• Chills
• Muscle aches
• Sweating

More severely, you may also see:

• Bluish tinge to fingernails and lips
• Confusion
• Rapid pulse
• Shortness of breath

Symptoms of atypical pneumonia may include:

• Chills
• Cough
• Fever
• Slight shortness of breath
• Fatigue

While symptoms of atypical pneumonia may seem mild, don’t let this fool you. Walking pneumonia can affect multiple organ systems. One study found that almost 90% of patients also experienced issues related to their cardiovascular, digestive, and neurologic systems — to name a few.

Although it can resolve without any treatment for some, timely diagnosis and treatment are key to preventing severe and potentially fatal complications.

How’s pneumonia diagnosed?

Your healthcare provider can diagnose pneumonia based on your symptoms and medical history. They’ll also use a stethoscope to evaluate your breathing and listen for fluid in your lungs. They may also attach a pulse oximeter to your fingertip to measure how well your lungs are oxygenating your blood.

A chest x-ray may be part of your diagnostic workup as well. This can show how much the infection has inflamed the air sacs in your lungs and the extent of fluid buildup. It can also provide clues for what’s causing your infection, as mycoplasma and some viruses often show up on x-rays in telltale patterns.

While x-rays are great diagnostic tools, further evaluations are sometimes needed to help determine the exact cause of infection. In these cases, you may need to undergo a sputum (mucus) test.

To give your provider an idea of how well your organs are functioning, they may order a liver or kidney function test or a blood gas test. Other blood tests can show how well your immune system responds with a complete blood count, or if the pathogen has entered your bloodstream with a blood culture.

If your symptoms are severe, however, they’ll likely recommend further diagnostics or consider admission to a hospital for closer monitoring and further testing. If you’re not responding to treatment, you may be referred for a bronchoscopy or pleural fluid culture.

How does pneumonia spread? Is it contagious?

Pneumonia can be contagious, but it isn’t always. For example, CAP is often caused by viruses or bacteria that spread from person to person via droplets or sometimes by aerosol. As you inhale them, the virus or bacteria colonize the inside of your nasal passages.

Lung infection can occur if your immune defences are down or the amount of pathogen entering your body is substantial enough. As the pathogen replicates in your lungs, your immune system responds. This leads to inflammation and damage to the inside of your lungs, causing pneumonia.

In most cases, however, these pathogens don’t have the opportunity to make it to your lungs. Even mycoplasma pneumonia, the most common cause of CAP, only causes pneumonia in about 5 to 10% of the people it infects. So, while you can easily pass on one of these illnesses, the person you give it to won’t necessarily develop pneumonia.

How to relieve pneumonia symptoms at home

If your symptoms are mild and you’re otherwise healthy, your pneumonia can go away on its own with simple at-home treatment. In this case, you’d treat it like any other respiratory infection.

Over-the-counter (OTC) pain relievers like acetaminophen (Tylenol) and ibuprofen (Advil) can address any aches and pains you’re experiencing. Meanwhile, prioritizing rest and hydration will help your body regain its strength. And, adding a cool mist vaporizer or clean humidifier to your bedroom or sitting in a steamy bathroom can help relieve congestion.

Because it can be severe and carries a risk of complications, it’s best to see a healthcare provider if you suspect you have pneumonia. If you have a bacterial form of the illness, your provider will prescribe an antibiotic, and the sooner you start taking it, the better.

What are the treatment options for pneumonia?

Treatment options for pneumonia differ depending on your infection type and whether you have additional risk factors. For a case of bacterial pneumonia, your provider will give you an antibiotic prescription. This usually means amoxicillin or ampicillin in children, while adults might get azithromycin.

Viral pneumonia can be trickier as it doesn’t respond to antibiotic treatment. In this case, your provider may prescribe an antiviral or recommend you manage your symptoms with at-home treatments.

While antifungals can be prescribed for fungal pneumonia, this type often affects the immunocompromised, who may require hospitalization. This allows doctors to monitor their condition and provide supportive treatments like oxygen and may also be necessary for other forms of severe pneumonia.

Can you die from pneumonia?

Pneumonia is a serious condition, but most people make a full recovery. In some cases, however, it can be fatal. Because it produces fluid buildup in the lungs, pneumonia can impede breathing, causing respiratory distress and sometimes respiratory failure.

Another severe outcome is sepsis, a potentially life-threatening overreaction of the immune system to an infection. Bacterial infections are its most common cause, but viral pneumonia can result in it as well.

Pneumonia reduces your body’s ability to oxygenate your blood, which weighs heavily on the heart. This can increase your chances of heart disease, heart attack, or heart failure long after your infection has resolved.

And that’s not all. Leftover pus from a pneumonia infection can get trapped in part of the lung, causing an abscess and killing part of the lung tissue. Swelling and fluid in the lung tissue (pleuritis and pleural effusion) can also cause lasting damage. All these may permanently reduce your lung capacity even after recovering from the illness.

How to prevent pneumonia from getting worse

There’s not much you can do to shorten the duration of your pneumonia. But, you may be able to prevent it from getting worse.

Since dehydration is associated with worse outcomes in pneumonia patients, staying hydrated is paramount. As a bonus, it’ll thin out the mucus you’re producing, helping to ease congestion.

Getting enough rest is crucial too. Your body needs energy to fight infections, and pushing yourself too soon can extend your illness.

For smokers, quitting smoking, at least for the duration of your illness, is also worth it. Smoking’s associated with worse pneumonia outcomes — including death. Stopping will prevent your illness from dragging on.

Alcohol is another factor that can draw out your recovery period. It impairs your immune system’s ability to send neutrophils — a type of white blood cell — to your lungs. Counteract this possibility by avoiding alcohol until you recover fully.

How can you prevent pneumonia?

It’s not possible to prevent pneumonia entirely. However, you can lessen your chances of contracting it and improve a weakened immune system. You can maintain a healthy immune system through good nutrition, adequate hydration, sufficient rest, and good hand hygiene. Not smoking and limiting the amount of alcohol you drink will also help.

Getting vaccinated against respiratory illnesses should be high on your list as well. Vaccines for COVID-19 and the flu lower your risk of contracting common respiratory illnesses that can turn into pneumonia. Even better, the pneumococcal vaccine protects against multiple bacterial infections, including some that cause pneumonia. And, it may shorten the duration and severity of your illness.

When should I see a doctor for pneumonia?

If you have trouble breathing, severe chest pain, or if your lips or fingertips take on a bluish tinge, get to a hospital right away.

In contrast, if you think your condition is getting worse, it’s a good idea to see a doctor. So, how do you know if your pneumonia is getting worse? If your cough worsens, your pain increases, or your breathing becomes more laboured, those are all good indications. Getting better and starting to feel worse again is another one.

If you’re experiencing any of these symptoms, we can help. Maple’s a telehealth platform that connects you with Canadian-licensed doctors and specialists via your phone, tablet, or computer. In many cases, doctors on Maple can diagnose your respiratory infection online by asking about your symptoms. Depending on the type of infection, they can prescribe antibiotics, as needed.

Even if you don’t show any of the symptoms above, it’s a good idea to speak to a doctor if you believe you have pneumonia. After all, pneumonia is more than a normal respiratory infection. Reach out to speak to a doctor today to help confirm your diagnosis and start the path to healing.

This blog was developed by our team and reviewed by a medical professional.