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Burning sensation in chest pneumonia: The request could not be satisfied


What Are the Symptoms of Pneumonia?

Pneumonia is an infection of the lungs that causes cough, fever and
trouble breathing, among other symptoms. Although you may think it is something
you could never get, pneumonia is one of the leading causes of hospitalizations in
America. Approximately one million American adults seek hospital care every
year due to pneumonia. Prompt treatment of pneumonia can mean the difference
between requiring hospitalization or recovering at home.

This FAQ will help you recognize the signs and symptoms of pneumonia,
available treatment options and ways to keep yourself and others healthy.

What causes pneumonia?

Pneumonia is an infection of the lungs caused by viruses, bacteria,
fungi and parasites. A person who becomes ill with a cold, the flu, bacterial
or other infection can develop pneumonia as a secondary illness. Pneumonia is
more common from autumn through spring because there are more cases of cold and
flu during this time.

Who gets pneumonia?

Anyone can get pneumonia, but some populations are at greater risk
including people with chronic conditions like asthma, individuals with heart
and lung disorders, premature infants, the elderly and people with compromised
immune systems.

What does pneumonia feel like?

Not everyone feels the same when they have pneumonia, but there are
core signs you can look out for, such as feeling like you’re out of breath,
generally feeling tired or sleepy and sharp, stabbing chest pain. Note, however,
that “walking pneumonia” might not have obvious symptoms or just
symptoms of a common cold.

Signs and Symptoms of Pneumonia

  • Pain or tightness in
    the chest that worsens with coughing or breathing
  • Cough with phlegm
  • Feeling suddenly worse
    after having a cold or the flu
  • High fever
  • Nausea
  • Diarrhea
  • Shaking chills
  • Shortness of breath
  • Vomiting

These are just some of the most common symptoms experienced by

What are the signs of pneumonia in children?

When children have pneumonia, they can experience the same symptoms as
adults including high fever, cough, difficulty breathing and pain in the chest,
but they may also complain of stomach pain, ear pain, have a decreased appetite
and be more tired or irritable than usual. If a child has “walking
pneumonia” their symptoms may be milder and can appear like a cold. Some
infants may not appear to have any symptoms beyond being restless and a
decreased appetite. In extreme cases of pneumonia, infants and small children
may have bluish fingernails, toenails, lips and mouth.

What are the symptoms of pneumonia in the elderly?

The elderly typically experience fever, chills, chest pain and
difficulty breathing, but symptoms may be mild. When older adults have
pneumonia, they are more likely to be confused, dizzy or have sudden changes in
mental awareness.

Do you run a fever with pneumonia?

In both viral and bacterial pneumonia, a fever is often present. It is
not, however, a “requirement.” In rare cases, it is possible to have the
illness without running an obvious fever, such as with infants and older adults
with naturally low body temperatures.

Does pneumonia cause chest pain?

Chest pain is one of the most common symptoms of pneumonia. Chest pain
is caused by the membranes in the lungs filling with fluid. This creates pain
that can feel like a heaviness or stabbing sensation and usually worsens with
coughing, breathing or laughing.

Does pneumonia cause vomiting?

Though not a classic symptom of pneumonia, vomiting can occur due to
nausea. Nausea or dizziness is a more common symptom of pneumonia, which can
sometimes lead to vomiting.

How do you treat pneumonia?

Treatment for pneumonia depends on the cause. If pneumonia is caused by
a bacterial infection, antibiotics will be prescribed to kill the harmful
bacteria. If pneumonia is caused by a viral infection, time and rest
are best for recovery. Fever reducing medications and cough medications
can help relieve symptoms and aid sleep.

How can I prevent pneumonia?

  1. Practice good
    Wash your hands, distance yourself from people who are
    ill, cough into your mouth and refrain from touching your eyes, mouth and
    nose. Following the same recommendations to reduce flu risk can also
    reduce the risk of developing pneumonia.
  2. Get a flu shot. The
    flu shot is a safe and effective way to prevent the flu. Since the flu is
    one cause of pneumonia, a flu shot can prevent you from getting the flu
    and minimize your risk of pneumonia
  3. Get a pneumococcal
    A pneumococcal vaccine cannot protect you from all
    causes of pneumonia, but it can minimize your risk of developing pneumonia
    from the most common strains. There are vaccinations developed for
    specific age groups. The Centers for
    Disease Control recommends the following routine pneumonia

Pneumococcal conjugate vaccination for:

  1. All babies and
    children younger than 2 years old
  2. People 2 years or
    older with certain medical conditions

Pneumococcal polysaccharide vaccination for:

  1. All adults 65 years or
  2. People 2 through 64
    years old with certain medical conditions
  3. Adults 19 through 64
    years old who smoke cigarettes

If you have been experiencing pneumonia symptoms, make an appointment
with your provider today. Prompt treatment of pneumonia is
important for recovery. Request
an appointment with a family medicine provider to receive your flu and
pneumococcal vaccinations.

Bronchitis vs. Pneumonia: The Difference Between Them

When a cold or the flu sets in, you probably know how it’s going to unfold. It starts maybe with that scratch in the back of your throat. You start to feel run-down. Next thing you know, you’re parked in front of the television with a box of tissues.

But when it comes to bronchitis and pneumonia, it might be a little harder to know what’s going on and how to tell them apart.

Bronchitis is when your bronchial tubes, which carry air to your lungs, get infected and swollen. There are two kinds:

  • Acute bronchitis. This lasts a few weeks and usually goes away on its own.
  • Chronic bronchitis. It’s more serious, and you’re more likely to get it if you smoke. In this article, we’re looking at acute bronchitis.

Pneumonia is another infection in your lungs, but instead of the bronchial tubes, you get it in tiny air sacs in your lungs called alveoli. It can be mild, but sometimes serious, especially for the very young, adults 65 or older, and people with weaker immune systems.

Learn more about these two conditions – see how they are alike and how they are different:

Symptoms of Acute Bronchitis

You may have various problems with breathing, such as:

  • Chest congestion, where your chest feels full or clogged
  • Coughing — you may cough up a lot of mucus that’s clear, white, yellow, or green
  • Shortness of breath
  • Wheezing or a whistling sound when you breathe

You may also have some of the typical cold or flu symptoms, such as:

Even after the other symptoms are gone, the cough can last for a few weeks as your bronchial tubes heal and the swelling goes down.

When to Call Your Doctor for Bronchitis

Call your doctor if your cough:

  • Brings up mucus that thickens or darkens in color
  • Keeps you awake at night
  • Lasts more than 3 weeks

You’ll also want to call your doctor if you have a cough and:

  • A foul-tasting fluid in our mouth (this could be reflux)
  • Fever over 100.4 F
  • Wheezing or shortness of breath

Symptoms of Pneumonia

Pneumonia symptoms can be mild or severe based on what causes it, your age, and your overall health. The most common symptoms are:

  • Cough (you might bring up yellow, green, or even bloody mucus)
  • Fever
  • Shaking chills
  • Shortness of breath (for some people, this happens only when they climb stairs)

You may also have:

  • Chest pain (you might get a stabbing or sharp pain that’s worse when you cough or take a deep breath)
  • Confusion (more common for adults 65 and older)
  • Run-down feeling
  • Headache
  • Heavy sweating and clammy, damp skin
  • Throwing up or feeling like you might

When to Call Your Doctor for Pneumonia

Call your doctor if you have a cough that won’t go away or you’re coughing up pus. Other symptoms that could spur a call:

  • Chest pain
  • Fever that stays at 102 F or higher
  • Shaking chills
  • Shortness of breath as you go about your day
  • Trouble breathing
  • Unable to keep liquids down

What Causes Bronchitis?

Most often, the same viruses that give you a cold or the flu also cause bronchitis. Sometimes though, bacteria are to blame.

In both cases, as your body fights off the germs, your bronchial tubes swell and produce more mucus. That means you have smaller openings for air to flow, which can make it harder to breathe.

What Causes Pneumonia?

Pneumonia can be caused by:

  • Bacteria
  • Certain chemicals
  • Fungi
  • Mycoplasmas, which are like bacteria and give you milder symptoms (sometimes called “walking pneumonia”)
  • Viruses (the same ones that cause colds and the flu can also give you pneumonia)

As your body fights off the germs, your lungs’ air sacs swell and may fill with fluid or pus, much like your bronchial tubes swell and fill with mucus when you have bronchitis.

Bronchitis Treatments

Most of the time, acute bronchitis goes away on its own within a couple of weeks. If it’s bacterial, your doctor may give you antibiotics. If you have asthma, allergies, or you’re wheezing, your doctor may suggest an inhaler.

It’s best to avoid cough medicine unless your cough keeps you awake at night. Bringing up mucus actually helps you because it clears the gunk out of your lungs. Avoid giving cough medicine to children younger than 4 years. For children 4 and older, check with your doctor first.

Here are some things you can do to ease your symptoms:

  • Drink a lot of water. Eight to 12 glasses a day help thin out your mucus and makes it easier to cough it up.
  • Get plenty of rest.
  • Take over-the-counter pain relievers with ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin to help with pain, but avoid giving aspirin to children. You can use acetaminophen (Tylenol) to help with pain and fever.
  • Use a humidifier or try steam to loosen up the mucus; a hot shower can work well.

Pneumonia Treatments

If it’s caused by bacteria, you’ll get an antibiotic. If it’s caused by a virus, you may get an antiviral drug. And if it’s really severe, you may need to go to the hospital, though that’s not as common.

To help ease your symptoms, you can do many of the same things as with bronchitis:

  • Drink plenty of fluids
  • Get as much rest as you can
  • Take pain relievers for pain and fever

And again, it’s best to avoid cough medicines. In fact, there’s actually very little proof that they can help with the cough you get from pneumonia.

Pneumonia usually runs its course within a few weeks with treatment, but you may be tired for as long as a month.

Pneumonia | NHS inform

Pneumonia is swelling (inflammation) of the tissue in one or both lungs. It’s usually caused by a bacterial infection.

At the end of the breathing tubes in your lungs are clusters of tiny air sacs. If you have pneumonia, these tiny sacs become inflamed and fill up with fluid.

Symptoms of pneumonia

The symptoms of pneumonia can develop suddenly over 24 to 48 hours, or they may come on more slowly over several days.

Common symptoms of pneumonia include:

  • a cough – which may be dry, or produce thick yellow, green, brown or blood-stained mucus (phlegm)
  • difficulty breathing – your breathing may be rapid and shallow, and you may feel breathless, even when resting
  • rapid heartbeat
  • fever
  • feeling generally unwell
  • sweating and shivering
  • loss of appetite
  • chest pain – which gets worse when breathing or coughing

Less common symptoms include:

  • coughing up blood (haemoptysis)
  • headaches
  • fatigue
  • nausea or vomiting
  • wheezing
  • joint and muscle pain
  • feeling confused and disorientated, particularly in elderly people

When to see your GP

See your GP if you feel unwell and you have typical symptoms of pneumonia.

Seek urgent medical attention if you’re experiencing severe symptoms, such as rapid breathing, chest pain or confusion.

Who’s affected?

In the UK, pneumonia affects around 8 in 1,000 adults each year. It’s more widespread in autumn and winter.

Pneumonia can affect people of any age, but it’s more common – and can be more serious – in certain groups of people, such as the very young or the elderly.

People in these groups are more likely to need hospital treatment if they develop pneumonia.

What causes pneumonia?

Pneumonia is usually the result of a pneumococcal infection, caused by bacteria called Streptococcus pneumoniae.

Many different types of bacteria, including Haemophilus influenzae and Staphylococcus aureus, can also cause pneumonia, as well as viruses and, more rarely, fungi.

As well as bacterial pneumonia, other types include:

  • viral pneumonia – most commonly caused by the respiratory syncytial virus (RSV) and sometimes influenza type A or B; viruses are a common cause of pneumonia in young children
  • aspiration pneumonia – caused by breathing in vomit, a foreign object, such as a peanut, or a harmful substance, such as smoke or a chemical
  • fungal pneumonia – rare in the UK and more likely to affect people with a weakened immune system
  • hospital-acquired pneumonia – pneumonia that develops in hospital while being treated for another condition or having an operation; people in intensive care on breathing machines are particularly at risk of developing ventilator-associated pneumonia

Risk groups

The following groups have an increased risk of developing pneumonia:

  • babies and very young children
  • elderly people
  • people who smoke
  • people with other health conditions, such as asthma, cystic fibrosis, or a heart, kidney or liver condition
  • people with a weakened immune system – for example, as a result of a recent illness, such as flu, having HIV or AIDS, having chemotherapy, or taking medication following an organ transplant

Diagnosing pneumonia

Your GP may be able to diagnose pneumonia by asking about your symptoms and examining your chest. Further tests may be needed in some cases.

Pneumonia can be difficult to diagnose because it shares many symptoms with other conditions, such as the common cold, bronchitis and asthma.

To help make a diagnosis, your GP may ask you:

  • whether you feel breathless or you’re breathing faster than usual
  • how long you’ve had your cough, and whether you’re coughing up mucus and what colour it is
  • if the pain in your chest is worse when you breathe in or out

Your GP may also take your temperature and listen to your chest and back with a stethoscope to check for any crackling or rattling sounds.

They may also listen to your chest by tapping it. Lungs filled with fluid produce a different sound from normal healthy lungs.

If you have mild pneumonia, you probably won’t need to have a chest X-ray or any other tests.

You may need a chest X-ray or other tests, such as a sputum (mucus) test or blood tests, if your symptoms haven’t improved within 48 hours of starting treatment.

Treating pneumonia

Mild pneumonia can usually be treated at home by:

  • getting plenty of rest
  • taking antibiotics
  • drinking plenty of fluids

If you don’t have any other health problems, you should respond well to treatment and soon recover, although your cough may last for some time.

As pneumonia isn’t usually passed from one person to another, it’s safe to be around others, including family members.

However, people with a weakened immune system should avoid close contact with a person with pneumonia until they start to get better.

For at-risk groups, pneumonia can be severe and may need to be treated in hospital.

This is because it can lead to serious complications, which in some cases can be fatal, depending on a person’s health and age.

Read more about treating pneumonia.

Complications of pneumonia

Complications of pneumonia are more common in young children, the elderly and those with pre-existing health conditions, such as diabetes.

Possible complications of pneumonia include:

  • pleurisy – where the thin linings between your lungs and ribcage (pleura) become inflamed, which can lead to respiratory failure
  • a lung abscess – a rare complication that’s mostly seen in people with a serious pre-existing illness or a history of severe alcohol misuse
  • blood poisoning (septicaemia) – also a rare but serious complication

You’ll be admitted to hospital for treatment if you develop one of these complications.

Preventing pneumonia

Although most cases of pneumonia are bacterial and aren’t passed on from one person to another, ensuring good standards of hygiene will help prevent germs spreading.

For example, you should:

  • cover your mouth and nose with a handkerchief or tissue when you cough or sneeze 
  • throw away used tissues immediately – germs can live for several hours after they leave your nose or mouth
  • wash your hands regularly to avoid transferring germs to other people or objects

A healthy lifestyle can also help prevent pneumonia. For example, you should avoid smoking as it damages your lungs and increases the chance of infection.

Find out how to stop smoking.

Excessive and prolonged alcohol misuse also weakens your lungs’ natural defences against infections, making you more vulnerable to pneumonia.

People at high risk of pneumonia should be offered the pneumococcal vaccine and flu vaccine.

Chest Burning Sensation – Symptoms, Causes, Treatments

Chest burning sensation may be caused by cardiac and pulmonary circulation disorders that reduce or block blood flow through the arteries that supply oxygen to heart and lungs. Gastrointestinal disorders are also common causes of chest burning sensation. Such disorders may be caused by gastric acid from the stomach and, sometimes, bile contents entering the esophagus, resulting in heartburn and indigestion.

Chest burning sensation can be the result of trauma or injury to the musculoskeletal structures of the chest area. Further causes are related to nerve involvement, whereby a nerve is damaged, diseased or injured. Less severe but common, a burning sensation in the chest can be caused by sunburn or chemical burns.

Gastrointestinal causes of chest burning sensation

Chest burning sensation can be caused by gastrointestinal disorders. Examples include:

  • Bloating from gas

  • Esophagitis (inflammation of the esophagus)

  • Gastric reflux or heartburn

  • Ulcers

Other causes of chest burning sensation

Chest burning sensation may be caused by other conditions including:

Serious or life-threatening causes of chest burning sensation

In some cases, chest burning sensation may be a symptom of a heart or lung disorder or injury to the chest. These conditions may be serious or life threatening and should be immediately evaluated in an emergency setting. These conditions include:

  • Angina (chest pain resulting from lack of blood flow to the heart)

  • Asthma

  • Chest trauma

  • Dissecting thoracic aortic aneurysm (life-threatening tear in a bulging or weakened wall of the body’s main artery that can cause severe hemorrhage)

  • Myocardial infarction (heart attack)

  • Stroke

Questions for diagnosing the cause of chest burning sensation

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your chest burning sensation including:

  • How long have you felt a chest burning sensation?

  • When do you feel a chest burning sensation?

  • Do you have any other symptoms?

  • Does anything relieve or worsen the burning sensation?

  • What medications are you taking?

What are the potential complications of chest burning sensation?

Because chest burning sensation can be caused by serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

I was regarded as having a ‘mild case’ of Covid-19. I had burning lungs and exhaustion for weeks | Anna Poletti

“I am pretty sure I have it.”

I started saying this to colleagues and students around 9 March 2020. I had a strange, hot pain in my lungs. It was the shape of a horseshoe – it ran down the outside and along the bottom of my lungs. I could breathe fine. I was still able to deliver a two-hour lecture, ride my bike, talk to people in meetings, walk to the supermarket; but I was a bit more tired at the end of the day. Then again, I thought to myself, I am always tired at this time of year. Winter was ending in the Netherlands, where I live, and I was almost halfway through what is the busiest time of my working year at the university.

I am a 43-year-old woman with no pre-existing health conditions. I am writing this essay because none of my Australian friends and family know anyone else who has had coronavirus. It took so long for me to get consistent medical attention because I have been regarded as a “mild case” while frontline medical professionals are busy managing an epidemic.

The last four months have taught me, over and over again, that we should believe the medical professionals when they tell us that they do not know or understand how this virus behaves, what impact it has on our bodies, and what we can do to treat it when we catch it. I want you to know that this virus does not just kill people – it can give healthy people a chronic illness that lasts for months.

In March, the Dutch government was advising us to stop shaking hands (the Dutch shake hands with everyone), to wash our hands regularly and to cover our mouths if we coughed. I was not really coughing – I would give a pathetic little single cough once or twice a day, and my chest was not feeling congested, there was no phlegm to be cleared. It just felt an electric blanket was running on the highest setting inside my chest. I had never felt anything like it.

My symptoms did not match the list on the National Institute for Public Health and Environment website but just to be on the safe side, I stopped meeting people in person and went to the supermarket once a week. When I went, I wore latex gloves and kept my distance from other shoppers. I was not coughing or sneezing or sniffing. I could still walk to the shop and carry my shopping home then, a 20-minute walk each way. By 16 March, the Netherlands was in “intelligent” lockdown.

Once this happened, I was working from home. As the month progressed and the fire kept burning in my lungs, I was getting more tired. I would wake up around 7.30am after nine hours of rest feeling OK, but by 11.30am I needed to sleep.

“This thing wants control of my lungs,” I said to a friend over the phone in Australia as April drew near. By late March all I could do was lie in bed, nap, read and eat. I drank a lot of fresh ginger tea. The fire in my lungs kept raging, I was only breathing into the very top of my lungs, I could not take a deep breath. I was not sleeping as well I usually do, and when I was very tired (usually in the afternoon) I had developed a spectacular case of tinnitus. I would lie in my bed listening to the phasing of the high-pitched frequencies in my ears with curiosity and trepidation. When a friend would call to check how I was while he was on his evening walk, I would sometimes have to ask him to repeat what he was saying three times because I could not hear his deep voice over the screaming high notes in my head. I was worried. I had not occupied physical space with another human being for three weeks. And my body was getting very weak.

I realised I was doing something I came to think of as ‘Covid breathing’. Short, shallow gasps

On 28 March, after a particularly stressful night, I called my doctor and he agreed to send me to a respiratory clinic to have my lungs checked. I walked to the clinic very slowly. When the medic came to get me, she wore full PPE. She checked my temperature (normal), the oxygen saturation of my blood (also normal) and listened to my lungs. She could hear the infection there. “I think it is coronavirus,” she said. “But I cannot test you. You can still walk, and talk. Go home and rest and call us if it gets any worse.” The Dutch only started widespread testing in June, so to this day I have still not been tested for the virus.

When I spoke to my doctor the next day, he advised that one version of coronavirus seemed to be doing this – giving people a long-running lung infection that could last up to six weeks. “So you probably have another three weeks or so to go,” he suggested.

I took sick leave from work and lay in bed with shortness of breath, burning lungs, ringing ears and total exhaustion for another three weeks. Time was a blur. People would drop off groceries every few days. I could barely stand in my open door and have a conversation with them. I was just too tired. My lungs burned and burned.

Ten days after my visit to the clinic, still with burning lungs and shallow breathing, I called the emergency doctor. I described my symptoms. He looked at the notes from my visit to the respiratory clinic.

“They think I have Covid-19,” I said. It was 2am. I was awake in the middle of the night. I was scared.

“I am sure you do,” he responded. “Your symptoms are consistent with it. But you can speak in full sentences to me on the phone, so I am not too worried about you. Take some paracetamol and try to rest. Call us if you cannot walk to your toilet, or if your breathing gets worse, or if you have a fever for more than two days.”

My doctor’s prediction was right. I had burning lungs, exhaustion and shallow breathing for a total of six weeks. By the middle of April, the burning started to subside and was replaced by a tightness in my chest and a weight on my lungs. I started coughing; after walking up the stairs in my apartment too fast, or if I talked in an animated way to a friend on WhatsApp for too long. I was so weak I could not walk around the block. Breathing was hard work. On 23 April, I was sent back to the respiratory clinic and checked again. No temperature. Oxygen saturation fine. This time, the medic could not hear evidence of an infection in my lungs when she listened to them.

“So why can’t I breathe? Why am I coughing?” I asked her, crying with frustration.

“We don’t know. There may be some inflammation there. I will give you a steroid to inhale, that might help.”

After the burning pain was replaced by these new symptoms I spent May and the first half of June trying to regain some strength and giving in to my total exhaustion. My lungs would get tired and ache after walking for 10 minutes, or talking for more than 20 minutes. I would fall off a cliff into total exhaustion with seemingly no warning and have to spend a day in bed. But slowly, with two steps forward and one-and-a-half steps backward, I was able to regain enough strength that I could take a walk with a friend (at half my usual pace), and sit with them and talk. This part of my recovery seems consistent with recovery from pneumonia, but I was never diagnosed with pneumonia.

Around this time the media started reporting on “long haul” cases of the virus. It was reassuring to see that I was not alone. The medical profession started to consider whether people like me were actually patients that needed ongoing care.

As June progressed, my fitness continued to improve but my lungs were still aching, and my chest was still tight. Bone-crushing fatigue was replaced by tiredness.

I realised I was doing something I came to think of as “Covid breathing”. Short, shallow gasps. After six weeks of healing, and 12 weeks since the problems started, there was little real improvement in my lung strength. I talked it over with my doctor, who suggested I see a physiotherapist who specialises in lung rehabilitation.

Two weeks ago, someone showed me how to breathe. It is a strange experience to have to relearn how to do a thing that you never had to learn in the first place. As July begins, I am almost able to breathe normally, but only when I give it my full attention. As I type these words for you I am shallow breathing.

I am writing this because we are four months into the pandemic and we are all tired and some people are wondering, because they lack direct firsthand experience of anyone with the virus, whether there is really anything to worry about. I caught the virus very early, and I can’t tell you how long it takes to recover from it, because I have not recovered. I am telling you about my experience with Covid-19 so far to help you keep your strength during this period of uncertainty and restrictions.

I have a long way to go, but after four months I think it might be possible that I will make a full recovery. Medical researchers have a long way to go too. The discipline and patience they are using to understand the virus is not that dissimilar to what I have to draw on now, and what you have to draw on as you continue to face restrictions to your personal freedoms, the worry that you might lose your job, the stress you feel that your postcode might be the next one where an outbreak of the virus occurs. Perhaps it would help us to recognise that we are all long-haul cases.

Anna Poletti is a writer, researcher and teacher based in Utrecht, the Netherlands

Walking Pneumonia (for Parents) – Nemours Kidshealth

What Is Walking Pneumonia?

It can seem like kids pick up one bug after another. Most of the time, these bugs only last for about a week. But those that last longer can sometimes turn into walking pneumonia.

Walking pneumonia, or atypical pneumonia, is a less serious form of the lung infection pneumonia. It’s caused by Mycoplasma bacteria, and causes cold-like symptoms, a low-grade fever, and a hacking cough.

Most kids with this form of pneumonia will not feel sick enough to stay at home — hence, the name “walking” pneumonia. But even a child who feels fine needs to stay at home for a few days until antibiotic treatment kicks in and symptoms improve.

What Are the Signs & Symptoms of Walking Pneumonia?

Colds that last longer than 7 to 10 days or respiratory illnesses like respiratory syncytial virus (RSV) can develop into walking pneumonia. Symptoms can come on suddenly or take longer to appear. Those that start slowly tend to be more severe.

Here’s what to look for:

  • a fever of 101°F (38.5°C) or below
  • headache, chills, sore throat, and other cold or flu-like symptoms
  • fast breathing or breathing with grunting or wheezing sounds
  • labored breathing that makes the rib muscles retract (when muscles under the ribcage or between ribs draw inward with each breath)
  • hacking cough
  • ear pain
  • chest pain or stomach pain
  • malaise (feeling of discomfort)
  • vomiting
  • loss of appetite (in older kids) or poor feeding (in infants)
  • rash
  • joint pain

Symptoms usually depend on where the infection is concentrated. A child whose infection is in the top or middle part of the lungs will probably have labored breathing. Another whose infection is in the lower part of the lungs (near the belly) may have no breathing problems, but may have an upset stomach, nausea, or vomiting.

How Is Walking Pneumonia Diagnosed?

Walking pneumonia is usually diagnosed through a physical examination. The doctor will check your child’s breathing and listen for a hallmark crackling sound that often indicates walking pneumonia.

If needed, a chest X-ray or tests of mucus samples from the throat or nose might be done to confirm the diagnosis.

How Is Walking Pneumonia Treated?

Antibiotics are an effective treatment for walking pneumonia. A 5- to 10-day course of oral antibiotics is usually recommended. If your doctor prescribes antibiotics, make sure your child takes them on schedule for as long as directed to recover more quickly.

Once on antibiotics, your child has a minimal risk of passing the illness on to other family members. But encourage everyone in your household to wash their hands well and often.

Don’t let your child share drinking glasses, eating utensils, towels, or toothbrushes. Wash your hands after touching any used tissues. Also make sure that your kids are up to date on their immunizations to help protect them from other infections.

How Can I Help My Child Feel Better?

Your child should drink fluids throughout the day, especially if he or she has a fever. Ask the doctor before you use a medicine to treat a cough. Cough suppressants stop the lungs from clearing mucus, which might not be helpful for lung infections like walking pneumonia.

If your child has chest pain, try placing a heating pad or warm compress on the area. Take your child’s temperature at least once each morning and each evening. Call the doctor if it goes above 102°F (38.9°C) in an older infant or child, or above 100.4°F (38°C) in an infant under 6 months of age.

With treatment, most types of bacterial pneumonia go away within 1 to 2 weeks. Coughing can take up to 4 to 6 weeks to stop.

Chest pain: First aid – Mayo Clinic

First aid for chest pain depends on the cause. Causes of chest pain can vary from minor problems, such as heartburn or emotional stress, to serious medical emergencies, such as a heart attack or blood clot in the lungs (pulmonary embolism).

It can be difficult to tell if your chest pain is due to a heart attack or other health condition, especially if you’ve never had chest pain before. Don’t try to diagnose the cause yourself. Seek emergency medical help if you have unexplained chest pain that lasts more than a few minutes.

Heart attack

A heart attack generally causes chest pain for more than 15 minutes. The pain may be mild or severe. Some heart attacks strike suddenly, but many people have warning signs hours or days in advance.

Someone having a heart attack may have any or all of the following:

  • Chest pain, pressure or tightness, or a squeezing or aching sensation in the center of the chest
  • Pain or discomfort that spreads to the shoulder, arm, back, neck, jaw, teeth or occasionally upper abdomen
  • Nausea, indigestion, heartburn or abdominal pain
  • Shortness of breath
  • Lightheadedness, dizziness, fainting
  • Sweating

In women, chest pain is not always severe or even the most noticeable symptom. Women tend to have more-vague symptoms, such as nausea or back or jaw pain, which may be more intense than the chest pain.

If you or someone else may be having a heart attack, follow these first-aid steps:

  • Call 911 or emergency medical assistance. Don’t ignore the symptoms of a heart attack. If you can’t get an ambulance or emergency vehicle to come to you, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only if you have no other option. Because your condition can worsen, driving yourself puts you and others at risk.
  • Chew aspirin. Aspirin is a blood thinner. It prevents clotting and keeps blood flowing through a narrowed artery that’s caused a heart attack. Don’t take aspirin if you have chest pain due to an injury. Also, don’t take aspirin if you are allergic to aspirin, have bleeding problems or take another blood-thinning medication, or if your doctor previously told you not to do so.
  • Take nitroglycerin, if prescribed. If you think you’re having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Don’t take anyone else’s nitroglycerin.
  • Begin CPR on the person having a heart attack. The American Heart Association recommends starting hands-only CPR. Push hard and fast on the person’s chest for 100 to 120 compressions a minute.
  • If an automated external defibrillator (AED) is immediately available and the person is unconscious, follow the device instructions for using it.


Angina is chest pain or discomfort caused by reduced blood flow to your heart muscle. It’s relatively common, but it can be hard to tell the difference from other types of chest pain, such as indigestion.

Angina can be stable or unstable.

  • Stable angina is chest pain that usually occurs with activity and is relatively predictable. The chest pain tends to follow a pattern. In other words, there’s been no change in how often you get the chest pain and how long it lasts.
  • Unstable angina is chest pain that is sudden or new or changes from the typical pattern. It may be a sign of a future heart attack.

If your angina gets worse or changes, seek emergency medical help immediately.

Pulmonary embolism

Pulmonary embolism is a blood clot in the lung. It occurs when a clot, usually in the leg or pelvis, breaks free and gets stuck in a lung artery (pulmonary artery). The clot interrupts blood flow, making it more difficult for your lungs to provide oxygen to the rest of your body.

Signs and symptoms of pulmonary embolism may include:

  • Sudden, sharp chest pain often with shortness of breath
  • Sudden, unexplained shortness of breath, even without pain
  • Cough that may produce blood-streaked spit
  • Rapid heartbeat with shortness of breath
  • Fainting
  • Severe anxiety
  • Unexplained sweating
  • Swelling of one leg only, caused by a blood clot in the leg

Pulmonary embolism can be life-threatening. If you have symptoms of a pulmonary embolism, seek emergency medical help immediately.

Aortic dissection

An aortic dissection is a tear in the inner layer of the aorta, the large blood vessel branching off the heart. Blood rushes through this tear into the middle layer of the aorta, causing the inner and middle layers to separate (dissect). Aortic dissection is a life-threatening condition that needs emergency medical treatment.

Typical signs and symptoms include:

  • Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back
  • Loss of consciousness (fainting)
  • Shortness of breath
  • Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of your body, such as having a stroke
  • Heavy sweating
  • Weak pulse in one arm compared with the other

If you are having any of these signs or symptoms, they could be caused by an aortic dissection or another serious condition. Seek emergency medical help immediately.

Pneumonia with pleurisy

Frequent signs and symptoms of pneumonia are chest pain accompanied by chills, fever and a cough that may produce bloody or foul-smelling sputum. Pleurisy is inflammation of the membranes that surround the lung (pleura). It can cause chest pain when taking a breath or coughing.

Unlike a true heart attack, pleurisy pain is usually relieved temporarily by holding your breath or putting pressure on the painful area of your chest.

If you’ve recently been diagnosed with pneumonia and then start having symptoms of pleurisy, contact your doctor or seek immediate medical attention to determine the cause of your chest pain. Pleurisy alone isn’t a medical emergency, but you shouldn’t try to make the diagnosis yourself.


Pericarditis is swelling and irritation of the thin, saclike tissue surrounding your heart (pericardium). Pericarditis can cause sharp chest pain that gets worse when you cough, lie down or take a deep breath.

Pericarditis is usually mild and goes away without treatment. If it’s severe, you may need medication or, rarely, surgery.

It may be difficult to tell the difference between sudden (acute) pericarditis and pain due to a heart attack. If you have sudden, unexplained chest pain, seek emergency medical help.

Chest wall pain

Chest wall pain is a type of muscle pain. Bruised chest muscles — from excessive coughing, straining or minor injury can cause harmless chest pain.

One type of chest wall pain is costochondritis. Costochondritis causes pain and tenderness in and around the cartilage that connects your ribs to your breastbone (sternum).

If you have costochondritis, pressing on a few points along the edge of your breastbone often triggers considerable tenderness. If gently touching the area with your fingers causes chest pain, it’s unlikely that a serious condition, such as a heart attack, is the cause of your chest pain.

When to see a doctor

Chest pain is a common reason that people seek medical treatment. Anxiety, indigestion, infection, muscle strain, and heart or lung problems can all cause chest pain.

If your chest pain is new, changing or otherwise unexplained, seek help from a doctor. If you think you’re having a heart attack, call 911 or your local emergency number. Don’t try to diagnose the chest pain yourself or ignore it. Your treatment will depend on the specific cause of the pain.

April 21, 2021

Show references

  1. Mason RJ, et al. Chest pain. Murray and Nadel’s Textbook of Respiratory Medicine. 6th ed. Elsevier; 2016. https://www.clinicalkey.com. Accessed March 2, 2021.
  2. Chest pain. Merck Manual Professional Version. https://www.merckmanuals.com/professional/cardiovascular-disorders/symptoms-of-cardiovascular-disorders/chest-pain. Accessed March 2, 2021.
  3. Heart attack. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/heart-attack#. Accessed March 2, 2021.
  4. Angina. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/angina. Accessed March 2, 2021.
  5. Pellegrino JL, et al. 2020 American Heart Association and American Red Cross focused update for first aid. Circulation. 2020; doi:10.1161/CIR.0000000000000900.
  6. Marx JA, et al., eds. Chest pain. In: Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed March 2, 2021.
  7. Venous thromboembolism. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism. Accessed March 2, 2021.
  8. Lavonas EJ, et al. Highlights of the 2020 AHA guidelines update for CPR and ECC. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines. Accessed Jan. 28, 2021.
  9. Warning signs of a heart attack. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack. Accessed Jan. 18, 2021.


90,000 Rospotrebnadzor named the consequences of COVID-19 infection

Natalya Pshenichnaya, deputy director for clinical and analytical work of the Central Research Institute of Epidemiology of Rospotrebnadzor, said that patients who have recovered from COVID-19 may have weakness, headache, cough, tachycardia and burning sensation in the chest, as well as memory loss for a long time. The expert recalled that after a serious infection, you cannot immediately go to work, you need to give the body time to recover.

Weakness, fatigue, headache, cough, tachycardia and burning sensation in the chest remain for a long time in those who have recovered from the COVID-19 coronavirus, said Natalya Pshenichnaya, deputy director for clinical and analytical work of the Central Research Institute of Epidemiology of Rospotrebnadzor.

Also, according to her, those who have survived the infection may experience cognitive impairment – a decrease in memory or concentration of attention, RIA Novosti reports.

“It is no coincidence that there is a rehabilitation period, when after a serious infection it is recommended not to go to work right away, but to take care of yourself, to give time for the body to recover,” the specialist reminded.

However, COVID-19 not only affects internal organs, but also provokes severe autoimmune diseases, warn doctors from Robert Wood Johnson University Hospital in the United States.The disease was able to provoke relapses of Guillain-Barré syndrome. Doctors described the details of the study in an article in the journal Pathogens.

Reports of the development of Guillain-Barré syndrome against the background of COVID-19 have already been met, but now doctors for the first time are faced with a relapse of the syndrome caused by coronavirus in a 54-year-old man.

Guillain-Barré syndrome is an acute autoimmune inflammatory lesion of peripheral nerves. It is manifested by paralysis, loss of sensitivity, autonomic disorders.

The syndrome often occurs as a complication of bacterial and viral infections, sometimes observed after operations, vaccinations and injuries.

Although in most cases patients recover completely, the persistence of paralysis, up to disability, is also not uncommon. The syndrome can lead to death from respiratory failure, sepsis, pulmonary embolism, cardiac arrest.

It should be noted, however, that modern methods of intensive therapy have reduced mortality to 3-5%.Only about 5% of patients experience recurrent Guillain-Barré syndrome.

“A patient went to the emergency room with complaints of progressive swallowing problems, then had a fever for three days, followed by weakness in the arms, legs and face,” said Erin McDonnell, one of the authors of the study.

The transferred coronavirus of a new type can cause paresthesia – a sensory disorder characterized by spontaneously arising sensations of burning, tingling and crawling on the skin, as told the newspaper earlier.Ru ”pulmonologist Marina Kazakova.

According to the physician, these symptoms are due to the fact that SARS-CoV-2 is a neurotropic virus that can affect nerve tissue. Kazakova stressed that it is too early to talk about the duration of such consequences of the disease, since doctors have not yet conducted long-term observations of patients.

“However, so far we assume that most of these effects disappear within two months after recovery,” – said the therapist.

At the same time, clinical pharmacologist, candidate of medical sciences Andrei Kondrakhin disagreed with his colleague. He believes that these neuralgic complications can be felt throughout the life of people who have recovered from COVID-19.

“Most often, patients complain precisely of pronounced fatigue:“ there is no strength for anything at all, it is very difficult to enter the usual rhythm, ”the doctor said.

Neurologist Patimat Isabekova detailed that damage to the nervous tissue of the body during a new type of coronavirus infection can occur due to the fact that the coronavirus interacts with ACE-2 receptors (a protein present in many body tissues, – “Gazeta.Ru “), which are present not only in the lungs, but also in the nervous system.

In turn, the doctor immunologist-allergist Vladimir Bolibok noted that patients who have recovered from COVID-19 more often than all other consequences have high blood pressure.

“This is a tendency for an increase in blood pressure due to a decrease in the elasticity of the vascular walls throughout the body,” said the expert.

According to the doctor, it is still unclear to specialists which organ of a person can get the coronavirus.And it is unclear whether the consequences for the body will be short-term or long-term.

“The whole organism can be affected. Probably no one knows what to do with this, ”he stressed.

Coronavirus infection can lead to a wide variety of consequences for the body – even after recovery, men who have undergone COIVD-19 may face consequences such as erectile dysfunction, American virologist Dena Grayson told NBC Chicago.

It is also related to vascular problems caused by COVID-19.The American physician warned that other delayed consequences of the infection, including neurological complications, may appear over time.

According to Anchi Baranova, professor at the School of Systems Biology at George Mason University, premature aging of the body is also one of the likely consequences of the coronavirus.

90,000 Pneumonia in children: symptoms and treatment

A lecture “Pneumonia in children” was held for medical workers in the children’s polyclinic No. 11.It was conducted by the head of the medical and preventive department Dmitry Trufanov. Dmitry Igorevich spoke about the symptoms and treatment of pneumonia.

Pneumonia in children is an acute infectious lesion of the lungs, accompanied by the presence of infiltrative changes on radiographs and symptoms of the lower respiratory tract.


· temperature rise;



pain in the chest or under the shoulder blades;


· increased intoxication.

The clinical manifestations of pneumonia largely depend not only on the type of pathogen that caused the inflammatory process, but also on the age of the child. At an older age of children, the disease has clearer and more characteristic manifestations, and in babies with minimal manifestations, severe respiratory failure and oxygen starvation can rapidly develop. It is rather difficult to predict how the process will develop.

At first, the baby may experience slight difficulty in nasal breathing, tearfulness, loss of appetite.Then the temperature suddenly rises (above 38 ° C) and lasts for 3 days or longer, there is an increase in respiration and heart rate, pallor of the skin, pronounced cyanosis of the nasolabial triangle, sweating.

The cough may appear on the 5-6th day, but it may not be. The nature of the cough can be different: superficial or deep, paroxysmal unproductive, dry or wet. Sputum appears only if it is involved in the inflammatory process of the bronchi.

With pneumonia, schoolchildren and adolescents almost always have previous minor manifestations of ARVI.Then the condition normalizes, and after a few days, chest pain and a sharp rise in temperature appear. The cough occurs within 2-3 consecutive days.

Treatment of pneumonia

The grounds for hospitalization of a child with pneumonia are: age up to 3 years, involvement in inflammation of two or more lobes of the lungs, severe respiratory failure, pleurisy, severe encephalopathy, malnutrition, congenital heart and vascular defects, chronic lung pathology (bronchial asthma , bronchopulmonary dysplasia, etc.), kidneys (glomerulonephritis, pyelonephritis), immunodeficiency states. In a febrile period, the child is shown bed rest, balanced nutrition and drinking load.

Symptomatic and pathogenetic therapy of pneumonia in children includes the appointment of antipyretic, mucolytic, bronchodilator, antihistamine drugs. After the fever subsides, physiotherapy is indicated: microwave, inductothermy, electrophoresis, inhalation, chest massage, percussion massage, exercise therapy.

Forecast and prevention

With timely recognition and treatment, the outcome of pneumonia in children is favorable.Pneumonia caused by highly virulent flora, complicated by purulent-destructive processes, has an unfavorable prognosis; proceeding against the background of severe somatic diseases, immunodeficiency states. A protracted course of pneumonia in young children is fraught with the formation of chronic bronchopulmonary diseases.

Prevention of pneumonia in children consists in organizing good child care, hardening it, preventing ARVI, treating ENT pathology, vaccination against influenza, pneumococcal infection, hemophilic infection.

All children who have had pneumonia are subject to dispensary registration with a pediatrician for 1 year with a control chest x-ray, CBC, examination of the child by a pediatric pulmonologist, an allergist-immunologist and an otolaryngologist.

Surgical treatment of a purulent process in the space around the lungs in comparison with non-surgical

Review question

We determined whether there is a difference in the outcomes of patients with purulent processes in the space around the lungs (empyema) during their surgical and nonsurgical treatment.We looked for differences in the proportion of surviving children and adults, length of hospital stay, and complications of treatment.


Pus can form in the space around the lungs due to pneumonia, complications of chest wall trauma or surgery. Hard formations called enclosed chambers can form inside the pus. Usually, the infection is not cleared up with antibiotics alone.

Several surgical and non-surgical treatments are available.Non-surgical treatments include draining the pus with a needle inserted through the chest wall (thoracocentesis) or by inserting a tube through the chest wall to drain the infection (thoracostomy). If a drainage tube is inserted, medications can be injected into the space around the lungs for therapeutic purposes. This is called fibrinolysis. Nonsurgical treatments can cause harm, including trapping air around the lungs, damaging the tissues in the chest, or filling the lungs with fluid when they expand.Surgery involves either opening the chest cavity and removing the infection (thoracotomy), or removing the infection through small incisions in the chest wall under camera control (video-assisted thoracoscopic surgery (VATS)). The tube removes any fluids after surgery. Among the risks associated with surgical interventions, we note the ingress of air into the space around the lungs, pain in the ribs and complications of anesthesia.

Search date

Evidence is current to October 2016.

Characteristics of research

We included eight studies with 391 participants in the review. Six studies focused on children and two on adults. Studies have compared drainage (nonsurgical treatment) with or without fibrinolysis to VATS or thoracotomy (surgical treatment).

Sources of research funding

Two studies reported no financial conflicts of interest; the six remaining studies did not report funding sources.


There was no difference in the proportion of patients of all ages who experienced empyema with surgical and non-surgical treatment. However, this finding was based on limited data: one study reported one death with each treatment, and seven studies reported no deaths. There were no differences in complication rates between patients who received surgical and non-surgical treatment.

There was limited evidence to suggest that VATS reduced hospital stay compared to nonsurgical treatment.

Quality of evidence

Overall, the quality of the evidence was moderate. The main limitations were the small number of studies for each of the analyzes and the inconsistency of studies.

Community-acquired pneumonia – Diagnostic approach

For updated information on the diagnosis and treatment of coexisting conditions during a pandemic, see Treatment of comorbid conditions in the context of COVID-19.

Patient history and physical examination are important components of the diagnosis and may indicate symptoms that are consistent with PFS, immunosuppression, and / or potential exposure to specific pathogens.However, a definitive diagnosis of pneumonia requires confirmation of the presence of a new infiltrate on a chest x-ray.


The purpose of the history is to identify symptoms compatible with CAP, impaired immunity and the possible risk of exposure to specific pathogens.

Risk factors include age over 65, hospitalization, COPD, HIV infection, exposure to cigarette smoke, alcohol abuse, poor oral hygiene, contact with children, and the use of certain drugs (for example, acid-lowering drugs, inhaled corticosteroids, antipsychotics, antidiabetic drugs, opioids).Diabetes mellitus and chronic liver or kidney disease are also associated with PFS.

Typically present clinical signs and manifestations of infection (fever or chills and leukocytosis) and respiratory symptoms (including cough, often with increased sputum production, shortness of breath, pleural pain, and hemoptysis). There may be complaints of non-specific symptoms such as myalgia and arthralgia. In elderly patients, patients with chronic diseases, and patients with weakened immune systems, the signs and symptoms of pulmonary infection may be less intense, and pneumonia may not be recognized due to the presence of non-respiratory symptoms.

Some causes of pneumonia (eg legionellosis) may have a specific history. Legionellosis can present with headache, confusion, digestive disorders such as diarrhea, and clinical manifestations of hyponatremia.

Mycoplasma pneumoniae infection is most common in young patients and patients who have been treated with antibiotics prior to the current presentation for pneumonia. It can be expressed by such extrapulmonary manifestations as myringitis, encephalitis, uveitis, iritis and myocarditis.[19] Torres A, Barberán J, Falguera M, et al. Multidisciplinary guidelines for the management of community-acquired pneumonia [in Spanish]. Med Clin (Barc). 2013 Mar 2; 140 (5): 223.e1-223.e19.
[66] Menéndez R, Torres A, Aspa J, et al. Community acquired pneumonia: new guidelines of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR) [in Spanish]. Arch Bronconeumol. 2010 Oct; 46 (10): 543-58.
http: //www.archbronconeumol.org / en / linkresolver / neumonia-adquirida-comunidad-nueva-normativa / S0300289610002000


Physical examination

Perform a physical examination. The patient may have fever, tachycardia, and dyspnea at rest. Auscultation of the chest may reveal wet wheezing, wheezing or bronchial breathing, dullness of percussion sound or weakening of vocal tremors may be determined.


Chest x-rays should be done as soon as possible to all patients hospitalized with suspected PFS to confirm or exclude the diagnosis. Chest x-rays are not necessary in outpatients with suspected PFS, unless the diagnosis is in doubt, the patient is not responding adequately to treatment, or the patient is at risk for underlying pulmonary disease.[67] Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct; 64 (suppl 3): iii1-iii55.

Front and oblique lateral views increase the likelihood of diagnosing pneumonia and are useful in determining the severity of the disease.

The benefits of chest x-ray in the diagnosis of CAP have been questioned by studies using pulmonary ultrasound and computed tomography (CT) of the chest. Consideration should be given to ultrasonography of the lungs if the chest x-ray is negative and the patient is elderly and weak, or clinical suspicion is doubtful. Chest CT should be considered in patients with an uncertain diagnosis after chest x-ray and ultrasound.[68] Niederman MS. Imaging for the management of community-acquired pneumonia: what to do if the chest radiograph is clear. Chest. 2018 Mar; 153 (3): 583-5.

Pulmonary ultrasound is a simple and affordable method for diagnosing CAP. It is not associated with radiation and is especially valuable if chest x-ray is not available. Diagnosis of PFS by ultrasound of the lungs at the patient’s bedside depends mainly on detecting a lump.However, induration is not always observed in PFS because pneumonia can be interstitial or manifest as diffuse pulmonary infiltration. [69] Reissig A, Gramegna A, Aliberti S. The role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia. Eur J Intern Med. 2012 Jul; 23 (5): 391-7.
Systematic reviews have shown that lung ultrasound can accurately diagnose pneumonia in adults, including in the emergency room.[70] Llamas-Álvarez AM, Tenza-Lozano EM, Latour-Pérez J. Accuracy of lung ultrasonography in the diagnosis of pneumonia in adults: systematic review and meta-analysis. Chest. 2017 Feb; 151 (2): 374-82.
[71] Orso D, Guglielmo N, Copetti R. Lung ultrasound in diagnosing pneumonia in the emergency department: a systematic review and meta-analysis. Eur J Emerg Med. 2018 Oct; 25 (5): 312-21.

Chest CT may improve the diagnosis of GBV because chest x-ray can lead to misdiagnosis. CT of the chest provides detailed information about the condition of the parenchyma and lungs, as well as the mediastinum. However, the main limitations include exposure to radiation, high cost, and inability to perform the exam at the patient’s bedside. One study has shown that in patients admitted to emergency and emergency departments with suspected GBV, early CT scan results, when used as an adjunct to chest x-ray, have a significant impact on both diagnosis and clinical management.[72] Claessens YE, Debray MP, Tubach F, et al. Early chest computed tomography scan to assist diagnosis and guide treatment decision for suspected community-acquired pneumonia. Am J Respir Crit Care Med. 2015 Oct 15; 192 (8): 974-82.

These alternative imaging modalities may be useful for diagnosing PFS because the availability of CT in the emergency and emergency department is increasing in parallel to the ability to scan as quickly as an equivalent dose chest x-ray.[29] Wunderink RG, Waterer G. Advances in the causes and management of community acquired pneumonia in adults. BMJ. 2017 Jul 10; 358: j2471.


Initial antibiotic treatment is empirical in most cases. Determination of microbial etiology reduces the misuse of broad-spectrum antibiotics and helps ensure appropriate antibiotic therapy, which is an important factor in reducing mortality.It also identifies resistant pathogens and pathogens that may have public health consequences (eg Legionella).

Bacteriological examination of sputum and blood:

  • Prior to treatment, Gram stain and bacteriological examination of lower respiratory secretions should be performed, as well as bacteriological examination of blood in the following patients in a hospital setting: [18] Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia.An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1; 200 (7): e45-e67.


    • Patients with severe CAP as defined by the American Thoracic Society (ATS) or the American Society of Infectious Disease Specialists (IDSA) criteria for severe CAP (see Diagnostic Criteria section), especially if such patients are intubated

    • Patients receiving empiric treatment for methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa

    • Patients previously infected with MRSA or P.aeruginosa, especially those with respiratory tract infections

    • Patients with hospital admissions and parenteral antibiotic therapy within the past 90 days.

  • These studies are generally not recommended for other inpatients, nor are they recommended for outpatient use. Local protocols for rational antimicrobial therapy, local etiological factors and clinical presentation should be taken into account when deciding whether to conduct these studies.[18] Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1; 200 (7): e45-e67.


  • Gram staining of sputum is a sensitive and highly specific method for identifying pathogens in patients with GBV.In a meta-analysis, this study was found to be highly specific for the detection of Streptococcus pneumoniae, Haemophilus influenzae, S. aureus, and gram-negative bacilli. However, the proportion of false negative results ranged from 22% (for H. influenzae) to 44% (for S. pneumoniae), which indicates that a negative result is not definitive confirmation of the absence of causative pathogens, and antibiotic therapy should not necessarily be stopped. based on a negative sputum Gram stain.[73] Del Rio-Pertuz G, Gutiérrez JF, Triana AJ, et al. Usefulness of sputum gram stain for etiologic diagnosis in community-acquired pneumonia: a systematic review and meta-analysis. BMC Infect Dis. 2019 May 10; 19 (1): 403.


Urinalysis for pneumococcal and Legionella antigens:

  • Urinalysis for pneumococcal antigen should be performed in patients with severe IHP.Urinalysis for Legionella antigen should be performed in patients with epidemiologic factors (eg, associated with a Legionella outbreak or recent travel) or in patients with severe IHP. In patients with severe NBH, lower respiratory secretions should be collected simultaneously for bacteriological testing for Legionella or nucleic acid amplification. Urinalysis for antigens has been associated with reduced mortality in large observational studies and should be considered when Legionella infections are increasing, especially in critically ill patients.[18] Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1; 200 (7): e45-e67.


Influenza virus testing:

  • Influenza virus testing using a rapid molecular test (as opposed to antigen-based tests) should be performed during the circulation of influenza viruses in the community.Research during periods of low influenza activity is also being considered. [18] Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1; 200 (7): e45-e67.


Laboratory tests

Hospitalized patients should be assigned a complete blood count, blood glucose, serum electrolyte, urea, and liver function tests. An elevated white blood cell count indicates infection. Chronic kidney and liver disease are risk factors for death and complications in patients hospitalized with CAP.

Arterial blood gas should be measured in critically ill or hospitalized patients.Oximetry is non-invasive and can be used continuously.

Biomarker studies such as C-reactive protein (CRP) and procalcitonin should be considered. These biomarkers are useful in predicting insufficient host response. High CRP or procalcitonin levels at first presentation are risk factors for insufficient host response, [74] Menéndez R, Cavalcanti M, Reyes S, et al. Markers of treatment failure in hospitalized community acquired pneumonia.Thorax. 2008 May; 63 (5): 447-52.

while low levels are protective. In patients with suspected pneumonia, CRP levels> 100 mg / L indicate the likelihood of pneumonia. [75] Woodhead M. New guidelines for the management of adult lower respiratory tract infections. Eur Respir J. 2011 Dec; 38 (6): 1250-1.

Increased PCT values ​​correlate with bacterial pneumonia, while low values ​​correlate with viral and atypical pneumonia. PCT is especially elevated in cases of pneumococcal pneumonia. [76] Menéndez R, Sahuquillo-Arce JM, Reyes S, et al. Cytokine activation patterns and biomarkers are influenced by microorganisms in community-acquired pneumonia. Chest. 2012 Jun; 141 (6): 1537-45.
http: //www.ncbi.nlm.nih.gov/pubmed/22194589?tool=bestpractice.com
[77] Ugajin M, Yamaki K, Hirasawa N, et al. Predictive values ​​of semi-quantitative procalcitonin test and common biomarkers for the clinical outcomes of community-acquired pneumonia. Respir Care. 2014 Apr; 59 (4): 564-73.

Initial empiric antibiotic therapy should be initiated in patients with clinical suspicion and radiographic evidence of PFS, regardless of initial procalcitonin levels.[18] Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1; 200 (7): e45-e67.


In all patients with pleural effusion, aspiration and culture of pleural fluid should be considered.Parapneumonic effusions – exudates; positive Gram staining of pleural fluid indicates empyema.


Bronchoscopy should be considered in immunosuppressed patients, in patients with severe IHP, and in cases of treatment failure. The most common sampling methods are bronchoalveolar lavage (BAL) and brush biopsy. A cut-off value of 10⁴ colony forming units (CFU) / ml in BAL fluid samples indicates infection.For brush biopsy, a threshold of 10³ CFU / ml is recommended to distinguish colonization from infection. [78] Sirvent JM, Vidaur L, Gonzalez S, et al. Microscopic examination of intracellular organisms in protected bronchoalveolar mini-lavage fluid for the diagnosis of ventilator-associated pneumonia. Chest. 2003 Feb; 123 (2): 518-23.

Molecular Methods

Routine inoculation on cultures is too time-consuming and not feasible from a treatment management point of view.Nucleic acid amplification techniques, such as polymerase chain reaction, have improved diagnostic accuracy in GBV. Molecular techniques provide high sensitivity and specificity in diagnosing mono- or polymicrobial infections and can help determine antimicrobial resistance (as can occur with Staphylococcus aureus, non-fermenting Gram-negative bacilli and Enterobacteriaceae), which is associated with severe IHP. [79] Murdoch DR. How recent advances in molecular tests could impact the diagnosis of pneumonia.Expert Rev Mol Diagn. 2016; 16 (5): 533-40.

Animated demonstration of venipuncture and phlebotomy

Main cons and advantages of CT in coronavirus

Russian doctors talk about another side effect of the coronavirus pandemic – CT hysteria, which began in society. Almost all patients who have developed even minor symptoms of acute respiratory viral infections require them to be referred for computed tomography of the lungs, and if they do not receive a referral, they are registered in paid centers.On the one hand, the total radiation dose is growing, on the other, general diagnostics sometimes leads to the identification of diseases that are not at all related to COVID-19.

In an environment where even leading experts recognize that every second PCR test gives a false-positive or false-negative result, radiation diagnostics, of course, plays an important role in the diagnosis of pneumonia. And CT has become one of the most popular studies in recent months.

In city CT centers, patients sit (and sometimes lie) in queues for several hours, in private appointments they are scheduled several days in advance.People who suspect that the virus has got into their lungs try to do a CT scan at all costs, even if they have no cough, no shortness of breath, no chest pain, or, at times, temperature.

On the other hand, experts emphasize, the detection of lung lesions in 6 or 15% will not affect the tactics of treatment in any way. Igor Tyurin, the chief specialist in radiation diagnostics of the Russian Ministry of Health, emphasizes that the course of the disease often does not depend at all on whether the patient has pneumonia on CT scan or not: “This, of course, does not apply to patients with obvious severe respiratory failure.But out of curiosity, you cannot do CT, just as you cannot perform this research for prevention, as today those who have someone sick at home are trying to do it. ”

“COVID-19 is not only a violation of the sense of smell, high fever, weakness, coughing and difficulty breathing, but also anxiety. Fear caused by completely objective reasons and multiplied by general hysteria. Computed tomography is becoming the gold standard of diagnostics, despite the fact that changes on it are nonspecific and do not change anything in the tactics of actions, and the radiation is quite real and completely unsafe, ”said the famous doctor Pavel Brand.

Doctor-cardiologist, doctor of the red zone, associate professor of the medical faculty of Sechenov University Anton Rodionov urges people not to do CT on their own: “I can only repeat after my colleagues that it is not CT that is being treated, but the patient. And changes on CT do not affect treatment tactics. ”

“CT scan should be performed when the patient has moderate and severe COVID-19,” says Igor Sergienko, a doctor of the “red zone”, a cardiologist, professor at the National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation. – One cannot but say that the very visit to CT centers is dangerous because you can become infected with the new coronavirus, and mass visits there by healthy people accelerate the spread of the pandemic.It is very important that CT scan for coronavirus infection has no specific signs – any other viral pneumonia will look the same. And the medical calculations about the percentages of lung damage and frosted glass are a little from the evil one. The main thing is not the interest, but the patient’s condition. CT data is sometimes needed to develop treatment tactics about the possibility of connecting oxygen and (sometimes) to connecting antibiotics (this is one of the points of help for the doctor to make a diagnosis). ”

However, there are other arguments as well.As the head of the department of radionucleide diagnostics of the Federal State Budgetary Institution of the National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation Vladimir Sergienko told MK, when receiving a positive PCR for the virus, he would still recommend to undergo a CT scan: die a day or two. If we talk about the radiation exposure that this study of the lungs entails, then it is quite standard, about 8 millisieverts (about the same load a person receives when flying an airplane at a distance of 2 thousand kilometers – Ed.). In these situations, we have even stopped talking about some kind of load. Of course, this does not mean that CT can be done ten times a year, no, in no case! But two or three times a year is perfectly acceptable. As for COVID-19, CT is usually done twice – the second time for control. Twice a month is quite normal, but three is too much. In any case, this should be decided exclusively by the doctor who deals with the patient, and not the patient himself. ”

Meanwhile, other doctors began to talk about the other side of the CT hysteria of Russians: thanks to this mass screening of the lungs, lung cancer has become more often detected in the early stages.“It’s too early to talk about any trends, but the number of accidental findings of early cancer has become much higher,” the oncologist said in a conversation with the MK columnist.

During the pandemic, doctors began to identify other pathologies of the chest organs not associated with coronavirus. “A huge number of people go to CT for psychotherapy of their COVID-anxiety,” says neurologist Oybek Turgunhuzhaev on his social network. “They invariably say:“ These tests are inaccurate.But CT is yes. Frosted glass. Everyone now knows about this glass. In most cases, responsible doctors react with irritation to such walking of patients on CT of the lungs without the appropriate doctor’s referral. But sometimes research can give an interesting find that you never thought about at the reception. ”

The doctor told about one patient who had been complaining of back pain for several years, he was even prescribed acupuncture and manual therapy, but the pain did not subside.And then the patient made a CT scan of the lungs on his own (due to covid anxiety, just like that). They didn’t find frosted glasses on him, on which he calmed down. However, the CT scan showed a thoracic aortic aneurysm, which was found by accident.

Such cases, however, are extremely rare. “And, of course, they cannot be the basis for including CT in the methods of mass screening of the population,” Igor Sergienko told MK. – We cannot recommend this method to everyone, as, for example, measuring cholesterol levels.For CT, clear indications are needed, and chest pain without other symptoms is not an indication, first the doctor must differentiate this pain, and then decide what additional tests the patient needs. ”

Dr. Pavel Brand, meanwhile, believes that today people do not hear reasonable explanations, therefore, to include CT in the list of methods performed strictly according to the doctor’s prescription: “I’m only afraid that in this situation people will panic even more and begin to take the departments of radiation diagnostics. by storm.The unknown fears more than the coronavirus. ”

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Moskovsky Komsomolets

90,000 fever, cough, pain and sports

Consequences of pneumonia
After pneumonia, cough remains
After pneumonia, the temperature remains 37
After pneumonia, chest hurts
Burning in the chest after pneumonia
Heaviness in the chest after pneumonia
After pneumonia ribs hurt
Pulmonary fibrosis after pneumonia
Is it possible to go to the bathhouse after pneumonia
Respiratory gymnastics to speed up rehabilitation

Cough remained after pneumonia

Uncomplicated pneumonia is usually treated within 14 days, after which for three months, the person who has recovered should be given proper time to rehabilitation measures …Unfortunately, even with high responsibility and care for the body, a cough with pneumonia can last for several weeks.

There are several reasons for this. Often, after inflammation, exudate remains in the bronchi, which comes out due to coughing. It is possible that the inflammation in the lungs was eliminated, but small foci remained in the bronchi, as evidenced by the presence of a cough. The reason for the residual cough can also be the restoration of soft tissues disturbed due to the action of the virus, repeated diseases of acute respiratory infections or acute respiratory viral infections, returning to smoking after a previous illness and slowing down the recovery processes due to this.

After pneumonia, damaged mucous membranes begin to recover. This process takes place over several weeks. During this time, any irritant can cause a cough attack.

Any irritants can cause a cough – physical activity, inhalation of cold air, cigarette smoke. This symptom is not dangerous and usually goes away without medication. Doctors often talk about a psychological habit or a neurological symptom of addiction to coughing, and this symptomatology can last for a long time.

Cough after pneumonia may be associated with ongoing inflammation or the development of complications. Observation by a doctor after an illness will make it possible to identify the causes of the cough and receive additional treatment, if necessary.

Residual cough after pneumonia is a frequent phenomenon and its elimination is part of the recovery, rehabilitation measures for a patient who has suffered pneumonia. With an attentive and careful attitude to oneself, observing all restorative measures, including breathing exercises, the cough will gradually disappear after the accumulated exudate is released and the general tone of the body is restored.

After pneumonia, the temperature is maintained at 37

An increase in body temperature (hyperthermia) is a normal reaction of the body to the inflammatory process. The temperature level in the fight against viruses and infections is usually in the range of 37-38 ° C. This temperature can persist up to two weeks after the onset of the acute phase of pneumonia.

With low-grade pneumonia, low-grade fever is one of the signs of untreated pneumonia. With this reason for the temperature, the patient often has a pronounced asthenic syndrome, accompanied by weakness, rapid fatigue, decreased appetite, irritability, tearfulness.The temperature of untreated pneumonia is usually 37 degrees and lasts more than three weeks. In this case, it is worth visiting a doctor to prescribe an examination and treatment.

After pneumonia, chest hurts

In many cases, pneumonia does not go away without a trace. The condition of the respiratory system deteriorates, and this negatively affects the entire body.

Some people have back pain after pneumonia. Others may be concerned about chest pain. This is understandable, because almost everyone has scars in the lungs after pneumonia.Sometimes they do not appear in any way in later life, but it so happens that the scars subsequently affect the work of the respiratory system.

More often the cause of pain is that pneumonia is transferred “on the legs” or is not treated. Pain in the lungs can remind of itself in the form of a slight tingling sensation during inhalation or rather severe pulling pains. In general, the localization and intensity of pain depends on the severity of the disease and its duration, as well as the quality of the treatment.

Chest pain may indicate an adhesive process in the lungs.Adhesions are abnormal fusion of tissues of internal organs. Adhesions in the lungs after pneumonia can be single and multiple. In an emergency, they cover the entire pleura. At the same time, it shifts and deforms, breathing becomes difficult.

Doctors detect the presence of adhesions in the area of ​​the lungs by x-ray, CT or MRI of the chest cavity.

The course of therapy for adhesive pathology is prescribed by a doctor and depends on the degree of its manifestation. In the presence of adhesions in the lungs, drug therapy is most often attributed.

Burning in the chest after pneumonia

Burning in the chest after pneumonia may indicate various conditions of the patient. In particular, a burning sensation in the side closer to the lower ribs with a radiating back pain may indicate the development of dry pleurisy. Perhaps a burning sensation in the chest indicates complications, adhesions, a large load on the heart, transferred during bilateral pneumonia. In addition, with high nervous tension during an illness, a long lying position, intercostal neuralgia may develop, and its pain symptoms are precisely a burning sensation in the chest during the acute stage.If there is a burning sensation in the chest, it is important to see a doctor and undergo additional examination. The doctor may prescribe additional anti-inflammatory treatments and drugs that stabilize the nervous system.

Severity in the chest after pneumonia

Severity in the chest after pneumonia is often associated with difficulty breathing, with a heavy load on the respiratory system during the fight against the disease, with the need to restore respiratory function. With bilateral pneumonia, we can talk about inflammation of the heart muscle, and this requires observation by a cardiologist.

In addition, the chest may experience a feeling of heaviness and constriction due to constant exhausting cough, tension in the intercostal, pectoral muscles and diaphragm. All this is a consequence of the severity of the disease, and after proper rehabilitation measures, compression in the chest usually goes away. In any case, in the process of monitoring after pneumonia, it is important to inform the attending physician about all such symptoms in order to prevent the growth of the adhesion process and the development of other complications.

Ribs hurt after pneumonia

Rib pain after pneumonia can have a different nature and etiology, and its causes are established against the background of general clinical manifestations. Often, pain in the rib area is associated with prolonged coughing during pneumonia. The tension of the intercostal muscles, the search for a comfortable position for full breathing, the frequent position of the body on the side or on the stomach becomes habitual for a person, but not physiologically convenient due to its unusualness. The intercostal muscles are in constant tension and there is a feeling of “pain in the ribs”.An intense cough forces the intercostal muscles to overextend. Pain arises.

Sometimes rib pain can be a symptom of serious complications, and this can be determined by additional testing. In any case, pain after pneumonia should always be a signal to visit a doctor and conduct research.

Fibrosis of the lungs after pneumonia

Fibrosis is a disease in which scar tissue forms in the area of ​​the lungs. Such a disease involves replacing the usual tissue of the lungs with connective tissue.This process makes it more difficult for oxygen to pass through the alveoli, as a result of which gas exchange and oxygen supply to the tissues of the body are disrupted. According to the severity of the proliferation of connective tissue, areas of a healthy lung alternate with areas replaced by connective tissue, and this is uncomplicated fibrosis. Sclerosis is characterized by compaction and a decrease in the elasticity of the lungs, cirrhosis is the terminal stage, which manifests itself in the complete replacement of the tissues of the lungs of the alveoli, partly of the vessels and bronchi with connective tissue.

In terms of prevalence, fibrosis can affect the apex of the lung, its root, an area in the lung, affect the entire lung or even both lungs.

The key symptom of fibrosis is dyspnea, and there may be a not very intense cough with little sputum production. Fibrosis is accompanied by the development of respiratory failure, which is associated with a decrease in the respiratory surface and lung compliance.

On its background, heart failure or pulmonary heart syndrome occurs, which is manifested by significant shortness of breath, pain behind the sternum, palpitations, swelling of the veins of the neck.

With fibrosis, the mental state and consciousness changes due to the acute reaction of the brain to the lack of oxygen. Depression, asthenic conditions, apathy, dizziness, loss of consciousness are often manifestations of the consequences of pulmonary fibrosis.

Fibrosis is diagnosed through X-ray examination of the lungs, CT and MRI, examination of the functional state of the lungs, fixation of forced expiratory volume indicators in 1 minute, targeted lung biopsy under CT control.

It is impossible to cure fibrosis, but it is quite possible to stop the process of proliferation of connective tissue due to drug therapy and breathing exercises, which should become part of the lifestyle of a patient with lung fibrosis.

Is it possible to go to the bathhouse after pneumonia

If all the time of illness and recovery the patient wanted to get to the bathhouse, then after consulting a doctor, you can think about a steam room. The conditions for visiting the steam room for those who have suffered from pneumonia should be sparing. The time spent in the steam room should not exceed 10 minutes; you should not go into the steam room more than three times. No alcohol, not even the lightest. Do not use contrasting procedures (dousing, cold pool after a steam room, rubdown).It is better to use a coniferous broom, but it is worth steaming at low temperatures until the body is completely restored after an illness.

The bathhouse is a test for the body, and it is better for those who have suffered pneumonia to visit it with extreme caution and only if the body is accustomed to bathing procedures. Carelessness towards yourself while visiting the bath can cause serious complications, relapse of pneumonia and resumption of treatment.

Respiratory gymnastics to accelerate rehabilitation

Respiratory gymnastics is necessary after pneumonia.It will restore the respiratory and circulatory systems, restore the normal respiratory cycle and strengthen the general tone of the body. During the recovery period, it is necessary to devote time to breathing exercises to improve pulmonary circulation and strengthen the pulmonary muscles. Breathing exercises are the first step to a normal healthy life after pneumonia, it is with them that the body’s training and its adaptation to normal loads begin. In fact, without breathing exercises, it will be much harder and much less effective to return to an active, fulfilling life after pneumonia.

There are a lot of types of breathing exercises. Everyone can choose breathing exercises after consulting a doctor, from inflation of balloons to Strelnikova’s complex gymnastics.

Today, most of those who have had pneumonia prefer to do breathing exercises with a “assistant”, the role of which is played by a breathing simulator. Due to breathing exercises with the “Samozdrav” simulator, exudate will be absorbed, sputum separation will be facilitated, the airways will be cleared, lung tissue will maintain health and elasticity, tissue metabolism will normalize and intoxication that accompanies the acute stage of the disease will be eliminated.Healthy breathing and a normal inhalation volume will be restored, shortness of breath will go away due to the normalization of the oxygen level in the body. Recovery will take place faster, and if you get into the habit of breathing correctly, your body will get sick less often.

Question from the lungs

An acute infectious disease affecting the lungs is pneumonia. It is this diagnosis that accounts for about 30% of diseases of the lower respiratory tract of an inflammatory nature. Despite the fact that, according to statistics, elderly people are more likely to get pneumonia, very young people also become patients with such a problem.What is the reason for this and what is the prevention of the disease? We talk about this and many other things with the head of the 1st Department of Internal Diseases of the Belarusian State Medical University, Associate Professor, Candidate of Medical Sciences Sergei Alekseychik


Sergey Evgenievich, in recent years we only hear that almost 90% of our diagnoses are primarily the body’s response to a negligent attitude towards it. Is pneumonia one of these?

Alekseychik Sergey Evgenievich

– Of course, how we feel about our health is critical to starting the chain of diagnoses.But before giving an example with pneumonia, let’s understand what it is. This is an acute infectious disease, the causative agents of which can be viruses, bacteria, fungi. It all depends on the interaction of the pathogen and the macroorganism – a person. If the latter has a normal immune status or the pathogen is not particularly virulent, there will be no serious consequences of contact. If there is a decrease in the immune status (sharp or gradual – it does not matter), then pneumonia may develop.At the same time, there is such a thing as “bronchopulmonary protection”. For example, the ciliated epithelium, which lines the bronchial mucosa and is covered with a layer of mucus. Due to the synchronous oscillation of the cilia of the epithelium, the mucus layer moves according to the “escalator principle” from the depths of the bronchial tree outward into the oral cavity. All dust, microorganisms of the inhaled air settle on the mucus and are mechanically removed. If phlegm does not accumulate, no problem. During normal functioning of the mechanisms of “self-cleaning” of the trachea and bronchi, the aspirated infected secretion is removed and does not cause the development of the disease.However (and here we come to the answer to the question about the attitude to their health!) In a certain category of people, bronchopulmonary protection does not work. First of all, we are talking about heavy smokers, including those who like electronic cigarettes. The fact is that when you inhale cigarette smoke, mineral particles settle on the mucous membrane, over time the epithelium becomes “bald”, the phlegm stagnates and turns into a breeding ground for bacteria, which we inevitably inhale with every breath of air.A chronic infectious focus is formed. And this means that at any time when immunity decreases, an inflammatory process will start, which can quickly turn into pneumonia.

– From the point of view of a doctor, what does the term “heavy smoker” mean?

– There are studies that prove that in the absence of serious diseases, our body, in principle, can “cope” with one cigarette per day. Two or more is too much. Unfortunately, among my patients there are both young and old people who smoke 1-2 packs a day.Many admitted that they started this business at school. A separate topic is female smoking. Every young woman needs to remember that she ruins not only her own health, but also the health of her future children. Not so long ago there was a case: a guy, 20 years old, does not drink, does not smoke, and his lungs are so affected that there can be no question of any military service. After a complete clinical examination, it turned out that the only risk factor was a mother who smoked from school.

A distinctive feature of pneumonia is a cough: it is not “barking”, but rather mild, since the lungs do not work at full capacity.Often, when coughing, such a patient can involuntarily bend towards the focus of pain

– You focused on reducing immunity. What contributes to this?

– Severe hypothermia, drafts, hyperinsolation. Many people who are far from medicine believe that pneumonia is a disease of the autumn-winter period, when it is cold and snowy outside. However, in fact, in the hot summer, we, doctors, record no less, and sometimes even more, pneumonia. A man sunbathed, lying on the ground near the reservoir that had not yet gained warmth, plunged into cold water (and how – you need to cool down when the air temperature is under thirty!) – and joined the ranks of our patients.Or another example: a vacationer received a powerful dose of ultraviolet radiation in a hot African country, which in itself is bad, not only in terms of the risk of developing melanoma. And then he returned to his native Belarus, where plus 18, wind, rain. Again the adaptation of the body, a decrease in the immune status. This is enough to trigger the disease mechanism. Third example: summer cottage, garden work. The workers of the garden sweated, went into the house where all the windows were wide open, sat under the drafts – here you are again at risk of getting pneumonia.

In addition, the age of the patient and the presence of concomitant diseases play an important role. The risk group includes people with diabetes mellitus, obesity, cancer, taking immunosuppressive therapy, alcohol abuse: their disease, as a rule, is difficult and may even be fatal. It can also be caused by gastroesophageal reflux disease (GERD), when stomach contents are refluxed into the mouth and aspirated into the airways.

– The symptoms of pneumonia are similar to those of a common ARI.How not to confuse and not to waste precious time doing such a popular, unfortunately, self-medication?

– Signs and symptoms of pneumonia range from mild to severe depending on factors such as the type of germ causing the infection, age, and general health. Mild signs and symptoms are often similar to those of a cold or flu, but they last longer. You need to pay attention to chest pain when you breathe or cough, shortness of breath (shortness of breath) with little exertion, talking, at rest, stabbing chest pain when inhaling.As a rule, the body temperature with this disease rises at 38 degrees, but sometimes it is found below normal (in people over 65 and people with a weak immune system). A distinctive feature is a cough: with pneumonia, it is not “barking”, rather moderate, since the lungs do not work at full capacity. Often, when coughing, such a patient can involuntarily bend towards the focus of pain. If you have such symptoms, you should immediately consult a doctor. Self-medication for any diagnosis is a risk, with pneumonia it is a serious risk.If the condition allows, it is better to come to the appointment for a referral for an X-ray and immediately do it.

Is the prevention of pneumonia primarily inoculations?

– Vaccines are now available to prevent certain types of pneumonia and influenza, but you should always check with your doctor before using them. It is also important to follow the rules of hygiene. To protect yourself from respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.Do not smoke! Cigarette smoke interferes with the lungs’ natural defenses against respiratory infections. Maintain your immune system: watch your weight (ideal body weight plus 10% is best), eat right, get enough sleep, and exercise regularly. And do not forget to treat chronic diseases in a timely manner!

It is impossible not to touch upon the topic of “covid” pneumonia. What is its main difference?

– This type of pneumonia is viral because it is caused by the SARS-CoV-2 virus.Differs in the unpredictable development of the disease scenario. In the overwhelming majority of cases, it is bilateral pneumonia, which at the onset of the disease is not always detected on a routine chest x-ray. It manifests itself in the form of shortness of breath, tightness in the chest, weakness, body temperature can rise sharply above 38 degrees, accompanied by muscle and headaches, upset stools, skin rash, decreased or disappearance of smell and taste. But it also happens that the patient does not even suspect that he has a coronavirus in the morning, and in the evening he is already hospitalized in serious condition with bilateral pneumonia.