What are the main causes of pneumonia. How do different organisms lead to pneumonia. What are the classic features of various types of pneumonia. How is pneumonia transmitted. What are the risk factors for developing pneumonia.

The Diverse World of Pneumonia-Causing Organisms

Pneumonia is a complex respiratory infection that can be caused by a wide variety of organisms. Understanding these causative agents is crucial for effective diagnosis and treatment. Let’s explore the main categories of pneumonia-causing organisms and their distinctive characteristics.

Gram-Positive Cocci: The Common Culprits

Gram-positive cocci are among the most frequent causes of pneumonia. What makes them so prevalent? These bacteria are often found in the upper respiratory tract and can easily be inhaled into the lungs.

• Streptococcus pneumoniae: The most common cause of community-acquired pneumonia in adults.
• Streptococcus pyogenes: Known for causing “typical” pneumonia and famously responsible for the death of Jim Henson, creator of The Muppets.
• Streptococcus agalactiae: A common cause of pneumonia in infants 0-2 months old.
• Staphylococcus aureus: Often associated with post-influenza pneumonia and intravenous drug use.

How do these organisms typically spread? They are usually transmitted through the inhalation of respiratory droplets. What are the classic features of pneumonia caused by these bacteria? Streptococcus pneumoniae often produces rusty sputum, while Staphylococcus aureus can cause multiple bilateral nodular infiltrates with central cavitation.

Gram-Positive Rods: Rare but Significant

While less common than their cocci counterparts, gram-positive rods can cause severe and sometimes chronic forms of pneumonia.

• Bacillus anthracis: The causative agent of anthrax, also known as Wool-Sorters disease.
• Nocardia sp.: Often affects immunocompromised hosts and can involve the pleura and chest wall.
• Actinomyces sp.: An anaerobic bacterium that can cause chronic pneumonia with distinctive sulfur granules.

What sets these organisms apart? They often have unique transmission routes and affect specific populations. For instance, Bacillus anthracis is associated with animal handlers and veterinarians, while Nocardia sp. primarily affects immunocompromised individuals.

Gram-Negative Organisms: A Diverse Group

Gram-negative bacteria encompass both cocci and rods, each with its own set of characteristics and associated pneumonia types.

Gram-Negative Cocci

• Neisseria meningitidis: Known for causing epidemics in military recruits.
• Moraxella catarrhalis: A common cause of respiratory infections.

Gram-Negative Rods

• Klebsiella pneumoniae: Often seen in patients with COPD, alcoholics, and the elderly.
• Escherichia coli: A common cause of pneumonia in newborns.
• Pseudomonas aeruginosa: Frequently affects patients with cystic fibrosis.
• Acinetobacter sp.: Known for its multiple drug resistance.

What makes gram-negative pneumonia challenging? These organisms often develop antibiotic resistance, making treatment more difficult. How can you identify gram-negative pneumonia? Look for specific features like the “currant jelly” sputum in Klebsiella pneumoniae infections or the green sputum associated with Pseudomonas aeruginosa.

Atypical Pneumonia: Beyond the Usual Suspects

Atypical pneumonia refers to pneumonia caused by organisms that are not typically associated with the disease. What sets atypical pneumonia apart from typical pneumonia?

• Mycoplasma pneumoniae: Often called “walking pneumonia” due to its milder symptoms.
• Chlamydophila pneumoniae: Can cause prolonged cough and mild upper respiratory symptoms.
• Legionella pneumophila: Associated with exposure to contaminated water sources.

How does atypical pneumonia differ in presentation? These infections often have a more gradual onset and may not show the classic consolidation on chest X-rays that is typical of bacterial pneumonia.

Aspiration Pneumonia: When Inhalation Goes Wrong

Aspiration pneumonia occurs when food, liquid, or other substances are inhaled into the lungs instead of being swallowed. What organisms are commonly associated with aspiration pneumonia?

• Peptostreptococcus sp.: An anaerobic bacterium often found in the mouth.
• Bacteroides melaninogenicus: Another anaerobe that can cause foul-smelling breath in aspiration pneumonia.
• Fusobacterium sp.: Known for causing severe infections when aspirated.

What are the risk factors for aspiration pneumonia? Conditions that impair the gag reflex, such as neurological disorders, excessive alcohol consumption, or sedation, can increase the risk of aspiration.

Zoonotic and Environmental Pneumonias

Some pneumonias are caused by organisms that typically reside in animals or the environment. How do humans contract these types of pneumonia?

• Burkholderia pseudomallei and B. mallei: Associated with exposure to contaminated soil.
• Yersinia pestis: The causative agent of pneumonic plague, initially spread by flea bites.
• Francisella tularensis: Transmitted through tick bites or contact with infected rabbits.

What makes these pneumonias particularly concerning? They often have severe presentations and can be difficult to diagnose due to their rarity in many parts of the world.

Pneumonia in Special Populations

Certain groups are more susceptible to specific types of pneumonia. How does pneumonia differ in these populations?

Neonatal Pneumonia

Newborns are particularly vulnerable to certain organisms:

• Streptococcus agalactiae (Group B Streptococcus): Acquired during passage through the birth canal.
• Escherichia coli: Can cause severe pneumonia in neonates.

Pneumonia in Immunocompromised Patients

Individuals with weakened immune systems are at risk for opportunistic infections:

• Pneumocystis jirovecii: A fungal infection common in HIV/AIDS patients.
• Cytomegalovirus: Can cause severe pneumonia in transplant recipients.

What precautions should be taken for these vulnerable populations? Prevention strategies, such as prophylactic antibiotics and careful monitoring, are crucial for these high-risk groups.

Diagnostic Challenges and Treatment Approaches

Given the wide variety of pneumonia-causing organisms, how do healthcare providers determine the specific cause? Diagnostic approaches may include:

• Sputum culture and gram stain
• Blood cultures
• Chest X-rays and CT scans
• Polymerase chain reaction (PCR) tests for atypical organisms

What factors influence treatment decisions? The choice of antibiotics depends on several factors:

• The suspected causative organism
• The severity of the infection
• The patient’s age and overall health
• Local antibiotic resistance patterns

How has the emergence of antibiotic-resistant strains impacted pneumonia treatment? The rise of drug-resistant organisms, such as methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Pseudomonas aeruginosa, has complicated treatment strategies and underscored the importance of appropriate antibiotic use.

Prevention Strategies and Public Health Implications

What can be done to prevent pneumonia? Prevention strategies include:

• Vaccination against common pneumonia-causing organisms like Streptococcus pneumoniae and influenza virus
• Good hygiene practices, including regular handwashing
• Smoking cessation, as smoking increases the risk of pneumonia
• Management of underlying health conditions that increase pneumonia risk

How do public health measures impact pneumonia rates? Initiatives such as childhood vaccination programs, smoking cessation campaigns, and efforts to reduce air pollution can all contribute to lower pneumonia incidence rates.

What role does global health play in pneumonia prevention and treatment? Pneumonia remains a significant cause of mortality, especially in low- and middle-income countries. Global health initiatives focusing on pneumonia prevention, diagnosis, and treatment can have a substantial impact on reducing worldwide pneumonia-related deaths.

Emerging Research and Future Directions

What new developments are on the horizon for pneumonia diagnosis and treatment? Ongoing research areas include:

• Rapid diagnostic tests to quickly identify causative organisms
• Novel antibiotics to combat resistant strains
• Immunomodulatory therapies to enhance the body’s response to infection
• Personalized treatment approaches based on genetic factors and microbiome composition

How might climate change impact pneumonia incidence and distribution? As global temperatures rise and weather patterns shift, the geographic distribution of certain pneumonia-causing organisms may change, potentially exposing new populations to unfamiliar pathogens.

What role will artificial intelligence play in pneumonia management? AI algorithms are being developed to assist in the interpretation of chest X-rays and to predict antibiotic resistance patterns, potentially improving diagnostic accuracy and treatment selection.

The Interconnected Nature of Respiratory Health

How does pneumonia relate to other respiratory conditions? Understanding the connections between pneumonia and conditions like chronic obstructive pulmonary disease (COPD), asthma, and bronchitis is crucial for comprehensive respiratory care.

What is the relationship between viral respiratory infections and bacterial pneumonia? Viral infections, such as influenza, can predispose individuals to secondary bacterial pneumonia by damaging the respiratory epithelium and altering immune responses.

How does the lung microbiome influence pneumonia susceptibility and outcomes? Recent research has highlighted the importance of the lung microbiome in maintaining respiratory health and its potential role in pneumonia pathogenesis and resolution.

Pneumonia in the Context of Global Pandemics

How do global pandemics, such as COVID-19, impact our understanding and management of pneumonia? The COVID-19 pandemic has brought renewed attention to respiratory infections and has led to advances in:

• Ventilation strategies for severe pneumonia
• The use of prone positioning to improve oxygenation
• The role of systemic inflammation in severe pneumonia
• The importance of healthcare system preparedness for respiratory disease outbreaks

What lessons from the COVID-19 pandemic can be applied to pneumonia management in general? The pandemic has underscored the importance of:

• Early detection and intervention
• Appropriate use of personal protective equipment
• The development of scalable treatment protocols
• The value of telemedicine in managing respiratory infections

How might future pandemics affect pneumonia epidemiology and treatment? Preparing for future respiratory disease outbreaks will require:

• Ongoing surveillance for emerging pathogens
• Investment in vaccine development and distribution infrastructure
• Strengthening of global health systems to respond to sudden surges in respiratory infections
• Continued research into broad-spectrum antiviral and antibacterial therapies

The Economic and Social Impact of Pneumonia

What are the economic consequences of pneumonia on healthcare systems and society? Pneumonia imposes significant costs through:

• Direct medical expenses for diagnosis and treatment
• Lost productivity due to illness and recovery time
• Long-term health effects that may require ongoing care

How does pneumonia affect different socioeconomic groups? Pneumonia disproportionately affects:

• Low-income communities with limited access to healthcare
• Elderly populations, especially those in long-term care facilities
• Children in regions with high levels of air pollution and poor nutrition

What strategies can help reduce the societal burden of pneumonia? Effective approaches include:

• Improving access to healthcare in underserved areas
• Implementing workplace policies that allow for adequate sick leave
• Educating communities about pneumonia prevention and early symptom recognition
• Addressing social determinants of health that contribute to pneumonia risk

Integrating Pneumonia Care with Overall Health Management

How can pneumonia prevention and treatment be integrated into broader health initiatives? Comprehensive approaches might include:

• Incorporating pneumonia screening into routine health check-ups
• Aligning pneumonia vaccination schedules with other immunization programs
• Addressing risk factors for pneumonia as part of chronic disease management
• Promoting respiratory health as a component of overall wellness programs

What role does patient education play in pneumonia management? Empowering patients with knowledge about:

• Recognizing early signs of pneumonia
• Understanding the importance of completing prescribed antibiotic courses
• Implementing lifestyle changes to reduce pneumonia risk
• Knowing when to seek medical attention for respiratory symptoms

How can healthcare providers improve pneumonia outcomes through interdisciplinary collaboration? Effective pneumonia care often requires:

• Coordination between primary care physicians, pulmonologists, and infectious disease specialists
• Integration of pharmacy services for optimal medication management
• Involvement of respiratory therapists in patient care and education
• Collaboration with public health officials for community-wide prevention strategies

As our understanding of pneumonia continues to evolve, so too must our approaches to prevention, diagnosis, and treatment. By considering the diverse array of causative organisms, the unique needs of different patient populations, and the broader context of respiratory health, we can work towards more effective management of this common yet potentially severe infection. The ongoing challenges posed by antibiotic resistance, emerging pathogens, and global health disparities underscore the need for continued research and innovation in the field of pneumonia care.

Organisms That Can Cause Pneumonia (Bacteria)

Type of Organism	Disease	Most Common Mode of Transmission	Classic Features
Bacteria  Gram positive cocci
Streptococcus pneumoniae *most common cause of community acquired pneumonia in adults	*Typical pneumonia	inhalation of droplets	rusty sputum
Streptococcus pyogenes	Typical pneumonia	inhalation of droplets	Group A Streptococcus, pneumonia that killed Jim Hensen (The Muppets creator)
Streptococcus agalactiae common cause of pneumonia in 0-2 month old patients	Typical pneumonia	inhalation of organisms as neonate passes down birth canal	Group B Streptococcus, usually causes pneumonia in neonates.
Staphylococcus aureus	Typical pneumonia	IV drug use, inhalation of droplets, post-influenza	Multiple bilateral nodular infiltrates with central cavitation. In children one can see ill-defined, thin walled cavities (“pneumatoceles”), bronchopleural fistulas, and empyema. Common cause of pneumonia in cystic fibrosis patients
Peptostreptococcus sp.  anaerobe	**Aspiration pneumonia	Aspiration	fluid-air levels, and abscess formation oftentimes seen on radiographs, foul breath, infiltrates in dependant lung segments
Bacteria Gram positive rods
Bacillus anthracis	Typical pneumonia, Anthrax, Wool-Sorters disease	inhalation	Associated with wool sorting,  with animal handlers, and veterinarians.
Nocardia sp.	***Chronic pneumonia	inhalation; immunocompromised hosts	beaded  filamentous appearance of the  rod shaped bacteria, Pleura and chest wall involvment
Actinomyces sp.  anaerobe	Chronic pneumonia	Aspiration	sulfur granules and a beaded appearance of the branched filamentous rod shaped bacteria, Rib destruction, Cutaneous sinuses, cavitation, spreads to pleura and chest wall
Bacteria Gram negative cocci
Neisseria meningitidis	Typical pneumonia	inhalation	epidemics in military recruits
Moraxella catarrhalis	Typical pneumonia	inhalation
Bacteria Gram negative Rods
Klebsiella pneumoniae	Typical pneumonia	aspiration	Current Jelly sputum, more commonly seen in patients with COPD, alcoholics, and the elderly, Bulging fissure sign of chest radiograph, lung necrosis
Escherichia coli common cause of pneumonia in 0-2 month old patients	Typical pneumonia	aspiration	usually seen in neonates, lung necrosis
Pseudomonas aeruginosa	Typical pneumonia	aspiration or inhalation	green sputum, abscess formation, Common cause of pneumonia in cystic fibrosis patients and those with  severely compromised respiratory defenses.
Acinetobacter sp.	Typical pneumonia	aspiration or inhalation , often found on  respiratory therapy equipment and on human skin	very difficult to treat due to multiple drug resistance.
Burkholderia pseudomallei	Typical pneumonia	inhalation	exposure with contaminated soil
Burkholderia mallei	Typical pneumonia	inhalation	exposure with contaminated soil
Yersinia pestis	Typical pneumonia, Pneumonic plague	Inhalation, or by hematogenous spread to lungs	Initial plague patients acquire this disease via flea bites
Francisella tularensis	Typical pneumonia, Tularemia	Infection is via tick bite or contact with contaminated rabbits.
Hemophilus influenzae	Typical pneumonia	inhalation	more commonly seen in patients with COPD, alcoholics, and the  elderly.
Bordetella pertussis	Whooping cough	inhalation	bronchopneumonia
Bacteroides melaninogenicus anaerobe	Aspiration pneumonia	Aspiration	fluid-air levels, and abscess formation oftentimes seen on radiographs, foul breath, infiltrates in dependant lung segments
Fusobacterium sp.  anaerobe	Aspiration pneumonia	Aspiration	fluid-air levels, and abscess formation oftentimes seen on radiographs, foul breath, infiltrates in dependant lung segments
Porphyromonas sp.   anaerobe	Aspiration pneumonia	Aspiration	fluid-air levels, and abscess formation oftentimes seen on radiographs, foul breath, infiltrates in dependant lung segments
Prevotella sp.  anaerobe	Aspiration pneumonia	Aspiration	fluid-air levels, and abscess formation oftentimes seen on radiographs, foul breath, infiltrates in dependant lung segments
Proteus sp.	Typical pneumonia	inhalation, aspiration	lung necrosis
Serratia sp.	Typical pneumonia	inhalation, aspiration	usually seen in immunocompromised hosts
Bacteria that do not gram stain or gram stain poorly
Mycobacterium tuberculosis	Chronic pneumonia	inhalation	ghon complexes, coin lesions, cavitation.
Other Mycobacterium sp.	Chronic pneumonia	inhalation, usually seen in immunocompromised host
Legionella pneumophila	****Atypical pneumonia	inhalation, usually the elderly or immunocompromised host	Relative bradycardia, abdominal pain, Vomiting and diarrhea, hematuria, mental confusion, abnormal liver and renal function tests, increased CPK
Mycoplasma pneumoniae – colonies Most common cause of Atypical pneumonia in adults.	Atypical pneumonia	inhalation	bullous myringitis, cold agglutinin positive, cobweb like infiltrates of lungs
Chlamydia trachomatis	Atypical pneumonia	inhalation	an afebrile pneumonia, usually seen in 2 wk to 6 months of age
Chlamydia psittaci	Atypical pneumonia	inhalation	acquired from certain birds (ex. parrots), normal or low leukocyte count
Chlamydia pneumoniae TWAR agent	Atypical pneumonia	inhalation
Coxiella burnetii (Q-fever)	Atypical pneumonia	ingestion of comtaminated milk, or inhalation of contaminated aerosols from barnyard animals	abnormal liver function tests

Pneumonia > Fact Sheets > Yale Medicine

Overview

Whether it’s bacterial, viral—or the friendlier sounding “walking” pneumonia—chances are you or someone you know has had this illness at some point. The infection, which is caused by bacteria, viruses or fungi, can occur in one or both of the lungs. It can be mild or life-threatening, especially to the elderly, the very young or those with compromised immune systems.

There are more than 30 different microorganisms (or microbes) that can cause pneumonia, and identifying the correct one isn’t always easy. At Yale Medicine, our physicians are experienced and skilled at treating everything from the most basic form of pneumonia to the more serious cases that might require hospitalization.

Researchers at Yale School of Medicine are studying how to better identify different types of pneumonia strains, so that the antibiotics given to patients are the best possible fit. “There has been a big push regarding antibiotics stewardship—how to treat patients appropriately with antibiotics, who needs antibiotics, and also what are some of the non-antibiotic alternatives to treat patients,” says Charles Dela Cruz, MD, a pulmonologist at Yale Medicine. 

What is pneumonia?

Pneumonia is an infection in which the air sacs in one or both of the lungs are filled with fluid or pus and become inflamed. The inflammation causes cough with phlegm, along with fever, chills and breathing troubles.

Pneumonia is often classified by where it was acquired. Hospital-acquired pneumonia, picked up during a hospital stay, is often more severe for two reasons. One, because the bacteria may be resistant to antibiotics and, two, the people who get it are already sick. Community-acquired pneumonia means it was acquired outside of a medical setting.

What causes pneumonia?

Pneumonia is caused by bacteria, viruses or fungus. There are literally dozens of different causes of pneumonia, grouped by the most common types. These are:

• Bacterial pneumonia. This is caused by bacteria, the most common of which is streptococcus pneumoniae. The pneumonia might just affect one small area of your lung, or it may encompass all of both of your lungs. 
• Viral pneumonia. Responsible for about one-third of all pneumonia cases, this type is caused by various viruses, includingflu (influenza). People may be more likely to get bacterial pneumonia if they first have viral pneumonia. Viral pneumonia is usually not as serious as bacterial and typically goes away more quickly.
• Mycoplasma pneumonia. Also known as walking pneumonia, this type is considered atypical because its symptoms and physical signs may vary. Also, it causes a milder illness. It most often occurs in older children and young adults.
• Fungal pneumonia. Fungi from soil or bird droppings can cause pneumonia in people who inhale large amounts of these organisms. One type, pneumocystis jirovecii pneumonia (PCP), generally affects people with weak immune systems, including those with AIDS.

Who is at risk for pneumonia?

Pneumonia strikes all ages, but it can be the most serious for certain populations, including: 

• Infants
• Children younger than 2
• Adults over age 65
• People with certain medical conditions, including heart failure or chronic lung problems
• People who smoke

What are the symptoms of pneumonia?

Symptoms of pneumonia, no matter the type, include: 

• Cough that may produce green, yellow or bloody mucus
• Fever (can be as high as 105 for bacterial pneumonia)
• Bluish color to lips and fingernails
• Confused state or delirium (in adults over age 65)
• Heavy sweating
• Rapid or troubled breathing
• Extreme fatigue
• Rapid pulse
• Sharp or stabbing chest pain when breathing or coughing

Symptoms that signal the need to see a doctor include trouble breathing, chest pain, a persistent fever of 102 degrees or higher, or a persistent cough. It’s especially important for people who fall into the higher risk groups to see a doctor.

How is walking pneumonia different?

Walking pneumonia, also known as atypical pneumonia, is caused by mycoplasma pneumoniae bacteria. It usually causes cold-like symptoms, in addition to a fever (often low grade) and a hacking cough. It is most common in school-aged children and young adults, says Annette Cameron, MD, a Yale Medicine pediatrician.  

Because this type of pneumonia typically causes milder symptoms, it may go undiagnosed for a while, especially if the child is able to participate in normal activities and isn’t as visibly sick as he or she would be with other forms of pneumonia. “And that’s why it’s called walking pneumonia,” Dr. Cameron says. “It might just be a little bit of malaise. Sometimes you can have community-acquired, or bacterial pneumonia, along with walking pneumonia, in which case we would just treat both of them.” 

How is pneumonia diagnosed?

A physician will first ask about your medical history and take a physical exam. This includes listening to your lungs with a stethoscope. The doctor does this to check for what is called “rales,” which are small clicking, bubbling or rattling sounds in the lungs.

“Rales, or crackling, is the classic sound when it comes to pneumonia, and when you are hearing it in a specific area of the lungs, then it is likely to be bacterial pneumonia,” Dr. Cameron says. “You don’t always need to get a chest X-ray if you hear the crackling, if there are other symptoms like a persistent cough, fever and a change in respiratory rate, which might be a little bit quicker.”   

Doctors also measure oxygen saturation (through a pulse oximeter, a small sensor clipped to a finger). 

“This can be a really subtle clue. Often times you can have a normal exam, especially with a little child who doesn’t know how to take deep breaths,” Dr. Cameron says. “But if the O2 saturation is a little off, maybe even 94 when we really want 97 or above, and the child is coughing a lot, we might want to do a chest X-ray to be sure. There is no strict formula. A lot of it depends on gut, or experience, in fitting the story together.”

Other tests, if needed, include:

• Blood tests. This will show whether infection is present and possibly identify the organism causing it. But precise identification isn’t always possible.
• Sputum test. A sample of fluid from your lungs (sputum) is taken after it coughed up. It then gets analyzed to see if there’s a lung infection. 

How is pneumonia treated?

Pneumonia treatment depends on numerous factors, including what type you have and how severe it is. Usually, it can be treated at home, but in serious cases, it may require a hospital stay.

“If the pneumonia is bacterial, it will respond to antibiotics and we typically start with amoxicillin,” Dr. Cameron says. “If it’s viral, antibiotics won’t help, but they might help walking pneumonia, in which case we would use azithromycin. ”

If your pneumonia is bacterial and it is unknown which bacterium is causing the infection, your doctor will choose among various antibiotics for treatment. Fever and pain reducers, such as Tylenol or Motrin, will help with discomfort.

For viral pneumonia, getting plenty of rest and staying hydrated should be enough. The infection should go away on its own. 

What about the influenza and pneumococcal vaccines?

Because the flu is a common cause of pneumonia, consider getting your flu vaccine. “This is one of the reasons we recommend the flu vaccine, because not only can you get the flu virus and feel really miserable, but you can end up with a secondary bacterial infection which could be very serious or even fatal,” Dr. Cameron says.

There is also a pneumococcal vaccine, which offers protection from a common form of bacterial pneumonia. The shot is recommended for children younger than 5 and adults 65 and older. It is also advised for children and adults who are at an increased risk of pneumonia due to other health conditions. 

What stands out about Yale Medicine’s approach to pneumonia?

Pneumonia is a common infection in both children and adults and can often be easily treated. However, if specialized care is required, Yale Medicine physicians practice at both Yale New Haven Hospital and Yale New Haven Children’s Hospital.

Furthermore, our researchers are involved in developing ways to more quickly and accurately diagnose lung infections through the Yale Center for Pulmonary Infection Research and Treatment (CPIRT). “We don’t tend to think of pneumonia as a chronic condition. But some  patients end up with longer-term problems,” says Dr. Dela Cruz, director of the CPIRT. The center focuses on finding new potential treatment options and running clinical trials to better understand the disease. 

symptoms, diagnosis and treatment of pneumonia

Bacteria and viruses that enter the human lungs through airborne droplets lead to pneumonia. Once in favorable conditions for themselves, microorganisms begin to multiply in the nasopharynx, and then reach the alveoli of the lung. When the volume of inhaled infection becomes significant or the person’s immune defenses are weakened, infection of the lungs occurs. The rapid immune response of a person damages lung tissue, which will lead to difficulty in transporting oxygen.

What are the types of pneumonia?

If a person gets pneumonia outside the hospital, the pneumonia is called community-acquired.

Nosocomial pneumonia, on the contrary, develops in hospitals, nursing homes. It also includes ventilator-associated pneumonia.

The division of the disease according to its origin helps to choose the necessary antibiotics in the first hours of the disease.

The more areas of the lungs will be covered by inflammation, the more dramatic the development of pneumonia. Depending on the location of the inflammation zones, there are unilateral, bilateral, polysegmental, lobar.

“Atypical” and “typical” pneumonia

Any pneumonia is dangerous if it is not detected in time and the correct treatment is not prescribed. The word “atypical” took hold after the introduction of SARS in 2003. This pneumonia required a completely different treatment. In atypical pneumonia, complaints and symptoms may differ from the classical one – not a high temperature, the symptoms are more like SARS.

Typical pneumonia is caused by “classic” pathogens. These include Streptococcus pneumonia (pneumococcus), as well as Haemophilus influenza (haemophilus influenzae).

Nonclassical organisms cause SARS. For example, Legionella, Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Coxiella burnetiid.

Pneumonias caused by respiratory viruses are grouped separately – Influenza A, Influenza B, Rhinoviruses, Parainfluenza, Adenovirus, Respiratory syncytial virus, Metapneumovirus, Coronaviruses (SARS Cov-1, SARS Cov-2, MERS).

The differences between “atypical” and “typical” conditional. If an x-ray of the lungs is taken, then it is possible to assume an atypical pathogen according to the features of the obtained x-ray.

What determines the severity of pneumonia?

• Pneumonia may be limited to fever, cough with sputum without respiratory failure. This is a mild form description.
• Severe course is manifested by respiratory disorders, multiple organ failure, sepsis.
• The human immune response determines the degree of damage to the lungs. The more massive the response, the more severe the disease.
• Obesity, chronic heart and lung disease, diabetes worsen the prognosis of the disease.

Who is more likely to get pneumonia?

• The older the person, the higher the risk of illness.
• Patients suffering from COPD, bronchiectasis, asthma, chronic heart disease (heart failure), stroke, diabetes.
• A past viral infection (ARVI) provokes bacterial or fungal pneumonia.
• Smoking and excessive drinking contribute to disease
• Other lifestyle factors – e. g. prisons, homeless shelters, exposure to environmental toxins (e.g. solvents, paints or gasoline)

Symptoms and signs of pneumonia

Complaints in pneumonia are sudden. Fever, chills, fatigue, chest pain with cough (with or without sputum), shortness of breath, shortness of breath, shortness of breath occur and increase over several hours.

Blood tests will help in the diagnosis of the disease: leukocytosis or leukopenia are the results of the body’s inflammatory response. Inflammatory markers such as ESR, C-reactive protein, and procalcitonin may be elevated, although the latter is largely specific to bacterial infections.

An X-ray of the lungs is considered a mandatory test for the diagnosis of pneumonia.

Pneumonia associated with COVID 19 infection.

The course of the disease does not go beyond the general understanding of pneumonia. The classic symptoms are present: fever, chills, muscle pain, cough.

80% suffer from pneumonia without respiratory failure and at home.

20% have severe manifestations of the disease: breathing is difficult, the person begins to breathe often, there is a need to use additional oxygen. With deterioration, failure of important organs, the heart, kidneys, may occur. The longer the patient is in the hospital, the more likely it is that a hospital infection and fungi will join.

Is hospitalization necessary for COVID 19 pneumonia?

No, hospital treatment is not always required.

Ambulatory treatment available for patients with mild pneumonia. Patients who are initially healthy, with normal breathing, without concomitant diseases are treated at home.

Hospitalization is required for patients with less than 94% oxygen saturation and rapid breathing.

I find it hard to breathe. Do I have respiratory failure?

The easiest way to tell if you’re developing respiratory failure is to count your breaths per minute. If more than 21, then you should call a doctor. Another way is to measure oxygen in the blood. Many people already have a pulse oximeter at home. This device can monitor saturation – if it is below 94%, then regard this situation as a deterioration and seek help from doctors.

Application of CT in the diagnosis of viral pneumonia.

Computed tomography has a high sensitivity compared to radiography, detects changes in the lungs at the initial stages of the disease before the results of laboratory tests.

• The method has the advantage of detecting changes in the lungs even in people infected with COVID-19 but who do not have symptoms of the infection.
• Despite its high sensitivity, CT cannot give an accurate answer about the causes of pneumonia (bacteria, viruses, fungi).

What is ground glass on a CT report?

Ground glass lung tissue seals are the initial phase of lung inflammation. Occurs when the alveoli gradually fill with fluid.

As the bronchi and alveoli fill with fluid, there will be areas of hardening called consolidation. Consolidation of lung tissue occurs during a long-term inflammatory process.

I have COVID 19 and CT-2 What does this mean?

It is important to understand how much lung tissue is affected. The more lung tissue is involved in inflammation, the more difficult it is to obtain oxygen from the inhaled air. Without oxygen, a person quickly dies. For example, with pneumonia caused by COVID 19, deterioration in the lungs takes several hours. The sooner a decision is made about hospitalization, oxygen therapy and treatment, the greater the chance of recovery.

To assess the changes, it is calculated how many percent of the lungs are damaged by pneumonia. The measurement is carried out “by eye”. The result obtained is compared with the scale of the prevalence of changes:

• CT-0 – no signs of pneumonia
• KT-1 – up to 25%
• KT-2 – from 25 to 50%
• KT-3 – from 50 to 75%
• KT-4 – over 75%

Percentage sorts patients who need urgent hospital treatment and those who can be treated at home.

If you have a CT 2, this is mild pneumonia. Such changes are not accompanied by shortness of breath, do not require hospitalization. But CT 2 can, with improper treatment, go to CT 3 and 4. Therefore, observation by a doctor is mandatory!

If the doctor does not hear wheezing in the lungs when listening, then I do not have pneumonia?

This is incorrect. Diagnosis requires demonstration of changes in lung tissue on x-ray (CT) and clinical manifestations (eg, fever, dyspnea, cough, and sputum production), changes in blood tests.

Treating pneumonia

To treat pneumonia, you need to know the name of the infection. In patients, the name of the pathogen at the very beginning of the disease is unknown, so empiric antibiotic therapy is used – treatment aimed at probable pathogens. For all patients with CAP, treatment regimens have been developed aimed at the destruction of S.pneumoniae and atypical pathogens.

Combination therapy with beta-lactam antibiotics or macrolides is used for most patients. Alternative regimens include fluoroquinolone monotherapy.

SARS CoV-2 treatment

• The principles of pneumonia treatment are general. Appointment of antiviral and antibacterial therapy.
• In severe cases, in a hospital setting, the appointment of high-flow oxygen therapy, monoclonal antibodies, anticoagulants, pulmonary ventilation.
• Antibiotics do not work against the COVID 19 virus.

Rehabilitation after pneumonia

In addition to drug therapy aimed at bacteria, virus and inflammation, it is necessary to restore lung function to its original healthy level.

Changes form in the lungs after an illness. This is “frosted glass” and fibrosis of the lung tissue, pneumofibrosis. In these areas, gas exchange is difficult, the nutrition of the alveoli and bronchi is disturbed, and the protection of the bronchi is reduced. Infection and pneumonia affect a person at the same time depriving him of strength, confidence, and the quality of life decreases. Efforts must be made to prevent fibrotic changes in the lungs. The problem is solved by a rehabilitation program consisting of a complex of medical procedures, inhalations, breathing simulators, exercise therapy exercises.

More about rehabilitation

Our specialists

Chikina Svetlana Yurievna

Candidate of Medical Sciences, pulmonologist of the highest category. Official physician expert of congresses of the Russian Federation in pulmonology.

more than 30 years

Kuleshov Andrey Vladimirovich

Chief physician, candidate of medical sciences, pulmonologist, somnologist, member of the European Respiratory Society (ERS).

Work experience 26 years

Meshcheryakova Natalya Nikolaevna

Candidate of Medical Sciences, pulmonologist of the highest category, associate professor of the Department of Pulmonology named after. N.I. Pirogov.

Work experience 26 years

Nikitina Natalia Vladimirovna

Deputy. chief physician, pulmonologist, allergist of the highest category. Full member of the European Academy of Allergology and Immunology.

Work experience 15 years

Cost of services

symptoms, causes and treatments

Content

• 1 Community acquired pneumonia
  • 1.1 Community-acquired pneumonia: main symptoms and causes
  • 1.2 High fever and chills
  • 1.3 Cough with chest pain
  • 1.4 Short-term sensation of respiratory distress
  • 1. 5 Joint pain 90 032
  • 1.6 General weakness and fatigue
  • 1.7 Shortness of breath
  • 1.8 Headache and loss of appetite
  • 1.9 Causes of community-acquired pneumonia
  • 1.10 Airborne infection
  • 1.11 Weakened immune system
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What symptoms accompany community-acquired pneumonia?
      • 1.13.0.2 What causes community-acquired pneumonia?
  • 1.14 Impaired respiratory hygiene
  • 1.15 Chronic exposure to harmful substances

hospitals. In the article we will consider the causes, symptoms and methods of treatment of this disease.

Community-acquired pneumonia is an inflammatory lung disease that develops in people who are not hospitalized. Although often referred to as the common cold or SARS, this illness can have serious consequences, and in some cases even death. Therefore, it is important to know the main symptoms, causes of development and effective methods of treating this disease.

Symptoms of community-acquired pneumonia can vary and include a runny nose, cough, chest pain, fever, weakness, and fatigue. However, in some cases, the symptoms may be less severe, especially in children or the elderly. In addition, specific symptoms may appear, such as blueness of the skin or short breath, which requires immediate medical attention.

There are several causes that can lead to the development of community-acquired pneumonia. The main cause is an infection caused by various microorganisms such as viruses, bacteria or fungi. These pathogens can enter the body through the air, close proximity to sick people, or contact with contaminated surfaces. Also an important risk factor is the weakening of the immune system, which can be caused by stress, chronic diseases or taking certain medications.

Treatment for community-acquired pneumonia may include antibiotics, antivirals, antifungals, or immune boosters. It is important to start treatment as early as possible to prevent complications and quickly restore health.

Community-acquired pneumonia: main symptoms and causes

Symptoms of community-acquired pneumonia:

• High body temperature (between 38 and 40 degrees Celsius).
• Great weakness and fatigue.
• Cough, usually with unproductive (dry) characteristics.
• Chest pain and difficulty breathing.
• Chill and sweat.
• Decreased appetite and deterioration in general condition.
• Shortness of breath and palpitations.

Community-acquired pneumonia causes:

Community-acquired pneumonia can be caused by various organisms such as bacteria, viruses, or fungi. The main reasons for the development of community-acquired pneumonia are:

1. Streptococcus pneumoniae is the most common and dangerous causative agent of pneumonia.
2. Influenza viruses – can lead to the development of complications in the form of pneumonia.
3. Pneumococci and Haemophilus influenzae often cause pneumonia in children and the elderly.
4. Legionella causes severe pneumonia and is often associated with infection of aquatic systems.
5. Mycoplasmas and chlamydia often cause atypical pneumonia.

It is important to remember that the symptoms and causes of community-acquired pneumonia may vary depending on the patient’s age, general health, and the presence of comorbidities. For an accurate diagnosis and the appointment of effective treatment, it is necessary to consult a pulmonologist.

Fever and chills

One of the main symptoms of community-acquired pneumonia is fever. In this case, the temperature can rise to high values ​​\u200b\u200bexceeding 38 degrees Celsius. A high temperature indicates an inflammatory process in the body and an acute reaction of the immune system to the infection.

Chills, a feeling of coldness and shivering, usually occur with fever. Chills are a protective reaction of the body to the ingress of harmful microorganisms and help increase body temperature.

Antipyretics such as paracetamol or ibuprofen are recommended for fever and chills. You can also apply cold compresses to your forehead and underarms to reduce fever and relieve chills.

However, it is important to remember that fever and chills are only symptoms of community-acquired pneumonia, and timely and correct medical therapy, including antibiotics and other drugs prescribed by a doctor, is necessary for a complete cure.

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Cough with chest pain

9 0002 Cough with chest pain is one of the main symptoms of community-acquired pneumonia. This disease, characterized by inflammation of the lungs, often leads to respiratory irritation and coughing.

Cough may vary in intensity and may be accompanied by chest pain. Often, chest pain occurs as a result of inflammation and irritation of the lining of the lungs, which is a typical manifestation of pneumonia.

In pneumonia, chest pain may be aggravated by coughing or taking a deep breath, due to increased pressure in the lungs. This can create a feeling of discomfort and pain in the chest.

If you have a cough with chest pain, you should see a doctor for diagnosis and treatment. The doctor may prescribe antibiotics or other drugs to fight the infection and relieve the symptoms of pneumonia. It is also important to drink more fluids and rest so that the body can recover.

Short-term sensation of respiratory insufficiency

A short-term sensation of respiratory insufficiency is one of the characteristic symptoms of community-acquired pneumonia. It is manifested by a sudden feeling of lack of air and difficulty in breathing.

This feeling can result from inflammation of the lungs caused by various causes, including viruses, bacteria and fungi. Respiratory failure is caused by a violation of the exchange of gases in the body, which leads to a lack of oxygen and the accumulation of carbon dioxide in the blood.

Feeling short of breath may be temporary and resolve on its own, but in some cases may indicate a serious condition and require medical attention. If the feeling of respiratory failure becomes prolonged or is accompanied by other symptoms such as severe weakness, dizziness or fainting, a doctor should be consulted for diagnosis and appropriate treatment.

Joint pain

Joint pain is a common symptom that causes discomfort and restricts movement. This condition can occur both as a result of injury and as a result of various diseases.

Joint pain can be caused by a variety of factors, including inflammation, wear and tear on the articular surfaces, and impaired blood circulation and nerve endings. In some cases, pain is the result of an autoimmune disease such as rheumatoid arthritis or lupus.

There are several methods for relieving joint pain. First, cold or heat can be applied—cold compresses can reduce inflammation, while warm compresses can relax joints and improve circulation. Second, you can try a variety of exercises and stretches that will help strengthen the muscles around your joints and increase their flexibility.

If joint pain persists or is accompanied by other symptoms such as swelling or redness, see a doctor. He will examine you and prescribe appropriate treatment, which may include anti-inflammatory drugs, physical therapy, or surgery, depending on the cause of the pain.

General weakness and fatigue

General weakness and fatigue are among the main symptoms of community-acquired pneumonia. The pathological state of the body caused by this disease leads to a decrease in the strength and endurance of the patient, which makes him quickly fatigued.

Community-acquired pneumonia causes significant general malaise, accompanied by a feeling of weakness. Fatigue becomes even more noticeable when performing everyday tasks, regardless of their complexity or simplicity. The patient may have difficulty with normal household chores, even with simple physical activities such as lifting light objects.

It is also worth noting that fatigue in community-acquired pneumonia is often accompanied by additional manifestations, such as shortness of breath, unproductive cough and loss of appetite. All these symptoms together can significantly limit the patient’s physical activity and negatively affect his quality of life.

In case of general weakness and fatigue due to community-acquired pneumonia, it is necessary to consult a doctor for diagnosis and appropriate treatment. Only under the supervision of a specialist can you effectively cope with these symptoms and restore the general condition of the body.

Trouble breathing

Trouble breathing may be one of the characteristic symptoms of community-acquired pneumonia. This condition often manifests itself as shortness of breath or irregularity. A person may experience a feeling of complete loss of breath or an inability to inhale a full portion of air.

Interrupted breathing may also cause wheezing or whistling sounds when inhaling or exhaling. This is due to a violation of the airway due to inflammation and congestion in the lungs. It is not uncommon for patients with community-acquired pneumonia to complain of a feeling of tightness or tightness in the chest, which may be exacerbated by exertion or lying down on the back.

Shortness of breath can be caused by various factors besides pneumonia. For example, they can be associated with asthma, chronic obstructive bronchitis, and even cardiovascular disease. Therefore, if you experience these symptoms, it is important to see a doctor to diagnose and identify the cause of respiratory problems.

Treatment for respiratory distress in community-acquired pneumonia usually includes antibiotics to control the infectious agent, cough and mucolytics to help loosen sputum, and anti-inflammatories to relieve swelling and inflammation in the airways. In addition, symptomatic treatment can be prescribed, aimed at facilitating breathing and reducing the feeling of dyspnea.

Headache and loss of appetite

Headache and loss of appetite are two common symptoms of community-acquired pneumonia. Headache can be caused by increased pressure in the chest due to inflammation of the lungs or due to a violation of blood circulation in the brain. It can manifest as a slight throbbing pain, discomfort or pressure pain.

Loss of appetite is usually associated with general symptoms of the disease, such as weakness, fatigue, fever and chest pain. Inflammation of the lungs leads to altered processing of food by the body and a decrease in the desire to eat.

To manage headaches and decreased appetite, it is important to take your doctor’s recommended medications and follow your diet. Your doctor may recommend regular pain medications and anti-inflammatory medications, and suggest a nutrient-dense diet to support your body during times of illness.

If you have a headache and loss of appetite, you should consult a doctor to diagnose and prescribe the correct treatment for community-acquired pneumonia. It is necessary to follow the doctor’s instructions and report any changes in the state of health in order to achieve a full recovery.

Causes of community-acquired pneumonia

Community-acquired pneumonia is an acute inflammatory lung disease that develops in people outside the hospital. Community-acquired pneumonia can be caused by a variety of causes, including:

1. Bacterial infection: Pneumonia can be caused by various bacterial pathogens such as pneumococci, Haemophilus influenzae, staphylococci, and others.
2. Viral infection: Viruses such as influenza, respiratory syncytial virus (RSV), or coronavirus can cause pneumonia in people who are hospitalized.
3. Fungal infection: Some fungal pathogens such as Candida, Aspergillus, or Pneumocystis Pneumonia (PCP) can cause community-acquired pneumonia.
4. Atypical pathogens: Sometimes pneumonia is caused by bacteria that are not typical pathogens of pneumonia, such as legionella, mycoplasma, or chlamydia.
5. Aerosol Infection: Community-acquired pneumonia can also develop through inhalation of aerosols containing pathogens, such as through contact with sick people or animals.

Understanding the causes of community-acquired pneumonia is important in choosing the most effective treatment and preventing complications. Each case of pneumonia requires a separate approach, and only an experienced doctor can determine the exact cause of the disease and prescribe the appropriate treatment.

Airborne infection

Community-acquired pneumonia is a common disease often caused by airborne infection. In this case, pathogenic microorganisms are transmitted from person to person through saliva droplets and respiratory secretions, which are formed when coughing, sneezing or talking.

Typical airborne pathogens that cause community-acquired pneumonia include pneumococci, Haemophilus influenzae, mycoplasma, and chlamydia. They are common causes of pneumonia in children and adults, especially in those with a weakened immune system or comorbidities.

To prevent infection by airborne droplets, some preventive measures are recommended. First and foremost, wash your hands regularly with soap and water, especially after contact with sick people or contaminated surfaces. It is also important to cover your nose and mouth when using nasal tissues when coughing or sneezing to prevent the spread of infection.

Weakened immunity

Weakened immunity is one of the main factors contributing to the development of community-acquired pneumonia. The immune system is the body’s defense system responsible for fighting infection. When the immune system is weakened, the body becomes more susceptible to various infections, including pneumonia.

Community-acquired pneumonia can develop in immunocompromised people for a variety of reasons. One of them is chronic stress, which has a negative effect on the human immune system. Stress causes an increased release of stress hormones, which can weaken the immune system and leave the body vulnerable to infections, including pneumonia.

Also, immunocompromised people are more likely to suffer from chronic diseases such as diabetes, cardiovascular disease, and lung disease. These diseases can negatively affect the immune system, making it less effective in fighting infection.

Medications such as high-dose corticosteroids, immunosuppressants, and antirheumatic drugs can also weaken the immune system and cause pneumonia.

Related videos:

Q&A:

What symptoms accompany community-acquired pneumonia?

The main symptoms of community-acquired pneumonia are cough with sputum, chest pain on inspiration, fever, weakness, fatigue, shortness of breath, and sometimes hemoptysis.

What causes community-acquired pneumonia?

Community-acquired pneumonia can be caused by various microorganisms such as bacteria, viruses, fungi. Also, the risk of developing pneumonia is increased in people who are immunocompromised, suffering from chronic diseases, smokers, and those who have recently been hospitalized or have been in contact with an infection.

Improper respiratory hygiene

Improper respiratory hygiene is one of the main causes of community-acquired pneumonia. Respiratory hygiene includes regular handwashing, especially before touching the face or contact with objects that may contain pathogens.

The shedding of pathogens through coughing and sneezing is also one of the modes of transmission. Therefore, it is necessary to cover your mouth and nose when coughing or sneezing, it is preferable to use disposable tissues or wash your hands after using cloth ones.

It is important to emphasize that the level of purity of the air environment also affects the state of the respiratory system. The use of filters and ventilation systems helps to reduce the spread of infections and pathogens. Also, keeping the room clean and fresh helps maintain respiratory health.

You should also pay attention to habits that can contribute to infection. Smoking, including passive smoking, increases the risk of community-acquired pneumonia. Smoking irritates the lining of the airways, making them more vulnerable to infections. Therefore, regular ventilation of the room and smoking cessation reduce the risk of disease.

Chronic exposure to harmful substances

Community-acquired pneumonia can develop in people who are constantly exposed to various harmful substances. This may be due to professional activities or living in a polluted environment.

There is often a problem with effective ventilation and air purification in work areas, resulting in constant inhalation of dust, gases, fumes and toxic substances. Workers in hazardous industries such as the mining, chemical, and construction industries are at increased risk of contracting pneumonia due to hazardous environments and constant exposure to hazardous substances.

Long stays in polluted areas, such as near industrial plants or communities with high concentrations of pollutants in the air, also increase the risk of developing community-acquired pneumonia.