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lung xray
By In-house Team, Circle Health Group

What is pneumonia

Pneumonia is inflammation of the lungs that can lead to serious complications.

What is pneumonia?

Pneumonia means inflammation of the lungs. This inflammation causes the air sacs in your lungs to fill with fluid or pus making it difficult to breathe.

Pneumonia is normally caused by a bacterial, viral or fungal infection. Bacterial pneumonia is usually more severe than viral pneumonia which often gets better on its own.

Most people with pneumonia recover within around two to four weeks. However, for some people, such as babies, older people, and those with chronic (long-term) illnesses, pneumonia can be serious and even life-threatening. Pneumonia can affect one or both lungs.

Is pneumonia serious?

While most people recover from pneumonia with treatment, in some cases, serious, life-threatening complications can occur. Complications from pneumonia are more likely to occur in high-risk groups such as older adults, babies, and people with chronic medical conditions or weakened immune systems.

Complications of pneumonia may include:

  • lung abscesses — are pockets of pus that develop in or around your lung and may need to be drained with surgery
  • respiratory failure— if your lungs stop working properly you may need to be put on a breathing machine (ventilator)
  • acute respiratory distress syndrome (ARDS) — is a severe, life-threatening type of respiratory failure
  • sepsis — occurs when the infection gets into your blood. Sepsis can lead to organ failure and may be life-threatening

Complications from pneumonia are more likely to occur in high-risk groups such as older adults, babies, and people with chronic medical conditions or weakened immune systems.

What are the symptoms of pneumonia?

The symptoms of pneumonia can start suddenly or come on gradually over a few days. They may be mild, moderate or severe.

Symptoms of pneumonia may include:

  • a cough, often producing yellow or green mucus (phlegm)
  • fever (a temperature above 38C)
  • shortness of breath that gets worse with activity
  • wheezing (noisy breathing)
  • chest pain
  • headache
  • muscle aches
  • fatigue
  • loss of appetite
  • confusion – this is more common in older people

Sometimes it can be difficult to tell the symptoms of pneumonia from other respiratory illnesses such as a cold or the flu. Pneumonia can be very serious and even fatal and needs urgent medical attention.

Make an urgent appointment with your consultant if you:

  • have had a cough for three weeks or more
  • are short of breath/ have difficulty breathing
  • are coughing up blood
  • ave chest pain

Call an ambulance or go straight to A&E if you:

  • are struggling to breathe, choking, gasping, or unable to speak
  • have bluish skin, lips, or nails
  • feel suddenly confused or disoriented

Signs of pneumonia in babies and children

Babies and young children may have no symptoms of pneumonia or show different symptoms to adults. Seek immediate medical attention if your baby or child has symptoms of pneumonia including: 

  • fever
  • cough
  • difficulty breathing
  • rapid breathing
  • loss of appetite/ difficulty feeding
  • pale skin
  • vomiting
  • listlessness/lack of energy
  • restlessness, irritability, or fussiness
  • crying more than usual
  • noisy breathing (babies may make a grunting sound when breathing)
  • passing less urine/ nappies that are less wet than usual
  • limpness/ floppiness

What causes pneumonia?

Pneumonia is usually caused by an infection with a virus or bacteria. Less commonly, pneumonia can be caused by a fungal or protozoal infection.

Pneumonia can be caused by:

  • bacteria - bacteria such as streptococcus pneumoniae and less commonly, mycoplasma pneumoniae can cause pneumonia
  • viruses - viral pneumonia can be caused by viruses, including the common cold, flu, and COVID-19 
  • fungi - rarely, fungi, like cryptococcus, pneumocystis, and coccidiosis can cause pneumonia, usually in people with weakened immune systems
  • protozoa - rarely, protozoa like toxoplasma can cause pneumonia

The symptoms of pneumonia can start suddenly or come on gradually over a few days. They may be mild, moderate or severe.

Types of pneumonia

There are several different types of pneumonia. They are categorised by what caused the pneumonia and how you got it.

Community-acquired pneumonia (CAP)

Community-acquired pneumonia (CAP) refers to pneumonia you develop in the community, and not in a healthcare facility such as a hospital. It is usually caused by a bacterial infection. 

Hospital-acquired pneumonia (HAP)

Hospital-acquired pneumonia (HAP) develops while you are having inpatient hospital treatment for another illness or procedure. Hospital-acquired pneumonia is often more serious than community-acquired pneumonia because it is commonly caused by bacteria that are resistant to antibiotics such as methicillin-resistant Staphylococcus aureus (MRSA) which can make it harder to treat.

Healthcare-associated pneumonia (HCAP)

HCAP is similar to hospital-acquired pneumonia but affects people in long-term care facilities such as nursing homes. Like hospital-acquired pneumonia, it's usually caused by antibiotic-resistant bacteria.

Ventilator-associated pneumonia (VAP)

This type of pneumonia affects people on a breathing machine (ventilator) in a hospital Intensive Care Unit. It can be caused by the same types of bacteria that cause community-acquired pneumonia or hospital-acquired pneumonia (antibiotic-resistant bacteria).

Aspiration pneumonia

Aspiration pneumonia occurs when solid food, liquids, saliva, or vomit pass through your windpipe (trachea) into your lungs causing infection.

What are the risk factors for pneumonia?

Anyone can get pneumonia, but you may be at increased risk if you:

Is pneumonia contagious?

Pneumonia itself isn't contagious, but the germs (bacteria or viruses) that cause it can be.

You can catch a virus such as a cold or flu, or a bacterial infection like streptococcus pneumoniae from someone who has it, though not all people that become infected will develop pneumonia.

Germs are spread by droplets in the air when someone coughs, sneezes, or speaks, or by touching contaminated surfaces.

Some types of pneumonia such as fungal pneumonia or aspiration pneumonia are not contagious.

How is pneumonia diagnosed?

Pneumonia is usually diagnosed using a combination of your symptoms, a physical examination, and a chest X-ray.

If you have been admitted to hospital with symptoms of pneumonia, you will probably have some other tests to confirm your diagnosis, evaluate the effect the pneumonia is having on your body and help identify the cause of your pneumonia.

These may include:

  • blood tests - to check your overall health, whether infection or inflammation is present, and for any other conditions
  • ECG - to check the electrical activity of your heart
  • pulse oximetry - measures the oxygen level of your blood
  • arterial blood gases - provide more information about the amount of oxygen and carbon dioxide in your blood as well as your blood pH and other parameters
  • sputum (phlegm) and urine test - to try and identify the bacteria that may have caused your pneumonia
  • CT scan - a type of X-ray that looks at your lungs in more detail
  • bronchoscopy - a thin flexible tube with a camera is passed into your lungs to allow your consultant to examine them more closely and take a sample of phlegm. This is normally only performed if you are not getting better after treatment for pneumonia

How is pneumonia treated?

Treatment for pneumonia depends on the type and severity of your pneumonia. In many cases, the cause cannot be determined, and treatment is focused on relieving your symptoms, treating any infection, and making sure your condition doesn't get any worse.

You may be treated at home or in a hospital, depending on how severe your pneumonia is and your risk of developing complications.

Medications for pneumonia

  • bacterial pneumonia is treated with antibiotics, either in the form of oral tablets or with IV (into a vein) antibiotics in hospital
  • viral pneumonia often goes away on its own or may occasionally be treated with antiviral medications. Your consultant will advise you on how to treat your symptoms at home to reduce your risk of complications.
  • fungal pneumonia can be treated with antifungal medications

Other hospital treatments

If you are admitted to hospital with pneumonia, you may be given other treatments to help make you feel more comfortable and reduce the risk of complications.

Other treatments for pneumonia may include:

  • oxygen may be given through a face mask or small tubes in your nostrils if your oxygen levels are low
  • IV fluids are given directly into your vein to treat or prevent dehydration
  • A build-up of fluid between your lung and chest wall (pleural effusion) may be drained using a catheter or surgery

Treating pneumonia symptoms at home

If your pneumonia is mild and doesn't pose a risk of complications, you may be able to manage your symptoms at home.

Some things you can do to relieve symptoms of pneumonia at home include:

  • take over-the-counter painkillers such as paracetamol or ibuprofen
  • rest
  • drink plenty of fluids
  • eat nutritious foods
  • use a humidifier, drink warm beverages, or inhale steam from the bath or shower to help loosen any mucus and open your airways
  • breathing exercises to help loosen mucus and make breathing easier. Your physiotherapist can show you some breathing exercises you can do at home

Can pneumonia be prevented?

The most effective way to prevent pneumonia is with a vaccine. The pneumococcal vaccine is recommended for people at high risk of developing pneumonia including: 

  • babies and young children
  • adults over 65 years of age
  • people with certain long-term conditions including diabetes, and some heart, lung, liver, kidney, and neurological conditions
  • people with a weakened immune system

Those in high-risk groups should also get a flu vaccine every year.

You can also reduce your risk of pneumonia by:

  • boosting your immune system by following a healthy diet, taking regular exercise, getting enough sleep and reducing stress
  • stopping smoking
  • limiting your alcohol intake to within safe limits
  • practicing good hygiene by washing your hands regularly and disinfecting surfaces

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If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.

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