Pneumonia

What is pneumonia?

Pneumonia is an infection in one or both lungs. The condition causes inflammation in the tiny air sacs (alveoli) in your lungs, filling them with fluid, which makes it harder to breathe. Pneumonia can be a serious condition needing medical attention and may require hospital admission.

What are the symptoms of pneumonia?

Pneumonia symptoms can vary depending on your age, health, and the cause of the infection. It may feel as though you have the flu or a heavy cold, and the main symptoms can include:

• A cough – this can be 'dry', or it may involve coughing up phlegm (mucus)

• Breathlessness

• Chest pain or discomfort that worsens when you breathe or cough

• A high temperature

• Sweating and shivering

• A rapid heartbeat

• A loss of appetite

Pneumonia symptoms can come on suddenly, or they may develop slowly over a few days.

Other pneumonia symptoms

Some less common symptoms of pneumonia include:

• Coughing up blood

• Headache

• Nausea

• Aches and pains in your muscles and joints

• Wheezing

• Fatigue

• Feeling confused

How is pneumonia diagnosed?

Pneumonia is usually diagnosed with a physical examination and sometimes a chest X-ray. In some cases, more tests might be necessary. 

Symptoms of pneumonia in children

Pneumonia symptoms in children vary depending on the child's age and the cause of the infection. A child with pneumonia will find it difficult to breathe and have a high temperature (above 38C). They may also have a cough.

Toddlers and older children will sometimes:

• Have chest or stomach pains

• Vomit

• Refuse to eat or drink

Pneumonia in newborns and young babies

Newborn babies and infants may not show any signs of infection. Alternatively, they may have several symptoms like a fever, vomit, cough, and appear restless or lack energy. Other pneumonia signs to look out for include:

• Breathing difficulties – they may grunt or move their head up and down with each breath

• Drawing the muscles under their chest in when they breathe (their stomach will appear to move in and out as they breathe)

• Fast breathing

• Periods of appearing to stop breathing

• Not feeding properly

• Lack of wet nappies for 12 hours or more

• Not sleeping properly

• Appearing irritable

• Bluish tinge to the skin inside their lips or under their tongue

When to call 999 for urgent help

• If your child's breathing pauses for more than 20 seconds

• Your child has a fever and is struggling to breathe

• The colour of your baby's skin inside their lips or under their tongue turns blue

What causes pneumonia?

A bacterial infection usually causes pneumonia, and the most common is a bacterium called Streptococcus pneumoniae.

Apart from bacterial pneumonia, there are several other types of pneumonia, including:

• Viral pneumonia – caused by a virus e.g. the flu or Covid-19.

• Aspiration pneumonia – occurs when bacteria is inhaled into the lungs from food, drink, vomit, saliva, smoke or a chemical.

• Fungal pneumonia – caused by fungi in soil or bird droppings. It’s rare in the UK and tends to only affect people with weakened immune systems.

• Hospital-acquired pneumonia – this develops in the hospital while receiving treatment for another condition. People in intensive care tend to be more at risk of this type of pneumonia.

Is pneumonia contagious?

Like a cold or flu, pneumonia is contagious when it's caused by a bacterial or viral infection. It can spread when someone with pneumonia coughs or sneezes, releasing tiny droplets of fluid containing infected particles. If another person inhales these particles, they may develop pneumonia.

Pneumonia can also spread when someone with droplet particles on their hand touches an object. If someone else touches the object and then touches their face, the infection can spread.

What is walking pneumonia?

Walking pneumonia is a non-medical term for mild pneumonia that isn't severe enough to need bed rest or hospitalisation. The symptoms are usually mild, and the person can continue normal activities. If your GP thinks you have walking pneumonia, they may treat it with a course of antibiotics.

Who is most at risk of pneumonia?

Anyone can get pneumonia, but certain groups are most at risk:

• Adults aged 65 and over

• Babies and younger children

• People who smoke

• People with other health conditions (e.g., asthma, cystic fibrosis, or a heart, liver, or kidney condition)

• Those with a weakened immune system caused by, for example, chemotherapy or HIV/AIDS

How is pneumonia treated?

Treatment depends on the severity of pneumonia. If you have bacterial pneumonia, the primary treatment is antibiotics. It’s also essential to rest, get enough sleep, and drink plenty of water. If chest pain or discomfort is an issue, painkillers like paracetamol will help.

Mild bacterial pneumonia cases can generally be managed at home with a 5-day antibiotic treatment from a GP. If the antibiotics don't work after 3 days, you may need a longer course of treatment.

In the case of viral pneumonia, antibiotics won't help. Instead, you'll need to have plenty of rest, drink lots of fluids, and manage your fever with aspirin or ibuprofen.

In severe pneumonia cases, a hospital stay may be needed because it can lead to serious, sometimes life-threatening, complications.

What are possible complications of pneumonia?

Pneumonia can sometimes cause complications like:

• Pleurisy – when the linings between your lungs and ribcage (pleura) become inflamed and cause chest pain. If you have pleurisy, you may also develop fluid in your lungs.

• Lung abscess – a rare complication and sometimes happens when a person has a pre-existing health condition.

• Blood poisoning (septicaemia or sepsis) – when the infection spreads from the lungs to the bloodstream. It's a severe complication that can cause low blood pressure and may require intensive care treatment.

• Respiratory failure – caused by low oxygen levels in the blood and may require intensive care treatment.

How to prevent pneumonia

There are some key things you can do to reduce your risk of pneumonia. If you've previously had pneumonia, it's essential to follow this advice to prevent it from developing again:

• Keep a good standard of hygiene – this includes using a tissue when you sneeze or cough, and throwing it in the bin immediately

• Stop smoking

• Avoid excessive alcohol consumption

• Get vaccinated – if you’re in a high-risk category, your GP may offer you a pneumonia vaccine (sometimes referred to as PPV) and the annual flu vaccine

How long does pneumonia last?

It may take a while to recover fully from pneumonia. Some people bounce back relatively quickly and feel well enough to return to their regular routines after about a week. Others find their pneumonia recovery can take weeks or months.

These tips can help you recover from pneumonia:

• Get plenty of rest

• Continue to drink lots of fluids

• Gradually increase activities as your symptoms improve

• Try taking slow, deep breaths to exercise your lungs

• Ask your GP about how much exercise you should do as you get better

• Avoid smoke (including cigarette smoke) to allow your lungs to heal

When should I talk to a doctor?

If you are unwell and have pneumonia symptoms, it's essential to contact a GP.

Dial 999 for urgent medical help if you are:

• Struggling to breathe

• Coughing up blood

• Feeling cold and sweaty

• Going blue in the lips or face

• Getting a rash that doesn't fade when you roll a glass over it

• Feeling confused or very tired

• Feeling faint

How can Livi help? 

A Livi doctor can talk to you about your symptoms and give you advice on the next best steps. This might involve antibiotics or advice to be seen physically by a doctor.