Pneumonia: Answers to Common Questions

You are getting over the flu but still have a cough, chills, fever and difficulty breathing. Could your flu have turned into pneumonia? It’s possible.

Pneumonia is an infection in one or both of your lungs, according to the American Lung Association. Pneumonia has more than 30 different causes, but a common one is the flu, says Johns Hopkins Medicine.

When you have pneumonia, the air sacs in your lungs fill up with fluid or pus. Pneumonia symptoms include a cough with a slimy substance known as phlegm (or mucus), fever, chills and difficulty breathing. You also may have chest and stomach pain, including nausea, vomiting and diarrhea. Your symptoms can be mild or severe, notes the National Heart Lung and Blood Institute.

Pneumonia is most serious in children younger than 5 and adults 65 or older. Also, pneumonia can be more serious for people with certain medical conditions, including heart failure, diabetes and COPD (chronic obstructive pulmonary disease) and for those who have weakened immune systems, including from HIV/AIDS, cancer treatments and stem cell or organ transplants.

Because the symptoms can be similar, some people confuse pneumonia with bronchitis. However, bronchitis is an inflammation of the tubes that carry air to your lungs, while pneumonia is an infection of the air sacs in your lungs. Untreated, bronchitis can lead to pneumonia.

What causes pneumonia?

The air we breathe contains bacteria, viruses and fungi — all of which can cause pneumonia when your body is weak and the germs are strong. Some of the most common causes include:

• Bacteria: In the United States, pneumococcal pneumonia is the most common kind of bacterial pneumonia.
• Viruses: Rhinoviruses that attack your upper respiratory tract can lead to viral pneumonia. The most common of these viruses in adults is the flu virus. The virus that causes the common cold also can lead to pneumonia in some adults. In young children, the most common cause of viral pneumonia is respiratory syncytial virus (RSV).
  In most people, viral pneumonia doesn’t last as long and doesn’t make you as miserable as bacterial pneumonia, the American Lung Association says. However, some people with viral pneumonia can develop a secondary invasion of bacteria and have all the symptoms of bacterial pneumonia, too.
• Fungi: Fungal infections also can cause pneumonia, especially in people whose treatment for other conditions, such as HIV/AIDS or cancer, suppresses their immune systems. Also, fungi found in soil in parts of the country can cause pneumonia in some people.

Is pneumonia contagious?

Pneumonia that is caused by airborne germs — bacteria or viruses — can be contagious. Sometimes pneumonia can spread throughout a health care setting, such as a hospital or long-term care facility.

Also, if you carry the bacteria that cause pneumonia in your nose and throat and you cough or sneeze, it can spread to others around you, the Centers for Disease Control and Prevention (CDC) says.

Should I get a pneumonia vaccine?

Vaccines are recommended for people 65 and older as well as those with certain health concerns. Currently, two pneumonia vaccines are available from your doctor or pharmacist:

• PCV13 (pneumococcal conjugate vaccine)
• PPSV23 (pneumococcal polysaccharide vaccine)

Some people need one; some people need both. Talk to your doctor to determine which is right for you.

Both vaccines will protect you against pneumococcal bacteria. PCV13 protects against 13 strains and PPSV23 against 23 strains. Both vaccines also protect against other illnesses, such as meningitis and bacteremia.

The CDC recommends the PCV13 for those who are 65 or older and for adults 19 or older who have certain health conditions. You should not get PCV13 if you've ever had an allergic reaction to this vaccine that was life-threatening or you have a severe allergy to any of its components.

Also, do NOT get PCV13 if:

• You had the earlier pneumococcal vaccine PCV7 or Prevnar
• You've previously had any vaccine that contains diphtheria toxoid such as DTaP.

The CDC recommends PPSV23 if:

• You are 65 or older.
• You are at least 19 and are younger than 64 and you have certain health conditions or smoke cigarettes.

The CDC says do NOT get PPSV23 if:

• You had a life-threatening allergic reaction to this shot.
• You are highly allergic to any of its components.

It's possible to get a flu shot and a pneumonia shot at the same time, but you should not get both pneumonia shots at the same time, according to the CDC. However, you need a flu shot every year, but that’s not true for the pneumonia shot. The pneumonia vaccines should last a lifetime.

If you and your doctor determine that you need both pneumonia vaccines, the CDC recommends that you get PCV13 first and wait at least eight weeks before getting a dose of PPSV23. If you get PPSV23 first, wait at least five years before getting PCV13, the agency says.

How can I prevent pneumonia?

The vaccines can help prevent pneumonia from specific organisms, but it's still possible to get the disease. The vaccines don't prevent all infections. But, there are other things you can do to help prevent pneumonia:

• Get other vaccines. Other vaccines are available that help prevent bacterial and viral infections that could lead to pneumonia. These include pertussis (whooping cough), chickenpox and measles, according to the American Lung Association. Talk to your doctor about whether your vaccines are up-to-date and whether you or your children need any booster shots.
• Wash your hands. You can help stop germs that can cause pneumonia from spreading by washing your hands with soap and water frequently, especially after you blow your nose, go to the bathroom or diaper a child and always before you prepare food or eat. You can use alcohol-based hand sanitizers if you don’t have access to a sink.
• Don’t smoke. When you smoke, you weaken your lung’s natural ability to fight infections.
• Adopt healthy habits. It’s important to eat a healthy diet and get regular exercise. Staying in shape helps you avoid getting sick and helps you recover faster if you do catch a cold or get the flu.

How is pneumonia treated?

What if, despite your best efforts, you get pneumonia? Here’s how it’s treated:

You may need to be hospitalized if your symptoms are severe, but many people can be treated at home. Treatment is designed to cure your infection and prevent you from having complications.

Everyone with pneumonia can benefit from staying hydrated — drinking lots of liquids — and getting plenty of rest, the American Lung Association says. Staying hydrated helps loosen secretions and allows you to get rid of phlegm. Rest will help you recover fully.

Knowing the cause of your pneumonia can be important because it can determine the best treatment for you and your pneumonia. However, doctors can’t always determine how you got your pneumonia.

Bacterial pneumonia is treated with antibiotics. You should begin to improve within a few days of starting your antibiotic. Be sure to finish your medicine, even if you feel better before you’re done, or your pneumonia could return. You may need oxygen therapy if the oxygen level in your bloodstream is low. Some people also may need to be given antibiotics intravenously and may need to be hospitalized to do so.

Antibiotics don’t work for pneumonia that is caused by a virus. However, you may be given antiviral medicine to treat it. You should start to feel better in one to three weeks.

Your doctor may want to see a chest X-ray to make sure your lungs are clear before your treatment is determined to be successful.

What about complications?

If you get pneumonia, it’s important that you get it treated because it can lead to serious and sometimes fatal complications. Possible complications include:

• Bacteremia and septic shock, where the bacterial infection spreads to your blood.
• Lung abscesses, which may require surgery or drainage.

Other potentially fatal complications including pleural effusions, empyema and pleurisy, kidney failure and respiratory failure.