Pneumonia

Pneumonia is swelling (inflammation) of the tissue in one or both lungs. It's usually caused by a bacterial infection. It can also be caused by a virus, such as coronavirus (COVID-19).

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

·      High temperature

·      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

·      Feeling sick or being sick

·      Wheezing

·      Joint and muscle pain

·      Feeling confused and disorientated, particularly in elderly people

When to get medical help?

If you have a high temperature, a new, continuous cough or a loss or change to your sense of smell, use the 111 online coronavirus service.

If you feel unwell and have any other symptoms of pneumonia, contact your GP or use the regular 111 online service.

Only call 111 if you cannot get help online or you need help for a child under 5.

Call 999 for an ambulance if you or someone you care for:

·      Are struggling to breathe

·      Are coughing up blood

·      Have blue lips or a blue face

·      Feel cold and sweaty, with pale or blotchy skin

·      Have a rash that does not fade when you roll a glass over it

·      Collapse or faint

·      Become confused or very drowsy

·      Have stopped peeing or are peeing much less than usua

Who's affected?

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 bacterial infection.

As well as bacterial pneumonia, other types include:

·      Viral pneumonia – caused by a virus, such as coronavirus

·      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

Diagnosing pneumonia

A doctor 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, a doctor may ask you:

·      whether you feel breathless or you're breathing faster than usual

·      how long you have 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

A doctor 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 will not 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 have not improved within 48 hours of starting treatment.

Treating pneumonia

Mild pneumonia can usually be treated at home by:

·      Getting plenty of rest

·      Taking antibiotics if the pneumonia is likely to be caused by a bacterial infection

·      Drinking plenty of fluids

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

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.

Treatment Pneumonia

Mild pneumonia can usually be treated at home with rest, antibiotics (if it's likely be caused by a bacterial infection) and by drinking plenty of fluids. More severe cases may need hospital treatment.

Unless a healthcare professional tells you otherwise, you should always finish taking a prescribed course of antibiotics, even if you feel better.

If you stop taking an antibiotic part way through a course, the bacteria can become resistant to the antibiotic.

After starting treatment, your symptoms should steadily improve.

However, how quickly they improve will depend on how severe your pneumonia is.

As a general guide, after:

·      1 week – high temperature should have gone

·      4 weeks – chest pain and mucus production should have substantially reduced

·      6 weeks – cough and breathlessness should have substantially reduced

·      3 months – most symptoms should have resolved, but you may still feel very tired (fatigue)

·      6 months – most people will feel back to normal

Treatment at home

Contact your GP or 111 online if your symptoms do not improve within 3 days of starting antibiotics.

Symptoms may not improve if

·      The bacteria causing the infection is resistant to antibiotics – a GP may prescribe a different antibiotic, or they may prescribe a second antibiotic for you to take with the first one

·      A virus is causing the infection, rather than bacteria – antibiotics have no effect on viruses, and your body's immune system will have to fight the viral infection by creating antibodies

Painkillers, such as paracetamol or ibuprofen, may help relieve pain and reduce fever.

However, you should not take ibuprofen if you:

·      Are allergic to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)

·      Have asthma, kidney disease, a history of stomach ulcers or indigestion

Cough medicines are not recommended as there is little evidence they are effective. A warm honey and lemon drink can help relieve discomfort caused by coughing.

Your cough may persist for 2 to 3 weeks after you finish your course of antibiotics, and you may feel tired for even longer as your body continues to recover.

Drink plenty of fluids to avoid dehydration, and get plenty of rest to help your body recover.

If you smoke, it's more important than ever to stop, as smoking damages your lungs.

Contact a GP or 111 online if, after following these self-help measures, you're feeling worse or you're not feeling any better.

Treatment in hospital

You may need treatment in hospital if your symptoms are severe.

You should be given antibiotics as soon as possible if your pneumonia is likely to be caused by a bacterial infection.

You will probably not be given antibiotics if the cause is likely to be a virus, such as corona virus. This is because antibiotics do not work for viral infections.

You may also be given fluids intravenously through a drip, and you may need oxygen to help breathing.

In serious cases of pneumonia, breathing assistance through a ventilator in an intensive care unit (ICU) may be required.