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 for you to breathe. Pneumonia can be a serious condition needing medical attention and may require hospital admission.

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
• High temperature
• Sweating and shivering
• Rapid heartbeat
• 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 (haemoptysis) Headache Nausea Aches and pains in muscles and joints Wheezing Fatigue Feeling confused

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

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

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 (apnoea)
• 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

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 (coronavirus).
• 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.

Yes, like a cold or flu, pneumonia is contagious when caused by a bacterial or viral infection. It spreads when someone with pneumonia coughs or sneezes, releasing tiny droplets of fluid containing infected particles. Another person then inhales these particles and they develop pneumonia.

Pneumonia can also spread by touching an object which transfers the droplet particles on to it. When someone else comes along, makes contact with the object, and then touches their mouth or nose, the infection will spread to them.

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.

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, due to having chemotherapy or HIV or AIDS

Any 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 five-day antibiotic treatment from a GP. If the antibiotics don't work after three 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.

Pneumonia can sometimes cause complications like:

• Pleurisy – this is when the linings between your lungs and ribcage (pleura) become inflamed and cause chest pains. If you have pleurisy, you may also develop fluid on your lungs.
• Lung abscess – this is a rare complication and sometimes happens when a person has a pre-existing health condition.
• Blood poisoning (septicaemia or sepsis) - happens when the infection spreads from the lungs to the bloodstream. It is 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.

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.

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

The following tips may help:

• Get plenty of rest – don't push yourself too hard
• 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