What is pneumonia?

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior
to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from
the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a
half a million of these people are admitted to a hospital for treatment. Although most of these people
recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the
United States.

How do people "catch pneumonia"?

Some cases of pneumonia are contracted by breathing in small droplets that contain the organisms that
can cause pneumonia. These droplets get into the air when a person infected with these germscoughs or
sneezes. In other cases, pneumonia is caused when bacteria or viruses that are normally present in the
mouth, throat, or nose inadvertently enter the lung. Duringsleep, it is quite common for people to aspirate
secretions from the mouth, throat, or nose. Normally, the body's reflex response (coughing back up the
secretions) and their immune system will prevent the aspirated organisms from causing pneumonia.
However, if a person is in a weakened condition from another illness, a severe pneumonia can develop.
People with recent viral infections, lung disease, heart disease, and swallowing problems, as well
asalcoholics, drug users, and those who have suffered a stroke or seizure are at higher risk for
developing pneumonia than the general population. As we age, our swallowing mechanism can become
impaired as does our immune system. These factors, along with some of the negative side effects of
medications, increase the risk for pneumonia in the elderly.

Once organisms enter the lungs, they usually settle in the air sacs and passages of the lung where they
rapidly grow in number. This area of the lung then becomes filled with fluid and pus (the body's
inflammatory cells) as the body attempts to fight off the infection.

What are pneumonia symptoms and signs?

Most people who develop pneumonia initially have symptoms of a cold (upper respiratory infection, for
example, sneezing, sore throat, cough), which are then followed by a high fever (sometimes as high as
104 F), shaking chills, and a cough with sputum production. The sputum is usually discolored and
sometimes bloody. Depending on the location of the infection, certain symptoms are more likely to
develop. When the infection settles in the air passages, cough and sputum tend to predominate the
symptoms. In some, the spongy tissue of the lungs that contain the air sacs is more involved. In this case,
oxygenation can be impaired, along with stiffening of the lung, which results in shortness of breath. At
times, the individual's skin color may change and become dusky or purplish (a condition known as
"cyanosis") due to their blood being poorly oxygenated.

The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest
pain may develop if the outer aspects of the lung close to the pleura are involved. This pain is usually
sharp and worsens when taking a deep breath and is known as pleuritic pain or pleurisy. In other cases of
pneumonia, depending on the causative organism, there can be a slow onset of symptoms. A worsening
cough, headaches, and muscle aches may be the only symptoms.
Children and babies who develop pneumonia often do not have any specific signs of a chest infection but
develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms
with pneumonia.