Pneumonia Health Article

Symptoms

The most common symptoms of pneumonia are:

• Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
• Fever, which may be mild or high
• Shaking chills
• Shortness of breath (may only occur when you climb stairs)

• Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
• Headache
• Excessive sweating and clammy skin
• Loss of appetite, low energy, and fatigue
• Confusion, especially in older people

Signs and tests

If you have pneumonia, you may be working hard to breathe, or breathing fast.

Crackles are heard when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall).

The health care provider will likely order a chest x-ray if pneumonia is suspected.

Some patients may need other tests, including:

• CBC to check white blood cell count
• Arterial blood gases to see if enough oxygen is getting into your blood from the lungs
• CT scan of the chest
• Gram's stain and culture of your sputum to look for the organism causing your symptoms
• Pleural fluid culture if there is fluid in the space surrounding the lungs

Treatment

Your doctor must first decide whether you need to be in the hospital. If you are treated in the hospital, you will receive fluids and antibiotics in your veins, oxygen therapy, and possibly breathing treatments. It is very important that your antibiotics are started very soon after you are admitted.

You are more likely to be admitted to the hospital if you:

• Have another serious medical problem
• Have severe symptoms
• Are unable to care for yourself at home, or are unable to eat or drink
• Are older than 65 or a young child
• Have been taking antibiotics at home and are not getting better

However, many people can be treated at home. If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have a viral or bacterial pneumonia, so you may receive antibiotics.

Patients with mild pneumonia who are otherwise healthy are sometimes treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).

Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following:

• Fluoroquinolone (levofloxacin (Levaquin), sparfloxacin (Zagam), gemifloxacin (Factive), or moxifloxacin (Avelox)
• High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin)
• Cephalosporin antibiotics (for example, cefuroxime or cefpodoxime) plus a macrolide (azithromycin, clarithromycin, or erythromycin)

If the cause is a virus, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication.

You can take these steps at home:

• Drink plenty of fluids to help loosen secretions and bring up phlegm.
• Get lots of rest. Have someone else do household chores.
• Do not take cough medicines without first talking to your doctor. Cough medicines may make it harder for your body to cough up the extra sputum.
• Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.