Pneumonia is a respiratory condition. Pneumonia is triggered when the lungs become infected. This happens due to the presence of bacteria, viruses, parasites, or fungi. Fluid then lingers in the lungs. When a person with an already weakened immune system gets pneumonia, it is called “pneumonia in an immune-compromised host.”
Having a weakened immune system makes it harder for you to fight off germs. Immediate medical intervention and careful monitoring are necessary. Without them, you run the risk of serious complications.
If you have a compromised immune system and develop symptoms of pneumonia, contact your doctor as soon as you can.
People with weakened immune systems will have more difficulty fighting off the bacteria or the virus that is causing their pneumonia. Below are some of the reasons that a person may be at risk of pneumonia.
The following medical conditions can lead to a weaker immune system:
- heart disease
- bone marrow or organ transplants
After any inpatient surgical procedure, your body is healing for at least a week. In this state, your immune system can be compromised and you may have a higher risk of pneumonia.
A major risk factor for pneumonia is chronic obstructive lung disease (COPD). People who are treated for COPD with corticosteroid medications can be more vulnerable to pneumonia risks. The longer this medication has been used, the higher the risk.
If you have an autoimmune condition, check your pill bottles and talk to your doctor about what the labels mean. The medication that you are on can increase your risk of a weak immune system.
Specifically, steroid medications, chemotherapy, and radiation therapy make people more vulnerable to pneumonia. This is because these drugs work by suppressing the immune system.
Air quality can be a huge risk factor. Smoking and air pollution can leave a person more vulnerable to contracting bacteria. These bacteria can get trapped in the lungs. The result of this is bacterial pneumonia. Populations in cities with poor air quality and high levels of fume exposure are more likely to have trouble resisting pneumonia. This also applies to people with a lot of exposure to agricultural fumes.
Pneumonia in the Hospital
People are checked into the hospital to recover from injury and illness. A prolonged hospital stay also means becoming more prone to hospital-borne infections and pneumonia.
The rate of contracting pneumonia jumps significantly in cases where the person is over 65 years old. However, the biggest hospital risk factor is intubation. Intubation is a procedure in which a tube is placed within the body for any medical reason. Hospital staff should be diligent in best practices for intubation of patients. In every case, measures to reduce the amount of time that patients are intubated should be taken.
Pneumonia occurs at a higher rate in babies that are born prematurely. If newborns are required to stay in a neonatal intensive care unit (NICU) for any reason, they also have a higher rate of pneumonia.
Fortunately, there are effective ways to prevent pneumonia in infants. These include:
- testing pregnant women for group B strep bacteria toward the end of their pregnancies
- zinc supplements for newborns with a weakened immune system
Zinc supplements have been recommended for immune-compromised infants, but the research into zinc’s use is ongoing.
The following symptoms are common signs of pneumonia:
- productive cough
- nausea and vomiting
- loss of appetite
- chest pain that is aggravated by coughing or deep breathing
- shortness of breath or other breathing difficulty
- swollen glands
Using a stethoscope, your doctor will probably check to see if there are abnormal sounds in your chest. If there is a crackling sound when you breathe, it could indicate pneumonia. Abnormal sounds can also mean a fluid buildup between your lungs and your chest wall. This fluid buildup is called pleural effusion.
Tests that can help diagnose pneumonia include:
- chest X-ray
- blood tests
- sputum Gram stain (a test to detect bacteria in mucus from your air passages)
- sputum direct fluorescent antibody (a test to examine mucus coughed up from your lungs)
In rarer cases, a bronchoscopy (a test used to view the airways), chest CT scan (a scan that creates more detailed X-rays), or a lung biopsy (a test performed to examine a sample of lung tissue) may be used.
Many people can be safely treated at home for pneumonia. Children generally begin to improve within a day or two, and adults take two to three days, according to the CDC.
If you have a weakened immune system, symptoms may be more severe and recovery could take longer. You may need to stay in the hospital for a few days, where you will receive intravenous fluids, and you can be safely monitored.
Depending on what is causing your pneumonia, you may be treated with antibiotics or antifungal medications. If your pneumonia is caused by a virus, getting lots of rest and drinking plenty of fluid may be your prescribed treatment.
If there is a buildup of fluid in the lining of your lungs, it can be removed by performing a thoracentesis. This is a minimally invasive technique where the doctor will insert a needle (guided by X-ray, if necessary) to take fluid from the pleural space surrounding the lungs. The fluid extracted with this procedure is sent to the laboratory for analysis (cell counts, bacteria, viral, fungal testing) and can be very helpful in the diagnosing your condition.
Some symptoms can last for weeks. Even when you begin to feel better, the infection may still be present, so it is important that you continue following your doctor’s treatment plan.
Be sure to take all of your prescribed medications, even if when you start to feel better. If you stop taking antibiotics too soon, the infection may return. Arrange a follow-up physical examination to get the all clear from your doctor at the end of your treatment.
Ask your doctor if you should receive the yearly vaccine for pneumonia. This is the pneumococcal vaccine, and is usually given at the same time as the flu vaccine. The World Health Organization notes that since the pneumococcal vaccine has been introduced, the number of occurrences of bacterial pneumonia has dropped dramatically.
If you need to stay in a hospital for any reason, you are at increased risk of hospital-acquired pneumonia. This is more common for people on a respirator. Healthcare workers can also pass it from patient to patient. This kind of pneumonia is very dangerous and can even be fatal. Your doctor may order antibiotics as a preventive measure if you are immune-compromised and require a prolonged hospital stay.
During cold and flu season, avoid crowds and wash your hands often.
Even in cases during which an immune-compromised person contracts pneumonia, the prognosis varies from person to person.
In people with a severely weakened immune system, complications are more common. These complications can include a rapid spread of infection and high levels of bacteria in the bloodstream. Respiratory failure and organ damage can also occur. In cases where pneumonia lingers for a long time, the use of a device to assist with breathing may become necessary.
In some cases, pneumonia can result in death. According to the Centers for Disease Control and Prevention, pneumonia and influenza are the 8th leading causes of death in the United States. However, there is a very wide mortality range that depends on the cause, severity, and availability of quality care to the person with pneumonia.
You Asked, We Answered
- What are the effects of pneumonia in a pregnant person and how can it be treated?
The effects of pneumonia in a pregnant woman are similar to that in a normal adult — but with one key difference. Pneumonia in pregnancy is associated with increased complications (and even higher death rates), so EARLY diagnosis and treatment is of utmost importance. So if you are pregnant, and experience some of the notable symptoms of pneumonia (e.g., rapidly progressing cold or flu, breathing difficulty, chest pain, fever with chills, or worsening productive cough), then you should seek immediate medical attention from either your primary doctor or your OB/GYN.- Steve Kim, MD