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Pneumonia
 Pneumonia is an acute infection or inflammation of the alveoli.
 Pneumonia caused by bacteria, viruses or fungi.
 Pneumonia causes your lung tissue to swell (inflammation) and can cause fluid or pus in
your lungs.
 Bacterial pneumonia is usually more severe than viral pneumonia, which often resolves
on its own.
 Pneumonia can affect one or both lungs. Pneumonia in both of your lungs is called
bilateral or double pneumonia.

Causes of Pneumonia:-
 Pneumonia can develop when your immune system attacks an infection in the small sacs
of your lung (alveoli).
 This causes your lungs to swell and leak fluids.
 Many bacteria, viruses and fungi can cause the infections that lead to pneumonia.
Bacteria are the most common cause in adults and viruses are the most common cause in
school-aged children.

Causative Agents Includes

Bacteria: The bacteria that most commonly causes pneumonia, Streptococcus pneumoniae,
can be spread from person to person by touching infected surfaces or through coughing and
sneezing.

Viruses: Viruses that cause the common cold, the flu (influenza), COVID-19 and respiratory
syncytial virus (RSV) can sometimes lead to pneumonia.

Fungi (molds): Fungi, like Cryptococcus, Pneumocystis jirovecii are uncommon causes of
pneumonia.

Pneumonia caused by fungi isn’t contagious. Fungal infections aren’t spread from person to
person like viruses and bacteria.

Protozoa: Rarely, protozoa like Toxoplasma cause pneumonia.

Types of Pneumonia:-
Community-acquired pneumonia (CAP)

When you get pneumonia outside of a healthcare facility, it’s called community-
acquired pneumonia. Causes include:
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Hospital-acquired pneumonia (HAP)

You can get hospital-acquired pneumonia (HAP) while in a hospital or healthcare

facility for another illness or procedure. HAP is usually more serious than
community-acquired pneumonia because it’s often caused by antibiotic-resistant
bacteria, like methicillin-resistant Staphylococcus aureus (MRSA). This means HAP
can make you sicker and be harder to treat.

Healthcare-associated pneumonia (HCAP)

You can get HCAP while in a long-term care facility (such as a nursing home) or
outpatient, extended-stay clinics. Like hospital-acquired pneumonia, it’s usually
caused by antibiotic-resistant bacteria.

Ventilator-associated pneumonia (VAP)

If you need to be on a respirator or breathing machine to help you breathe in the

hospital (usually in the ICU), you’re at risk for ventilator-associated pneumonia
(VAP). The same types of bacteria as community-acquired pneumonia, as well as
the drug-resistant kinds that cause hospital-acquired pneumonia, cause VAP.

Aspiration pneumonia

Aspiration is when solid food, liquids, spit or vomit go down your trachea (windpipe)
and into your lungs. If you can’t cough these up, your lungs can get infected.

Symptoms
Symptoms of bacterial pneumonia

Symptoms of bacterial pneumonia can develop gradually or suddenly. Symptoms

include:

High fever (up to 105 F or 40.55 C).

Cough with yellow, green or bloody mucus.

Tiredness (fatigue).

Rapid breathing.

Shortness of breath.

Rapid heart rate.

Sweating or chills.

Chest pain and/or abdominal pain, especially with coughing or deep breathing.

Loss of appetite.
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Bluish skin, lips or nails (cyanosis).

Confusion or altered mental state.

Symptoms of viral pneumonia

Symptoms of viral pneumonia usually develop over several days. You might have
symptoms similar to bacterial pneumonia or you might additionally have:

Dry cough.

Headache.

Muscle pain.

Extreme tiredness or weakness.

Symptoms of pneumonia in young children

Babies and newborns may not show any symptoms of pneumonia or their symptoms
may be different from adults, including:

Fever, chills, general discomfort, sweating/flushed skin.

Cough.

Difficulty breathing or rapid breathing (tachypnea).

Loss of appetite.

Vomiting.

Lack of energy.

Restlessness or fussiness.

Signs you can look for in babies and young children include:

Grunting sound with breathing or noisy breathing.

A decreased amount of pee or diapers that are less wet.

Pale skin.

Limpness.

Crying more than usual.

Difficulty feeding.

Symptoms of pneumonia in adults over 65

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Adults over 65 or those with weakened immune systems may have mild or less
noticeable symptoms of pneumonia (like cough and shortness of breath). Symptoms
of ongoing health conditions may worsen. Older adults may experience:

A sudden change in mental state.

Low appetite.

Fatigue.

diagnose pneumonia?
chest X-ray or CT scan to take pictures of your lungs to look for signs of infection.

 Blood tests: Your provider can use a blood test to help determine what kind
of infection is causing your pneumonia.
 Sputum test: You’re asked to cough and then spit into a container to collect a
sample for a lab to examine. The lab will look for signs of an infection and try
to determine what’s causing it.
 Pulse oximetry: A sensor measures the amount of oxygen in your blood to
give your provider an idea of how well your lungs are working.
 Pleural fluid culture:Your provider uses a thin needle to take a sample of
fluid from around your lungs. The sample is sent to a lab to help determine
what’s causing the infection.
 Arterial blood gas test: Your provider takes a blood sample from your wrist,
arm or groin to measure oxygen levels in your blood to know how well your
lungs are working.
 Bronchoscopy: In some cases, your provider may use a thin, lighted tube
called a bronchoscope to look at the inside of your lungs. They may also take
tissue or fluid samples to be tested in a lab.

Prevention of pneumonia
1. Vaccination:- Vaccines are available to prevent pneumonia caused by certain bacteria and
viruses. The pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide
vaccine (PPSV23) protect against pneumococcal pneumonia, while the influenza vaccine
helps prevent pneumonia caused by the influenza virus.

2. Hand Hygiene:- Regular handwashing with soap and water, or using alcohol-based hand
sanitizers, can help prevent the spread of respiratory viruses and bacteria that can cause
pneumonia.
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3. Respiratory Hygiene:- Covering your mouth and nose with a tissue or your elbow when
coughing or sneezing can help prevent the spread of respiratory droplets containing infectious
agents.

4. Avoid Smoking:- Smoking damages the lungs and increases the risk of respiratory
infections, including pneumonia. Avoiding smoking and secondhand smoke exposure can
reduce the risk of pneumonia.

5. Healthy Lifestyle:- Eating a balanced diet, getting regular exercise, and maintaining a
healthy weight can support overall immune function and reduce the risk of infections,
including pneumonia.

6. Avoiding Exposure to Environmental Irritants:- Limiting exposure to air pollutants,

chemicals, and other environmental irritants can help protect the lungs and reduce the risk of
respiratory infections.

7. Prompt Treatment of Respiratory Infections: Seeking medical attention promptly for

respiratory infections such as the common cold or flu can help prevent complications such as
pneumonia.

8. Good Respiratory Practices: Practicing good respiratory hygiene, such as avoiding close
contact with individuals who are sick and staying home when you are ill, can help prevent the
spread of respiratory infections.

Treatment

1. Amoxicillin:- It works by inhibiting the formation of bacterial cell walls, leading to the
weakening and eventual death of the bacteria.

2. Azithromycin and Clarithromycin:-These macrolide antibiotics inhibit bacterial protein

synthesis by binding to the bacterial ribosome, thereby preventing the translation of mRNA
into proteins essential for bacterial growth and reproduction.

3. Levofloxacin:- Levofloxacin is a fluoroquinolone antibiotic that works by inhibiting the

bacterial enzymes DNA gyrase and topoisomerase IV, which are essential for DNA
replication, repair, and transcription. By interfering with these processes, levofloxacin
prevents bacterial growth and reproduction.

4. Ceftriaxone:- As a third-generation cephalosporin antibiotic, ceftriaxone works by

disrupting bacterial cell wall synthesis, leading to cell lysis and bacterial death.

It is the most common infectious cause of death in the United States, where an estimated 4 million
cases occur annually. When certain microbes enter the lungs of susceptible individuals, they release
damaging toxins, stimulating inflammation and immune responses that
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have damaging side effects. The toxins and immune response damage

alveoli and bronchial mucous membranes; inflammation and edema cause the alveoli to fill with
fluid, interfering with ventilation and gas exchange.

The most common cause of pneumonia is the pneumococcal

bacterium Streptococcus pneumoniae, but other microbes may also

cause pneumonia. Those who are most susceptible to pneumonia are

the elderly, infants, immunocompromised individuals (AIDS or cancer

patients, or those taking immunosuppressive drugs), cigarette smokers, and individuals with an
obstructive lung disease. Most cases of

pneumonia are preceded by an upper respiratory infection that often

is viral. Individuals then develop fever, chills, productive or dry cough,

malaise, chest pain, and sometimes dyspnea (difficult breathing) and

hemoptysis (spitting blood).

Treatment may involve antibiotics, bronchodilators, oxygen therapy,

increased fluid intake, and chest physiotherapy (percussion, vibration,

and postural drainage).

Bacteria: Infection with Streptococcus pneumoniae bacteria, also called

pneumococcal disease, is the most common cause of CAP. Pneumococcal disease
can also cause ear infections, sinus infections and meningitis. Mycoplasma
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pneumoniae bacteria causes atypical pneumonia, which usually has milder

symptoms. Other bacteria that cause CAP include Haemophilus
influenza, Chlamydia pneumoniae and Legionella (Legionnaires’ disease).

Viruses: Viruses that cause the common cold, the flu (influenza), COVID-19 and
respiratory syncytial virus (RSV) can sometimes lead to pneumonia.

Fungi (molds): Fungi, like Cryptococcus, Pneumocystis jirovecii and Coccidioides,

are uncommon causes of pneumonia. People with compromised immune systems
are most at risk of getting pneumonia from a fungus.

Protozoa: Rarely, protozoa like Toxoplasma cause pneumonia.