What Are The 4 Stages Of Pneumonia
Pneumonia is a serious infection that affects the lungs, particularly in children, older adults, and those with weakened immune systems. The lungs are made up of air sacs that expand and contract with the air you breathe in and out. If fluid or pus gets into those air sacs, it can lead to symptoms of pneumonia. In order to diagnose pneumonia, your doctor will likely want to run a series of tests, including blood tests to confirm if an infection is present, pulse oximetry to measure the level of oxygen in your blood, and a chest X-ray. An X-ray of your chest can help your doctor get a better look at your lungs and better assess what stages of pneumonia you are experiencing. A CT scan can also provide more detailed images of your lungs and chest. Visit an Atlanta Imaging Center near you to get a chest X-ray and CT scan. Your doctor can also talk to you about the four stages of pneumonia and your treatment options.
Respiratory And Circulatory Failure
Pneumonia can cause respiratory failure by triggering acute respiratory distress syndrome , which results from a combination of infection and inflammatory response. The lungs quickly fill with fluid and become stiff. This stiffness, combined with severe difficulties extracting oxygen due to the alveolar fluid, may require long periods of mechanical ventilation for survival. Other causes of circulatory failure are hypoxemia, inflammation, and increased coagulability.
is a potential complication of pneumonia but usually occurs in people with poor immunity or hyposplenism. The organisms most commonly involved are Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae. Other causes of the symptoms should be considered such as a myocardial infarction or a pulmonary embolism.
How Your Doctor Chooses
Your doctor will select the right antibiotic for you based on multiple factors, including:
- Your age: People 65 and older have a greater risk of serious complications from pneumonia infections.
- Your health history: A history of smoking, lung diseases, or other conditions may influence a person’s ability to fight off infections.
- The exact infection you have: Your doctor may take a sample and test it for bacteria. They can then pick an antibiotic based on your specific infection.
- Your previous experiences with antibiotics: Make sure to tell your doctor if you are allergic to any medications, had bad reactions to antibiotics in the past, or have developed an antibacterial-resistant infection.
- The antibiotic sensitivity of the bacteria: The lab will test the bacteria causing your pneumonia to determine which antibiotics it is sensitive or resistant to.
Doctors typically choose your antibiotics prescription based on what medicines they think will be most effective and cause the fewest side effects.
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Mild Moderate Or Severe Pneumonia
To be able to provide the right treatment, doctors also classify community-acquired pneumonia as mild, moderate or severe. They take the risk of complications into account as well.
Pneumonia is considered to be mild with no increased risk if the patient
- is younger than 65 years old,
- is conscious and lucid,
- has normal blood pressure and pulse,
- is not breathing too fast ,
- has enough oxygen in their blood,
- has not been given any in the past three months,
- has not been in the hospital in the past three months, and
- does not have any other severe medical conditions.
People with mild pneumonia can be treated at home and are given in tablet form.
The signs of moderate pneumonia include drowsiness and confusion, low blood pressure, worsening shortness of breath, and risk factors such as old age and underlying diseases. People with these symptoms need to have treatment at a hospital. Some will be given a combination of two different , at least at the beginning of the treatment.
Pneumonia is classified as severe when the heart, the kidneys or the circulatory system are at risk of failing, or if the lungs can no longer take in enough oxygen. Treatment with an antibiotic infusion in intensive care is then usually needed, sometimes with artificial respiration or additional drugs such as corticosteroids.
Pneumonia in children is only classified as either not severe or severe.
How Common Is Pneumonia

Approximately 1 million adults in the United States are hospitalized each year for pneumonia and 50,000 die from the disease. It is the second most common reason for being admitted to the hospital — childbirth is number one. Pneumonia is the most common reason children are admitted to the hospital in the United States. Seniors who are hospitalized for pneumonia face a higher risk of death compared to any of the top 10 other reasons for hospitalization.
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What Can I Do To Feel Better If I Have Pneumonia
- Finish all medications and therapies prescribed by your doctor. Do not stop taking antibiotics when you start feeling better. Continue taking them until no pills remain. If you dont take all your antibiotics, your pneumonia may come back.
- If over-the-counter medicines to reduce fever have been recommended , take as directed on the label. Never give aspirin to children.
- Drink plenty of fluids to help loosen phlegm.
- Quit smoking if you smoke. Dont be around others who smoke or vape. Surround yourself with as much clean, chemical-free air as possible.
- Use a humidifier, take a steamy shower or bath to make it easier for you to breathe.
- Get lots of rest. Dont rush your recovery. It can take weeks to get your full strength back.
If at any time you start to feel worse, call your doctor right away.
Types Of Antibiotics For Pneumonia
There are multiple types of antibiotics that work in slightly different ways. Some are more commonly used to treat pneumonia than others based on things like:
- The bacteria causing infection
- The severity of the infection
- If youre in a patient group at greatest risk from pneumonia
The types of antibiotics that your doctor might typically prescribe for pneumonia include the following:
Antibiotics prescribed for children with pneumonia include the following:
- Infants, preschoolers, and school-aged children with suspected bacterial pneumonia may be treated with amoxicillin.
- Children with suspected atypical pneumonia can be treated with macrolides.
- Children allergic to penicillin will be treated with other antibiotics as needed for the specific pathogen.
- Hospitalized, immunized children can be treated with ampicillin or penicillin G.
- Hospitalized children and infants who are not fully vaccinated may be treated with a cephalosporin.
- Hospitalized children with suspected M. pneumoniae or C. pneumoniae infection may be treated with combination therapy of a macrolide and a beta-lactam antibiotic .
- Hospitalized children with suspected S. aureus infections might be treated with a combination of Vancocin or clindamycin and a beta-lactam.
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What Are The Complications Of Pneumonia
Most people with pneumonia respond well to treatment, but pneumonia can be very serious and even deadly.
You are more likely to have complications if you are an older adult, a very young child, have a weakened immune system, or have a serious medical problem like diabetes or cirrhosis. Complications may include:
-
Acute respiratory distress syndrome . This is a severe form of respiratory failure.
-
Lung abscesses. These are pockets of pus that form inside or around the lung. They may need to be drained with surgery
-
Respiratory failure. This requires the use of a breathing machine or ventilator.
-
This is when the infection gets into the blood. It may lead to organ failure.
What Stands Out About Yale Medicines Approach To Pneumonia
Pneumonia is a common infection in both children and adults and can often be easily treated. However, if specialized care is required, Yale Medicine physicians practice at both Yale New Haven Hospital and Yale New Haven Childrens Hospital.
Furthermore, our researchers are involved in developing ways to more quickly and accurately diagnose lung infections through the Yale Center for Pulmonary Infection Research and Treatment . We dont tend to think of pneumonia as a chronic condition. But some patients end up with longer-term problems, says Dr. Dela Cruz, director of the CPIRT. The center focuses on finding new potential treatment options and running clinical trials to better understand the disease.
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How Is Walking Pneumonia Different
Walking pneumonia, also known as atypical pneumonia, is caused by mycoplasma pneumoniae bacteria. It usually causes cold-like symptoms, in addition to a fever and a hacking cough. It is most common in school-aged children and young adults, says Annette Cameron, MD, a Yale Medicine pediatrician.
Because this type of pneumonia typically causes milder symptoms, it may go undiagnosed for a while, especially if the child is able to participate in normal activities and isnt as visibly sick as he or she would be with other forms of pneumonia. And thats why its called walking pneumonia, Dr. Cameron says. It might just be a little bit of malaise. Sometimes you can have community-acquired, or bacterial pneumonia, along with walking pneumonia, in which case we would just treat both of them.
Whats The Treatment Like For Pneumonia In Older Adults
Some cases of pneumonia in older adults can be treated at home. However, depending on your symptoms and overall health, its also possible that you may be hospitalized.
Antibiotics are used to treat pneumonia thats caused by bacteria. The types of antibiotics used can depend on the type of bacteria causing the infection and on the infections severity. They may be given orally or .
Some examples of antibiotics used for pneumonia can include one or a combination of the following:
- macrolides
- beta-lactams
Viruses cant be treated with antibiotics.
Treatment of viral pneumonia focuses on supportive care, such as easing symptoms, maintaining hydration, and monitoring vital signs. In some cases, antiviral drugs may be used.
In the case of the flu, an antiviral, such as Tamiflu, may be prescribed.
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Questions About Your Symptoms
Bacterial pneumonia, which is the most common form, tends to be more serious than other types of pneumonia, with symptoms that require medical care. The symptoms of bacterial pneumonia can develop gradually or suddenly. Fever may rise as high as a dangerous 105 degrees F, with profuse sweating and rapidly increased breathing and pulse rate. Lips and nailbeds may have a bluish color due to lack of oxygen in the blood. A patient’s mental state may be confused or delirious.
The symptoms of viral pneumonia usually develop over a period of several days. Early symptoms are similar to influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness. Within a day or two, the symptoms typically get worse, with increasing cough, shortness of breath and muscle pain. There may be a high fever and there may be blueness of the lips.
Symptoms may vary in certain populations. Newborns and infants may not show any signs of the infection. Or, they may vomit, have a fever and cough, or appear restless, sick, or tired and without energy. Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness. For individuals that already have a chronic lung disease, those symptoms may worsen.
When to call a doctor
How Soon After Treatment For Pneumonia Will I Begin To Feel Better

How soon you will feel better depends on several factors, including:
- Your age
- The cause of your pneumonia
- The severity of your pneumonia
- If you have other at-risk conditions
If you are generally healthy, most symptoms of bacterial pneumonia usually begin to improve within 24 to 48 hours after starting treatment. Symptoms of viral pneumonia usually begin to improve within a few days after starting treatment. A cough can last for several weeks. Most people report being tired for about a month after contracting pneumonia.
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Atypical Pneumonia And Their Symptoms
Atypical pneumonia is a term that included pneumonia caused by several different organisms. The most of these is a bacterium called Mycoplasma. Mycoplasma pneumonia is also called walking pneumonia because most patients have only mild symptoms. They could even be unaware that they have pneumonia.
Here are some of the common symptoms of walking pneumonia:
- Dry cough
- Headaches
Elderly At Increased Risk For Pneumonia
Every day people encounter germs that cause pneumonia, but the young and healthy are rarely in danger. However, seniors are at a significantly increased risk. Pneumonia tends to be far more aggressive with the elderly.
The reasons why pneumonia attacks aging individuals:
- Aging immune system that is less effective at fighting off infections
- Chronic illnesses such as diabetes and heart disease
- Lung related problems like chronic obstructive pulmonary disease
- Frailty that makes it hard to produce a strong cough
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How Is Pneumonia Spread From Person To Person
Pneumonia is spread when droplets of fluid containing the pneumonia bacteria or virus are launched in the air when someone coughs or sneezes and then inhaled by others. You can also get pneumonia from touching an object previously touched by the person with pneumonia or touching a tissue used by the infected person and then touching your mouth or nose.
Pleural Effusion Empyema And Abscess
In pneumonia, a collection of fluid may form in the space that surrounds the lung. Occasionally, microorganisms will infect this fluid, causing an empyema. To distinguish an empyema from the more common simple parapneumonic effusion, the fluid may be collected with a needle , and examined. If this shows evidence of empyema, complete drainage of the fluid is necessary, often requiring a drainage catheter. In severe cases of empyema, surgery may be needed. If the infected fluid is not drained, the infection may persist, because antibiotics do not penetrate well into the pleural cavity. If the fluid is sterile, it must be drained only if it is causing symptoms or remains unresolved.
In rare circumstances, bacteria in the lung will form a pocket of infected fluid called a lung abscess. Lung abscesses can usually be seen with a chest X-ray but frequently require a chest CT scan to confirm the diagnosis. Abscesses typically occur in aspiration pneumonia, and often contain several types of bacteria. Long-term antibiotics are usually adequate to treat a lung abscess, but sometimes the abscess must be drained by a surgeon or radiologist.
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Critical Role Of Pneumococcal Vaccine In Preventing Pneumonia
In children aged three months to four years, the most common type of bacterial pneumonia is Strep. pneumoniae. In children greater than age four, it remains in the top three most common types. The pneumococcal vaccine series, started at two months of age, significantly reduces the rates of bacterial pneumonia from Strep. Pneumoniae. The vaccine is usually administered during wellness or prevention visits and cannot be given to a child with a fever. This emphasizes the need for healthcare access globally.6
With global vaccination rates currently plateauing, the challenges of diagnosing and treating community acquired pneumonia are even more pertinent for prevention of severe respiratory illness. Vaccine uptake challenges can be overcome with global measures to increase the access and use of vaccines. Addressing vaccine use and providing education about common pneumonia symptoms can aid in early diagnosis of pneumonia and lower the rate of severe respiratory illness and prolonged hospitalization.
References
World Health Organization Health Topics. Immunization, Vaccines and Biologicals: National programs and systems on improving vaccination demand and addressing hesitancy. 17 June 2020 update.
Popovsky EY, Florin TA. Community-Acquired Pneumonia in Childhood. Reference Module in Biomedical Sciences. 2020 B978-0-08-102723-3.00013-5. doi:10.1016/B978-0-08-102723-3.00013-5
How Long Youll Take Them
A course of antibiotics for uncomplicated pneumonia treatment is usually for five to seven days. One course will usually be enough to cure your pneumonia. In some cases, you may need more than one course of antibiotics if your infection doesnt start improving or it seems like its not responding to the medications.
Stay in touch with your doctor to ensure your infection is clearing up. Youll likely start to feel better and have some symptom relief one to three days after you start your pneumonia treatment, but it may take a week or more for your symptoms to go away completely.
Taking your medication as prescribed, especially for antibiotics, is incredibly important. Even if youre feeling better, you need to take the entire course.
Do not stop taking antibiotics early, even if your symptoms improve, as the infection would not be fully treated and could become antibiotic-resistant. This will make treatment more complicated. If youre experiencing side effects, talk to your doctor. Only stop your medication if your doctor tells you its OK to do so.
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How Can I Tell If I Have Pneumonia Versus The Common Cold Or The Flu
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Watch for these ongoing symptoms that occur in pneumonia:
- Serious congestion or chest pain.
- Difficulty breathing.
- A fever of 102 or higher.
- Coughing that produces pus.
Pneumonia symptoms last longer than cold and flu. If your symptoms arent severe, its okay to try such home remedies as getting more rest, drinking more fluids and taking some over-the-counter medicines and see what happens. But if you dont see improvement in your symptoms after three to five days, or if you are experiencing more serious symptoms such as dizziness or severe difficulty breathing, see your healthcare provider. Dont let it go. Pneumonia-like symptoms in very young children or in adults older than 65 are a cause for concern. Also, pneumonia can cause permanent lung damage if left untreated for too long. And always seek immediate care if you experience chest pain or have breathing difficulties.