When Can I Return To Work School And Regular Activities If I Have Pneumonia
You typically can resume your normal activities if your symptoms are gone, mild or improving and you do not have new or worsening:
- Shortness of breath or tiredness
- Chest pain
- Mucus, fever or cough
If you are generally healthy, most people feel well enough to return to previous activities in about a week. However, it may take about a month to feel totally back to normal.
What Are The Symptoms Of Pneumonia
Pneumonia symptoms can vary from so mild you barely notice them, to so severe that hospitalization is required. How your body responds to pneumonia depends on the type germ causing the infection, your age and your overall health.
The signs and symptoms of pneumonia may include:
- Cough, which may produce greenish, yellow or even bloody mucus
- Fever, sweating and shaking chills
- Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
- Loss of appetite, low energy, and fatigue
- Nausea and vomiting, especially in small children
- Confusion, especially in older people
Etiology Of Bacterial Pneumonia
Although pneumonia may be caused by myriad pathogens, a limited number of agents are responsible for most cases, Most authors categorize bacterial pneumonias by their infectious agents, which include pneumococcal agents Haemophilus influenzae Klebsiella, Staphylococcus, and Legionella species gram-negative organisms and aspirated micro-organisms. Microaspiration of organisms that colonize the upper respiratory tract and mucosal surfaces is probably the most common mode of infection. Some agents, notably Staphylococcus species, may be spread hematogenously.
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Medical History And Physical Exam
- Exposure to sick people at home, school, or work or in a hospital
- Flu or pneumonia vaccinations
- Exposure to birds and other animals
During your physical exam, your doctor will check your temperature and listen to your lungs with a stethoscope.
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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What Health Complications Can Pneumonia Lead To
If you have flu-like symptoms that persist or worsen despite treatment, talk to your doctor.
Your doctor can monitor your lungs while you inhale, listening for crackling sounds that are audible only with a stethoscope.
In order to confirm the diagnosis and identify the specific germ causing the illness, you may get a chest X-ray as well as a blood test, depending on your medical history and physical exam, if your doctor suspects that you have pneumonia.
If left untreated, pneumonia can become severe.
People with severe pneumonia experience higher fevers along with GI symptoms, such as vomiting and diarrhea, as well as:
- Difficulty breathing
Preventing Transmission Of Covid
At this time there is no vaccine and no medication available that can prevent COVID-19. However, there are a number of ways to protect yourself and others around you from getting COVID-19. To help prevent the spread of COVID-19 within the community, the governments throughout the world and in the United States are recommending that people wear cloth masks or face coverings and practice social distancing. Steps to follow in preventing the spread of COVID-19 include:
- Avoid crowded public places and large or small gatherings.
- Stay at least 6 feet from other people.
- Always wear a face mask or cloth face cover when you will be around other people.
- Work from home .
- If possible, avoid public transportation and rideshares.
If you have COVID-19 or have symptoms of it, you must isolate yourself at home and avoid contact with other people, both inside and outside your home, to avoid spreading the illness. This is called home isolation. Steps to follow in home isolation for COVD-19 include:
For the most up-to-date news and information about COVID-19, you can visit the following websites:
Centers for Disease Control and Prevention website. Coronavirus Disease 2019 . www.cdc.gov/coronavirus/2019-ncov/index.html
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Antibioticsor Wait It Out
Along with a physical exam, your doctor may take a sputum culture, chest X-ray, and blood work to determine if you have a viral or bacterial form of pneumonia, Turner says.
Your diagnosis is important since it helps determine treatment. If you have viral pneumonia, I wouldnt prescribe to you an antibiotic, says Dr. Brown.
Thats for three important reasons. First, antibiotics simply dont work to treat viruses. And, they can lead to unpleasant side effects . Finally, unnecessary use of antibiotics means that they might not be effective when you do actually need them for treatment, says Dr. Brown. We always strive to give the right treatment to the right patient at the right time, she notes.
How Is Pneumonia Treated
Treatment depends on the type of pneumonia you have. Most of the time, pneumonia is treated at home, but severe cases may be treated in the hospital. Antibiotics are used for bacterial pneumonia. Antibiotics may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have specific treatment. They usually get better on their own.
Other treatment may include eating well, increasing fluid intake, getting rest, oxygen therapy, pain medicine, fever control, and maybe cough-relief medicine if cough is severe.
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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.
Is Pneumonia Treated Any Differently In Children
Essentially no. Just like adults, bacterial causes of pneumonia in children may be treated with antibiotics. Antibiotics are not used to treat pneumonia caused by viruses. Flu-related pneumonia may be treated with antiviral medicine if caught early in the course of illness. Most cases of pneumonia are treated with comfort care measures that ease symptoms. These may include:
- Drinking more fluids.
- Getting more rest.
- Taking over-the-counter medicines for cough and acetaminophen for fever. Be sure to check with your healthcare provider or pharmacist if you have any questions or concerns about giving medicines to your child.
- Using a cool mist humidifier in your childs room.
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What’s The Connection Between Coronavirus And Pneumonia
Infection with SARS-CoV-2 begins when respiratory droplets containing the virus enter your body through your upper respiratory tract. As the virus multiplies, the infection can progress to your lungs and can further spread the infection. During this time, the chances of developing pneumonia become high and thus can lead to COVID-19 pneumonia.
Now, the question comes – how does this actually happen? Well, the oxygen you breathe into your lungs crosses into your bloodstream inside the alveoli, the small air sacs which are present in your lungs. However, infection with SARS-CoV-2 can damage the alveoli and surrounding tissues.
Further, as your immune system fights the virus, inflammation can cause fluid and dead cells to build up in your lungs. These factors interfere with the transfer of oxygen, leading to symptoms like severe coughing and extreme shortness of breath.
According to the studies, people infected with COVID-19 pneumonia can also go on to develop other illnesses such as acute respiratory distress syndrome . Acute respiratory distress syndrome is a progressive type of respiratory failure that occurs when the air sacs in the lungs fill up with fluid. This can make it the person hard to breathe and thus leads to breathlessness.
At times, such patients are also put under ventilation for life support.
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.
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
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How Is Pneumonia Diagnosed
Sometimes pneumonia can be difficult to diagnose because the symptoms are so variable, and are often very similar to those seen in a cold or influenza. To diagnose pneumonia, and to try to identify the germ that is causing the illness, your doctor will ask questions about your medical history, do a physical exam, and run some tests.
Your doctor will ask you questions about your signs and symptoms, and how and when they began. To help figure out if your infection is caused by bacteria, viruses or fungi, you may be asked some questions about possible exposures, such as:
- Any recent travel
- Exposure to other sick people at home, work or school
- Whether you have recently had another illness
Your doctor will listen to your lungs with a stethoscope. If you have pneumonia, your lungs may make crackling, bubbling, and rumbling sounds when you inhale.
If your doctor suspects you may have pneumonia, they will probably recommend some tests to confirm the diagnosis and learn more about your infection. These may include:
- Blood tests to confirm the infection and to try to identify the germ that is causing your illness.
- Chest X-ray to look for the location and extent of inflammation in your lungs.
- Pulse oximetry to measure the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
- Sputum test on a sample of mucus taken after a deep cough, to look for the source of the infection.
What Is Bacterial Pneumonia
Bacteria are the most common cause of pneumonia in adults.
Types of bacteria that cause pneumonia include:
- Streptococcus pneumoniae
- Chlamydophila pneumoniae
- Haemophilus influenzae type B
Streptococcus pneumoniae, also known as pneumococcus, is the most common cause of bacterial pneumonia in adults, called pneumococcal pneumonia.
It may be prevented by a vaccine. The Centers for Disease Control and Prevention recommends two pneumonia vaccines for adults 65 years and older: pneumococcal conjugate vaccine, or Prevnar 13 , and pneumococcal polysaccharide vaccine, or Pneumovax 23 .
According to the CDC:
- You should receive a dose of the pneumococcal conjugate vaccine first, followed at least one year later by a dose of the pneumococcal polysaccharide vaccine .
- If you’ve already received any doses of PPSV23, the dose of PCV13 should be given at least one year after the most recent PPSV23 dose.
- If you’ve already received a dose of the PCV13 at a younger age, another dose is not recommended.
Mycoplasma pneumoniae usually infects younger adults who work in crowded areas, such as schools, homeless shelters, or prisons.
Chlamydophila pneumoniae causes a mild pneumonia infection that usually affects people older than 60.
Other bacterial pneumonia symptoms include:
- High fever
- Sore throat
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Take Steps To Help Your Body Recover
The following steps can help your body recover from pneumonia.
- Choose heart-healthy foods, because good nutrition helps your body recover.
- Drink plenty of fluids to help you stay hydrated.
- Dont drink alcohol or use illegal drugs. Alcohol and illegal drugs weaken your immune system and can raise the risk of complications from pneumonia.
- Dont smoke and avoid secondhand smoke. Breathing in smoke can worsen your pneumonia. Visit Smoking and Your Heart and Your Guide to a Healthy Heart. For free help quitting smoking, you may call the National Cancer Institutes Smoking Quitline at 1-877-44U-QUIT .
- Get plenty of sleep. Good quality sleep can help your body rest and improve the response of your immune system. For more information on sleep, visit our How Sleep Works health topic.
- Get light physical activity. Moving around can help you regain your strength and improve your recovery. However, you may still feel short of breath, and activity that is too strenuous may make you dizzy. Talk to your doctor about how much activity is right for you.
- Sit upright to help you feel more comfortable and breathe more easily.
- Take a couple of deep breaths several times a day.
Diagnosis Of Bacterial Pneumonia
Tools to assess the severity of disease and risk of death include the PSI/PORT , the CURB-65 system, and the APACHE , among others.
The following laboratory tests are also useful for assessing illness severity:
Serum chemistry panel
Arterial blood gas determination
Venous blood gas determination
Complete blood cell count with differential
Serum free cortisol value
Serum lactate level
Sputum Gram stain and culture should be performed before initiating antibiotic therapy. A single predominant microbe should be noted at Gram staining, although mixed flora may be observed with anaerobic infection caused by aspiration.
Chest radiography: The criterion standard for establishing the diagnosis of pneumonia
Chest computed tomography scanning
Lung tissue can be visually evaluated and bronchial washing specimens can be obtained with the aid of a fiberoptic bronchoscope. Protected brushings and bronchoalveolar lavage can be performed for fluid analysis and cultures.
This is an essential procedure in patients with a parapneumonic pleural effusion. Analysis of the fluid allows differentiation between simple and complicated effusions.
Sputum, serum, and/or urinary antigen tests
Immune serologic tests
Histologic inflammatory lung changes vary according to whether the patient has lobar pneumonia, bronchopneumonia, or interstitial pneumonia.
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Other Ways To Prevent Pneumonia
You can take the following steps to help prevent pneumonia:
- Wash your hands with soap and water or alcohol-based hand sanitizers to kill germs.
- Dont smoke. Smoking prevents your lungs from properly filtering out and defending your body against germs. For information about how to quit smoking, visit Smoking and Your Heart and Your Guide to a Healthy Heart. These resources include basic information about how to quit smoking. For free help and support, you may call the National Cancer Institutes Smoking Quitline at 1-877-44U-QUIT .
- Keep your immune system strong. Get plenty of physical activity and follow a healthy eating plan. Read more about heart-healthy living.
- If you have problems swallowing, eat smaller meals of thickened foodand sleep with the head of your bed raised up. These steps can help you avoid getting food, drink, or saliva into your lungs.
- If you have a planned surgery, your doctor may recommend that you dont eat for 8 hours or drink liquids for 2 hours before your surgery. This can help prevent food or drink from getting into your airway while you are sedated.
- If your immune system is impaired or weakened, your doctor may recommend you take antibiotics to prevent bacteria from growing in your lungs.
What Increases Your Risk Of Bacterial Pneumonia
Anyone of any age can develop bacterial pneumonia, but there are certain factors that can increase a persons risk. Risk factors for bacterial pneumonia include:
- Being an infant or child
- Being a senior
- Living with impaired or weakened immune system
- Using immunosuppressant drugs for a long time
- Having chronic obstructive pulmonary disease
- Using inhaled steroids for a long time
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