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What is pneumonia and what are its symptoms?

What is pneumonia and what are its symptoms?
In the UK, 150,000 people develop pneumonia every year. We explore the causes and symptoms of pneumonia, and what to do if you catch it
In the UK, 150,000 people develop pneumonia each year. Most cases are bacterial, and thanks to effective antibiotics, the vast majority of people recover. However, the condition can be fatal. In the UK, 3,000 people aged between 15 and 55 die from pneumonia each year, and the disease causes up to a quarter of all deaths in elderly people.
"Pneumonia" is a general term for an acute inflammation of the lungs—specifically the air sacs (alveoli). The many types of pneumonia are all caused by infection with one of three micro-organisms: bacteria, viruses and mycoplasma
Pneumonias caused by mycoplasma are rarely life-threatening, but can take a long time to clear up. Viral pneumonia is less serious than the other forms.
Pneumonia is the third most common infection acquired by patients staying in hospital. One to two per cent of all post-operative patients and 25 per cent of those in intensive care pick up the infection. The death rate from hospital-acquired pneumonia is much greater than that from pneumonia caught in day-to-day life. 
About two-thirds of people who acquire pneumonia in hospital and half of those who develop it while in intensive care survive.

Who is at risk?

Anyone can develop pneumonia, but people who are most at risk are:
  • the very young
  • elderly people
  • people with underlying health problems, such as chronic obstructive pulmonary disease, diabetes, heart problems, AIDS or asthma
  • people with a weak immune system, such as those undergoing chemotherapy or radiotherapy treatments for cancer or those who have recently had a transplant
  • people in inadequate housing
In addition, major risk factors include:
  • excess alcohol
  • cigarette smoking
  • the infection bronchiectasis, which affects the smallest airways in the lungs
  • obstruction in the airways
  • drug abuse

Symptoms

The symptoms vary from person to person and also depending on the cause of the pneumonia. The main symptoms include:
  • a cough—this may start off dry, but within a couple of days you will start to bring up mucus. People infected with mycoplasma will probably experience very forceful coughs that produce white phlegm
  • infected mucus (sometime blood-flecked)
  • high fever
  • shortness of breath
  • pains in the chest. These are caused by an infection of the sac that contains the lungs and protects them from rubbing against the chest (the pleura). They are usually associated with bacterial forms of pneumonia
In addition, general symptoms include:
  • feeling generally very ill
  • shaking
  • loss of appetite
  • sweating, often profusely
  • headaches
  • aching muscles and joints
Children may experience extra symptoms. If your child is breathless or has a fever with chest pain, you should see a doctor immediately.
Symptoms in children under 18 months:
  • Sudden rise in temperature
  • Fast breathing and difficulty in breathing. Often the distress caused by the infant trying to breathe makes feeding impossible. If breathlessness leads to a blueish tinge around the lips, the child needs immediate medical attention
Symptoms in children over 18 months:
  • Brief cold at first, followed by high temperatures
  • Shaking and chills
  • Possible tummy pains
  • Fast, shallow breathing

Treatments

Pneumonia is a serious disease—the sooner it is diagnosed and treated, the better. If you have the symptoms of pneumonia, especially if they last more than a couple of days, consult your doctor at once.
If you have symptoms of pneumonia that come on very quickly, if you become breathless without any exertion, or if you have a pulse rate that is higher than 100 beats per minute, you should have yourself driven immediately to your nearest casualty department. If you are alone, call an ambulance.
Antibiotics
Bacterial pneumonia can be treated with antibiotics
Most forms of pneumonia are diagnosed from the physical symptoms. In addition, a doctor will probably tap on your chest—the sounds made will help to locate the infection. A chest X-ray may also be taken, as well as a sample of your phlegm, which will be sent for analysis to discover the cause of the pneumonia.
There is no direct treatment for viral pneumonia, but it is generally less severe than pneumonia caused by bacteria or mycoplasma. You may be given painkillers to alleviate chest pain or drugs to reduce fever.
Antibiotics are an effective treatment against bacteria, the most common cause of pneumonia. Antibiotics may also be helpful if you have a pneumonia caused by mycoplasma. Although these drugs do not work directly on mycoplasma, they may help to speed up recovery by preventing the development of any secondary infection.
The doctor will also ask about your recent movements to determine where you may have caught pneumonia. For example, it is significant if you have been travelling abroad. In Spain, 30 per cent of Streptococcus pneumoniae bacteria are resistant to the usual antibiotics.
If there is no noticeable improvement within 48 hours of starting treatment, contact your doctor again. The treatment will probably have to be changed. If symptoms become more severe, go to casualty immediately.
Severe cases of pneumonia require hospital treatment. In hospital, antibiotics may be given intravenously (direct into the bloodstream) and you may also be given pain relief and oxygen.
You can also:
  • Rest in a warm atmosphere
  • Drink plenty of fluids
  • Avoid smoking and smoky atmospheres

Preventing pneumonia

Vaccine for pneumonia
You can get vaccines for the main form of bacterial pneumonia
There is no sure way to prevent all forms of pneumonia. But there are vaccines for the main form of bacterial infection. Since one of the complications of flu is pneumonia, those at risk should have both the vaccine for flu and for bacterial pneumonia.

Complications

Most people make a full recovery from pneumonia, but complications can include: pleural effusion (liquid in the sac enclosing the lungs), which can lead to pleurisy; lung abscess (in less than one per cent of people); blood poisoning; and scarring of the lungs (fibrosis).

Pneumoconiosis

Pneumoconiosis is an occupational disease affecting the lungs. Small areas of inflammation in the lungs, caused by harmful dust particles, eventually result in solid lumps, giving the spotty appearance on a lung X-ray that indicates the disease.
As lung tissues become thickened and inflexible, sufferers become increasingly breathless, with a persistent cough. Pneumoconiosis takes many years to develop, so most cases occur among retired workers.
Types of pneumoconiosis include:
  • silicosis, which is caused by hard rock dust from quarrying
  • asbestosis, caused by asbestos dust
  • coalminers' pneumoconiosis, caused by coal dust
Consult a doctor immediately if you suspect pneumoconiosis. The doctor may order an X-ray to aid with diagnosis, and may recheck you annually. If you have pneumoconiosis, stop the work that is the cause and try to give up smoking
You may be able to claim Industrial Injuries Disablement Benefit—contact your local Citizens Advice Bureau or Benefits Agency for details. Pneumoconiosis can be checked only if caught early. Once the disease takes hold, destruction of lung tissue continues even after the exposure to dust has ceased.
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