Pneumonia

What is it?

Pneumonia is an acute respiratory infection of the lungs: the air sacs fill with pus and fluid, making breathing painful and limiting the oxygen taken in (WHO).

According to WHO it accounted for 14% of deaths in children under five, i.e. about 740,000 children in 2019; these mortality data are specific to children and do not reflect adults.

Causes

According to the NHS: usually a bacterial or viral infection, and it may follow flu, respiratory syncytial virus or COVID-19, rarely fungal, and it may result from inhaling food or fluids into the lung.

In children, according to WHO: Streptococcus pneumoniae is the most common bacterial cause, followed by Haemophilus influenzae type b, and respiratory syncytial virus is the most common virus, and Pneumocystis in infants with HIV.

Risk factors

According to the NHS: infants, older adults, and people with heart or lung disease or weakened immunity. According to WHO in children: malnutrition, not being exclusively breastfed, HIV infection or measles, exposure to indoor air pollution, overcrowding and parental smoking.

Symptoms

Cough, shortness of breath, high temperature, chest pain, body aches, severe tiredness, loss of appetite, and a wheezing or grunting sound when breathing; confusion may appear in older people (NHS).

In children: cough or difficulty breathing with or without fever, and fast breathing or lower chest indrawing; in severe cases, inability to breastfeed or eat, loss of consciousness, low temperature and seizures (WHO).

How is it diagnosed?

A chest X-ray and blood tests may be done to confirm the diagnosis and rule out other conditions (NHS). In children under five, WHO diagnosis is based on cough or difficulty breathing with fast breathing or chest indrawing.

Treatment

The treatment categories usually used are listed here; this is not a prescription. The doctor chooses the plan according to each person's condition; do not change any medicine or dose without a specialist.

Bacterial cases are treated with antibiotics, and recovery usually takes 2 to 4 weeks. The NHS recommends hospital admission for people over 65, those with heart or lung disease, those whose illness is severe or who have not improved on antibiotics, and oxygen and corticosteroids may be given. At home: rest, fluids, fever-reducing medicines and simple painkillers, while avoiding cough medicines because coughing helps recovery.

For children, WHO considers amoxicillin dispersible tablets the first-line treatment, and the oral antibiotic can be given at community level under the supervision of trained staff. No doses are given.

Prevention

Vaccines: according to the NHS, pneumococcal, flu, respiratory syncytial virus (for defined groups) and COVID-19 vaccines according to the national programme, and the groups and timing differ between countries. According to WHO for children: immunisation against Haemophilus influenzae, pneumococcus, measles and whooping cough, exclusive breastfeeding for 6 months, and reducing indoor air pollution and overcrowding.

General measures include covering the mouth when coughing, hygiene, and quitting smoking (NHS).

Common questions