In today’s world, pneumonia has come to be one of the most widespread infections one can contract. It affects people of all ages and in the United States alone it affects millions of souls claiming the lives of about 55,000 people annually. It has been proven to be the most prevalent cause of death especially in underdeveloped nations as a consequence of failing medical facilities.
1. What is Pneumonia?
Pneumonia is a respiratory infection that affects the lungs causing the air sacs (alveoli) in it to swell by filling it with fluid or pus. It is brought on by viruses, fungi, or bacteria. The buildup of pus and fluid results in breathing difficulties alongside making you cough up phlegm.
Given that pneumonia can affect anyone irrespective of their age, it tends to strike more frequently and tends to be more severe in individuals who have weak immune systems. As a result of this, elderly people and young children are more at risk.
Pneumonia poses a special risk to patients with major surgical procedures, especially those with chronic disorders like human immunodeficiency virus (HIV/AIDS), cancer, or other underlying ailments. It can affect either of your lungs or in some cases both the lungs. When both lungs are affected, it is known as bilateral or double pneumonia.
Pneumonia brought on by viruses (viral pneumonia) is not as severe as bacterial pneumonia.
2. What are the Types of Pneumonia?
Along with pathogens that cause pneumonia i.e. viruses, bacteria, and fungi, in terms of how you caught it, pneumonia can be categorized into five groups: community-acquired, hospital-acquired, ventilator-associated pneumonia, aspiration pneumonia and walking pneumonia.
Let us now discuss each one of them individually.
2.1. Community-Acquired Pneumonia
Community-acquired pneumonia (CAP) is the term used to describe pneumonia that is obtained outside of a hospital or clinic. This type of pneumonia is often caused by bacteria, viruses, fungi, or protozoa. It accounts for 5–12% of lower respiratory infections in persons who receive care from primary physicians.
Community-acquired pneumonia can further be branched into three groups, these being bacterial, fungal and viral pneumonia.
2.1.1. Bacterial Pneumonia
The primary cause of CAP is infection with the bacteria Streptococcus pneumoniae, often known as pneumococcal illness. Meningitis, sinus infections, and ear infections can all be brought on by pneumococcal illness.
Chlamydia pneumoniae, Legionella, and Haemophilus influenza are additional bacteria that contribute to CAP.
2.1.2. Viral Pneumonia
Pneumonia can occasionally be brought on by viruses that causes sickness such as the common cold, influenza virus, COVID-19, and respiratory syncytial virus (RSV).
2.1.3. Fungal pneumonia
According to the Centers for Disease Control and Prevention (CDC) people with compromised immune systems may be more susceptible to developing fungal pneumonia. However, people with strong immune systems too are likely to contract it.
Fungal infection may happen after breathing in fungus spores or could originate from elements like dirt or animal waste.
2.2. Ventilator-Associated Pneumonia
Patients run the risk of developing ventilator-associated pneumonia (VAP) if they use a respirator or other breathing assistance while receiving medical care (often in the intensive care unit).
Ventilators can be extremely helpful for patients who are seriously ill or recuperating from surgery, but they may also make it a lot easier for pneumonia-causing bacteria to get into the lungs.
2.3. Hospital Acquired Pneumonia
Hospital-acquired pneumonia (HAP) can occur while a patient is receiving treatment for another condition or having surgery at a hospital or healthcare facility. This type of pneumonia can develop in hospitals when the patient’s breathing tubes that healthcare personnel use to support breathing, harm the lungs.
Since HAP is frequently brought on by bacteria that are resistant to antibiotics, such as methicillin-resistant Staphylococcus aureus (MRSA), it is typically more dangerous than community-acquired pneumonia. So, HAP can make you worse and be more challenging to treat.
2.4. Aspiration Pneumonia
When solid food, liquids, saliva, or vomit unknowingly enters your lungs through your trachea (windpipe) and infects your lungs, it is known as aspiration pneumonia.
In such cases, lung infections may result if you are unable to cough these objects out.
2.5. Walking Pneumonia
A bacterial infection is the root of walking pneumonia. Another name for it is atypical bacterial pneumonia.
Mycoplasma pneumoniae, a microorganism, causes atypical pneumonia, which often has milder symptoms because of which some people aren’t even aware of having contracted the infection.
3. Difference between Viral Pneumonia and Bacterial Pneumonia
Although caused by pathogens, bacterial pneumonia, and viral pneumonia differs mainly in its symptoms and effects.
The prevalence and gravity of bacterial pneumonia are typically higher than those caused by viral pneumonia. Because of its severe symptoms, antibiotic treatment is done by doctors and hospitalization is necessary in this type of pneumonia.
Symptoms of viral pneumonia, on the other hand, resemble those of the flu and are more likely to go away on their own and typically don’t require a specific course of therapy.
3. Causes of Pneumonia
It must have been evident by now that pneumonia is caused due to the infection of the lung by various pathogens i.e. viruses, bacteria, or fungi. Older adults are more frequently affected by bacteria, whereas children are most frequently affected by viruses.
Listed below are some of the common illnesses or causes that result in pneumonia:
- SARS-COV-2 (COVID-19)
- The influenza virus, or the flu
- Common cold (rhinovirus)
- HMPV, or human metapneumovirus
- Mycoplasma pneumoniae bacteria
- Pneumococcal disease
- Legionnaires’ disease
- RSV, or respiratory syncytial virus
- HPIV, or human parainfluenza virus
- Pneumocystis pneumonia
4. Symptoms of Pneumonia
Since pneumonia shares some symptoms with the common cold and influenza (the flu), treating it can occasionally be challenging. The intensity of pneumonia symptoms varies according to a person’s health; pneumonia is significantly more difficult to treat and manifests with worsening symptoms in people with weakened immune systems or underlying lung diseases.
4.1 Common Symptoms
Common symptoms of pneumonia include:
- Thick phlegm
- Difficulty breathing
- Dry cough
- Loss of appetite
- Chest pain
- Rapid breathing or shortness of breath
- Muscle pain
4.2. Bacterial Symptoms of Pneumonia
Bacterial pneumonia symptoms include:
- High fever escalating up to 40.55 C or 105 F
- Rapid breathing
- Shortness of breath
- Chills or perspiration
- Cough with yellow, green or red phlegm
- Loss of appetite
- Stomach or chest pain, especially when coughing or taking big breaths
- Nails, lips, or skin that are blue (cyanosis)
- Confusion or a shift in your state of mind
4.3. Symptoms Among Toddlers
Other symptoms of pneumonia among toddlers are:
- Fever, chills, general unease, and flushed or perspiring skin
- Cough or vomiting
- Breathing difficulties or rapid breathing (tachypnea)
- Agitation or restlessness
- Breathing that makes a grunting noise
- Pale skin
- A reduction in the amount of urine or the amount of moisture in the diapers
5. Complications and Risk Factors
Although pneumonia is typically curable when properly treated, if overlooked it can be quite hazardous.
It can have serious complications that are potentially fatal including:
- Deterioration of long-term lung conditions like Chronic Obstructive Pulmonary Disease (COPD);
- Lung abscesses, which is the development of pus in the air sacs of lung tissue;
- breathing problems or even respiratory failure, which may demand being put on a ventilator in order to receive oxygen;
- Pleural effusion, meaning fluid buildup in the lungs, which can lead to infection and may need to be drained; and
- Bacteremia occurs when bacteria enter the bloodstream and may result in septic shock.
5.2. Risk Factors
You have a greater risk of developing pneumonia if you:
- are either under the age of two or older than 65
- are a person suffering from underlying health condition, such as diabetes, asthma, heart disease, COPD, sarcoidosis, and emphysema.
- a person with impaired immune systems
- possess a neurological disorder that makes swallowing challenging
- are going through chemotherapy, receiving an organ transplant, have HIV/AIDS, or are on immune-suppressing medicines.
Your risk of developing aspiration pneumonia is increased by illnesses like dementia, Parkinson’s disease, and stroke.
6. Can You Have Pneumonia Without a Fever?
Although one of the most common symptoms of pneumonia is fever, on some rare occasions it is possible to have pneumonia without a fever or with a very mild condition.
This usually happens when the patient is under the age of 2, is older than the age of 65, or has a weakened immune system. It is also possible in instances of “walking pneumonia” which is a less severe version of the illness.
In accordance to the National Heart, Lung and Blood Institute, infants, elderly people, and those with weakened immune systems can develop atypical symptoms, such as a lower-than-normal temperature instead of a fever.
The American Lung Association (ALA) also states that older people and people with compromised immune systems may also have less or milder symptoms. Older adults are susceptible to confusion as well.
Although pneumonia has an extensive list of symptoms, including difficulty breathing, congestion, and mucus production among many others, it is essential to acknowledge this uncommon feature of pneumonia because the absence of fever does not always mean the infection is mild or shouldn’t be addressed seriously.
7. How is Pneumonia diagnosed?
If your doctor thinks you could have pneumonia, they’ll usually suggest several tests to make sure and find out more about your infection. Since pneumonia symptoms often resemble those of other illnesses, a correct diagnosis frequently involves two stages.
A healthcare provider will inquire about your medical history and conduct a physical examination to diagnose pneumonia. These physical exams include:
- Blood tests– to confirm the infection to pinpoint the pathogen that is affecting you as well as access your immune system’s capacity to combat pneumonia.
- X-ray of the chest to determine the location and degree of lung inflammation.
- Pulse oximetry to determine how much oxygen is in your blood.
- Sputum test on a specimen of mucus (sputum) collected after a strong cough to identify the infection’s origin.
- Pleural Fluid Culture is done by taking a small sample of fluid from the lung tissue to examine and identify the bacteria causing the pneumonia.
- A CT scan can aid in the search for complications like lung abscesses or fluid in the lungs.
- Bronchoscopy could prove helpful to obtain a fluid or tissue sample or to see if anything is obstructing your airways.
8. Treatment of Pneumonia
The cause of pneumonia will determine its course of treatment. After determining the root cause of pneumonia, the following treatments can be adopted:
- Antibiotics to treat bacterial pneumonia;
- Antifungal medications to treat fungal infection;
- Antiviral medications to treat viral pneumonia;
- Draining of fluids in case of fluid trapped between your lung and chest wall;
- Oxygen therapy for difficulty breathing.
Symptoms of pneumonia can also be treated at home by drinking plenty of fluids while taking over-the-counter medications such aspirin, nonsteroidal anti-inflammatory drugs, or acetaminophen getting enough rest, drinking warm beverages, and using a humidifier.
9. Preventive Measures
Getting vaccinated against the germs and viruses that frequently cause pneumonia is the best method to prevent it. These vaccinations include the Pneumococcal Conjugate Vaccine, or PCV13, and the Pneumococcal Polysaccharide Vaccine, or PPSV23.
You can also take routine safety measures to help lower your risk of pneumonia. These measures include practicing good hygiene, quitting smoking, avoiding consumption of alcohol, using alcohol-based hand sanitizer, maintaining a well-balanced diet, and avoiding close contact with people with infectious diseases such as cold, flu, or COVID-19.
Thus, to conclude, a person may contract pneumonia without having a fever. Unfortunately, it appears that elderly people, children, and people with compromised immune systems are more likely to experience this. These groups of people might instead experience body temperatures that are lower than usual.
Multiple microorganisms, some of which are contagious, can cause pneumonia, and depending on the cause of illness and your general health, the course of treatment and length of recovery may vary.
Furthermore, it should be remembered that not all of the pneumonia symptoms will manifest in a patient at once while some symptoms may not manifest at all.
Lastly, pneumonia has an extensive range of symptoms and numerous underlying causes. The uncertainty of whether some symptoms are indicative of a more serious condition can be troubling. Therefore you shouldn’t overlook signs like a high fever, bloody or otherwise abnormally colored mucus, chest pain, or shortness of breath. In such scenarios, it is advised that you get medical attention to prevent symptoms from getting worse.