Pneumonia

Pneumonia is an inflammation of the lower airways, mainly the alveoli and the surrounding tissue. Sometimes only a certain area of the lungs is inflamed, but the inflammation can also be spread over an entire lung or both lungs. When both lungs are inflamed, this is known as double pneumonia.

The body will try to clear the bacteria or virus through an inflammatory reaction. In this inflammatory process, mucus can form in the lungs. This mucus, together with irritation of the lungs, can cause a cough. It also temporarily makes gas exchange in the alveoli less effective.

How does pneumonia develop?

In most cases, pneumonia is caused by bacteria. The best-known variant is the Streptococcus pneumoniae bacterium.

After bacterial pneumonia, a virus is the most common cause. At the time of writing (2020), there is a worldwide outbreak of the COVID-19 coronavirus. This virus can cause pneumonia and is highly contagious through inhalation of the virus or physical contact with an infected person.

A parasite, fungus, or inhalation of an irritating gas or dust can also trigger pneumonia, although these causes are less common.

Anyone can get pneumonia, but some people have an increased risk. These risk groups include very young children, older adults, and smokers, but also people with a weakened immune system or a chronic lung condition.

What are the symptoms of pneumonia?

The most common symptoms of pneumonia are (high) fever and/or chills, shortness of breath, and coughing. If the cough is accompanied by mucus production, at the start of pneumonia this mucus is almost always yellow or green. There may also be chest pain, which gets worse with deep inhalation and coughing.

Other possible symptoms are a general feeling of illness, such as reduced appetite, fatigue, and headache.

How is pneumonia diagnosed?

Pneumonia is well diagnosed by the family doctor after a physical examination and additional tests. The family doctor will first check the vital signs by measuring blood pressure, temperature, heart rate, respiratory rate, and oxygen saturation in the blood.

Blood tests provide more information about elevated inflammatory markers. A sputum culture, in which the coughed-up mucus is cultured for about a week, identifies the possible cause of the pneumonia. If there is doubt about pneumonia, or to investigate other possible causes of the symptoms, the family doctor can refer for an X-ray.

What is the treatment for pneumonia?

In the case of confirmed pneumonia, the family doctor will almost always prescribe an antibiotic course lasting seven to ten days. The pneumonia will largely subside during this course. The high fever and the general feeling of illness usually decrease after a few days. Coughing may, however, persist for several weeks. Shortness of breath and fatigue can still be noticeable after several months in some cases.

In more severe pneumonia, hospital admission may be necessary. In addition to administering antibiotics, the body is supported with fluids via an IV and extra oxygen where necessary.

During recovery from pneumonia, the physical therapist can guide the resumption and build-up of daily activities. Important pillars here are expanding endurance and building muscle strength through active exercise therapy.