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    Contributed by Dept of Respiratory & Critical Care Medicine


    Pneumonia is inflammation of the lungs that can be caused by bacteria. The air sacs in the lungs are filled with pus and when the infection is severe, oxygen has trouble reaching the blood. More than half of the cases of pneumonia are caused by bacteria. Other causes include viruses, mycoplasma and others (parasites and fungi).


    Patients may complain of a recent onset of the following:

    • Cough
    • Fever (sometimes associated with shaking chills) and sputum
    • Sputum production (may be rusty or greenish in colour)
    • Chest pain that is aggravated by breathing and coughing

    The patient may appear to be breathing rapidly and have rapid pulse rate. The lips and tongue may appear to have a bluish tinge due to lack of oxygen.

    Risks and Causes

    People considered at high risk for pneumonia include the elderly, those with chronic illness such as chronic obstructive pulmonary disease, diabetes mellitus and congestive heart failure. Viral infections such as influenza, illness such as AIDS that impair the immune system including those undergoing chemotherapy for cancer and patients on immunosuppressant drugs post organ transplant are particularly vulnerable.


    Besides a clinical diagnosis of pneumonia made on history and physical examination, a chest x-ray is often required to confirm the diagnosis. Other tests may include sputum and blood tests.


    In the young, healthy patients, early treatment with antibiotics (usually taken orally) can cure and speed recovery from pneumonia. There is no effective treatment for viral pneumonia. In certain cases, viral pneumonias may become secondarily infected with bacteria and such cases require antibiotics as well. The type of antibiotics used to fight the pneumonia are determined by the most likely germ causing the pneumonia as well as the doctor's judgment.

    In more severe cases, hospitalization and antibiotics given directly to the blood stream is required. In addition other supportive treatment like oxygen therapy may be needed. Patients with severe pneumonia may require admission to the intensive care unit because of its life threatening. With prompt treatment, most types of non-severe bacterial pneumonia can be cured within 1-2 weeks, but viral and certain other types of pneumonia may last longer.

    Frequently Asked Questions

    Do patients with pneumonia need to be hospitalised?

    Only about 15% of patients with pneumonia require hospitalization. Elderly patients, those with underlying serious illnesses and those who have serious infection may require hospitalization. Younger and relatively fit patients with 'mild' disease may be treated on an outpatient basis.

    Can one die of pneumonia?

    Yes. Until 1936, before the advent of antibiotics, pneumonia was the leading cause of death in the United States. Despite modern antibiotic therapy pneumonia remains a leading cause of death worldwide.

    Is it possible to prevent pneumonia?

    The bacteria known as pneumococcus is the most common cause of bacterial pneumonia in the community. A vaccine is available against pneumococcal blood infection and this is usually given to people at high risk of getting the disease e.g. patients with chronic illnesses such as chronic lung disease, heart disease, kidney disease, or diabetes; patients who are recovering from severe illness, who are in nursing homes, and the elderly. The vaccine is generally safe and effective and is usually given once.

    Useful Links
    American Lung Association:
    The Ontario Lung Association:

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