Pneumonia

Pneumonia is inflammation of the lung tissue, and it's usually caused by a bacterial infection. Your lungs have clusters of tiny air sacs. When you have pneumonia, these sacs become inflamed and fill up with fluid.

The symptoms can develop suddenly over 24 to 48 hours, or they may come on more slowly over several days.

Pneumonia is more widespread in autumn and winter.

• you have severe difficulty breathing, for example you struggle to speak without pausing, or you are gasping or choking
• you have severe pain in the middle of your chest that isn't going away (it may feel like pressure, tightness or squeezing)
• you have pain that spreads to your arms, back, neck and jaw
• you feel more drowsy than usual or find it more difficult to wake up
• your lips or skin are turning very pale, blue or grey (on brown or black skin this is easier to see on the palms of your hands)

Information on breathing problems in children

Contact your doctor urgently if you:

• are more short of breath than usual
• have pain when breathing in or coughing
• are feeling confused, dizzy, or lightheaded
• feel sick or are being sick (for example, you can't keep food or fluids down)
• are coughing up blood (haemoptysis)
• have heart palpitations, which may feel like your heart is racing, going too slowly or skipping a beat, or like a fluttering feeling in your chest
• are peeing less than usual, which can be a sign of dehydration
• have a very high or low temperature (for example, you feel either hot or cold to touch, or you're shivering)

If you can't reach your doctor, for example because the chamber is closed, call a doctor or the 16263 health line.

Talk to your doctor if:

• your breathlessness is not getting better
• you have had a cough for more than 3 weeks
• your symptoms are not improving, or they are getting in the way of your daily life

Your doctor may be able to diagnose pneumonia by asking about your symptoms and examining your chest. In some cases you may need further tests.

Pneumonia can be hard to diagnose because its symptoms are similar to those of other conditions, for example the common cold, bronchitis and asthma.

To help make a diagnosis, your doctor may ask you:

• if you feel breathless
• if you're breathing faster than usual
• how long you've had your cough
• if you're coughing up mucus and, if so, what colour it is
• if the pain in your chest is worse when you breathe in or out

Your doctor may also take your temperature and listen to your chest and back with a stethoscope for any crackling or rattling sounds.

They may also listen to your chest by tapping it. Lungs filled with fluid make a different sound from normal healthy lungs.

If you have mild pneumonia, you may need a chest X-ray and some blood tests. You will not need a sputum sample unless you have recurrent infections, or persistent infections that don't respond to treatments.

Mild pneumonia can usually be treated at home.

Pneumonia isn't usually passed from one person to another, so it's safe to be around others, including family members. The one exception is people with a weakened immune system. They should avoid close contact with someone who has pneumonia until that person starts to get better.

• get plenty of rest
• take antibiotics if you've been prescribed them, and always finish the course, even if you feel better, unless a doctor tells you otherwise
• drink plenty of fluids
• take pain relief such as paracetamol if needed, and always follow the manufacturer's instructions

Cough medicines aren't recommended. A warm honey and lemon drink can help ease the discomfort that coughing causes.

If you smoke, it's more important than ever to stop, because smoking damages your lungs.

Full recovery from pneumonia can take up to 3 months.

Speak to your doctor if your symptoms don't improve within 3 days of starting antibiotics.

If your symptoms are severe, you may need treatment in hospital. There you may be given antibiotics and fluids through a drip into a vein, and you may need oxygen if the oxygen level in your blood is low.

In very serious cases of pneumonia, you may need help with breathing from a ventilator. This is done in a high dependency unit (HDU) or an intensive care unit (ICU).

Your doctor may ask you to come back for a follow-up appointment. In some cases, they may also arrange follow-up tests if:

• your symptoms haven't improved
• your symptoms have come back
• you smoke
• you're over the age of 50

Some people may be advised to have a flu vaccination or pneumococcal vaccination after they have recovered.

Pneumonia is commonly the result of pneumococcal infection, which is caused by a bacteria called Streptococcus pneumoniae. Other causes of pneumonia are:

• other types of bacteria, including Haemophilus influenzae and Staphylococcus aureus
• viruses
• fungi (rarely)

Pneumonia also comes in other types, apart from the bacterial kind:

• viral pneumonia: caused by viruses including the respiratory syncytial virus (RSV), coronavirus (COVID-19) and sometimes influenza type A or B. Viruses are a common cause of pneumonia in young children
• aspiration pneumonia: caused by breathing in vomit, a foreign object, such as a peanut, or a harmful substance, such as smoke or a chemical
• fungal pneumonia: rare, and more likely to affect people with a weakened immune system
• hospital-acquired pneumonia: pneumonia that develops in hospital while you're being treated for another condition or having an operation. People in intensive care on breathing machines are particularly at risk of developing ventilator-associated pneumonia

Pneumonia can affect people of any age. It's more common, and can be more serious, in certain groups of people. People in these risk groups are more likely to need hospital treatment.

The groups with an increased risk of developing pneumonia are:

• babies and very young children
• elderly people
• people who smoke
• people with other health conditions, such as asthma, cystic fibrosis, or a heart, kidney or liver condition
• people with a weakened immune system, including people with undiagnosed HIV

Pneumonia is a health condition that occurs more often in people living with HIV. If you have been diagnosed with pneumonia and you are under the age of 65, you should be offered an HIV test. If you have been diagnosed but haven't been offered one, you can:

• speak to your doctor about getting tested for HIV

Testing for HIV when you have pneumonia can help with early diagnosis, treatment and preventing passing it on.