Pneumonia

Learning objectives

Pneumonia is an infection that inflames the alveoli in one or both lungs
The alveoli may fill with fluid or pus causing cough with phlegm or pus, fever, and difficulty breathing
Caused by bacteria (Streptococcus pneumoniae), bacteria-like organisms (Mycoplasma pneumoniae), viruses, or fungi
Can also be caused by aspiration of food, fluids, vomit, or saliva
Can be mild to life-threatening
The disease may be classified by where it was acquired, such as community- or hospital-acquired or healthcare-associated pneumonia

General symptoms	Symptoms of bacterial pneumonia	Symptoms of viral pneumonia	Symptoms of viral pneumonia
- Chest pain when breathing or coughing - Confusion /changes in mental awareness - Cough, which may produce phlegm - Fatigue - Fever and sweating - Lower than normal body temperature - Loss of appetite - Nausea, vomiting, or diarrhea - Shortness of breath	- High fever (up to 40.5 C) - Cough with yellow, green, or bloody mucus - Tiredness (fatigue) - Rapid breathing - Shortness of breath - Rapid heart rate - Sweating or chills - Chest pain and/or abdominal pain, especially with coughing or deep breathing - Loss of appetite - Bluish skin, lips, or nails (cyanosis) - Confusion or altered mental state	- Symptoms similar to bacterial pneumonia - Dry cough - Headache - Muscle pain - Extreme tiredness or weakness	Babies and newborns may not show any symptoms of pneumonia or their symptoms may be different from adults, including: - Fever, chills, general discomfort, sweating/flushed skin - Cough - Difficulty breathing or rapid breathing (tachypnea) - Loss of appetite - Vomiting - Lack of energy - Restlessness or fussiness Signs in babies and young children include: - Grunting sound with breathing or noisy breathing - A decreased amount of pee or diapers that are less wet - Pale skin - Limpness - Crying more than usual - Difficulty feeding

Pneumonia is most commonly classified by where or how it was acquired:
- Community-acquired pneumonia
- Aspiration pneumonia
- Healthcare-associated pneumonia
- Hospital-acquired pneumonia
- Ventilator-associated pneumonia
It may also be classified by the area of the lung affected:
- Lobar pneumonia
- Bronchial pneumonia
- Acute interstitial pneumonia

Children < 2 years of age
Adults > 65 years of age
Hospitalization – ICU – long-term care facility
Chronic disease: asthma, COPD, or heart disease
Smoking
Pregnancy
Weakened or suppressed immune system: HIV/AIDS
Neurological conditions making swallowing difficult: dementia, Parkinson’s disease, or stroke

Be aware that:

Anesthesia can contribute to postoperative pneumonia by causing gastric contents like stomach acid to enter the lungs, resulting in pulmonary complications and increased risk of infection
Pulmonary infections and pneumonia are the most common cause of pulmonary ARDS