Pneumonia is an infection which causes the normal air-containing spaces within the lungs (called the alveoli) and the smaller bronchial tubes to become inflamed and fill with fluid. Special white blood cells then travel the lungs to fight off the infection. This all leads to impairment of the lungs’ main function – which is to get oxygen from the air into the bloodstream and then around the whole body.


Many different germs can cause the infection that results in pneumonia. Although some are common and easy to identify, in quite a few people with pneumonia the germ causing the problem is never discovered.


Cross-section pleurosy and pneumonia
Some germs, particularly viruses, are breathed into the lungs because they are present in the air, especially if someone nearby has an infection and is coughing or sneezing. Others, including some bacteria, already live in the throat where they usually do no harm but may get into the lungs if the person is ‘under the weather’ or weakened by a virus. Some of the rarer types of pneumonia may arise from unusual sources. The germs which cause Legionnaires’ disease are sometimes found in faulty air-conditioning systems or water showers and those which cause psittacosis can be acquired from sick parrots!


Anyone can get pneumonia – even the young and fit. However, it is more common (and usually more serious) in the very young, the very old, people who smoke and in anyone weakened by long-term illness, especially if it interferes with the body’s normal defences against infection.


Viruses are the most common cause of pneumonia in children, especially in the pre-school years. It will generally settle within a few days and antibiotics do not help. Bacterial germs can also cause pneumonia and it is sometimes difficult to decide whether it is a virus or bacteria that is causing the problem. If there is any doubt, antibiotics are usually given. Occasionally children with pneumonia become very unwell and will need to be admitted to hospital. Often, they are given oxygen to help breathing.


People with pneumonia usually feel ill, feverish and off their food. These symptoms are similar to flu, but people with pneumonia nearly always have a cough (often with mucky sputum), and they may be short of breath with a feeling of tightness in the chest. At this point, it is advisable to consult a GP. Sometimes a sharp pain in the side, worsened by breathing, can occur if the infection also involves the lining of the lung. This condition is called pleurisy.


Antibiotics are the mainstay of treatment. A high fluid intake is important and sometimes painkillers may be needed. Most people with pneumonia are treated at home by their GP, but about one person in six is ill enough to need admission to hospital or specialised care. Most make a complete recovery but, although the fever may improve quickly, a feeling of tiredness and lethargy can persist for some time – several weeks in some cases. Some people have also complained of feeling lethargic as well. Unfortunately, a few people still die of pneumonia, and research is being directed at this group of individuals to see what can be done to improve things in future.


Avoidance of smoking is most important since cigarette smokers are at increased risk of pneumonia. Pneumonia and all chest infections in children are more common when parents smoke. A flu vaccination at the beginning of winter is strongly advised for anyone with long-standing lung problems, as sometimes flu can lead onto pneumonia, especially in the old and poorly. There is also a vaccine available to protect adults and children over two years against the commonest cause of pneumonia, called pneumococcal pneumonia. This vaccine is also recommended for anyone with lung or heart problems and need only be given every five years or so. Another vaccine provides babies and children under two years with protection from the same type of pneumonia.


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