Pneumonia

Pneumonia may be caused by viral infections, bacterial infections, or rarely, fungi. The most common bacterial type that causes pneumonia is Streptococcus pneumoniae.

Pneumonia can be spread in a number of ways. The viruses and bacteria that are commonly found in a child’s nose or throat, can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze.

Examples of bacteria that can cause pneumonia:

• Streptococcus pneumoniae
  The most common cause of pneumonia. Often occurs as a complication after a cold or flu. Occurs at all ages, but is more common among young children and older people.
• Mycoplasm
  A contagious bacterium transmitted through direct contact or air drops. Often several people in the area are affected at the same time. It is most common in people under 50, including children.
• Hib – Haemophilus influenza type b
  Transmitted mainly by air droplets and contaminated materials. For example, children who are not vaccinated can be infected through toys. People who are affected are often the elderly or people with underlying illness, mainly COPD.
• Chlamydia
  Transmitted through direct contact or air droplets. Occurs at all ages and it is common to become infected before the age of 20.
• Legionella
  This bacterium propagates in water that is 18–45 degrees and spread through droplets in the air, for example in a shower or via air conditioning. It is most common to be infected abroad. Occurs at all ages.

Examples of viruses that can cause pneumonia:

• RSV
  RSV is an abbreviation of respiratory syncytial virus. It is transmitted through direct contact and air drops – children can be infected through the toys. Every year, RSV causes epidemics among younger children and can sometimes lead to serious illnesses.
• Influenza
  Influenza viruses are transmitted through direct contact or air drops. Occurs at all ages and can sometimes cause major outbreaks of pneumonia such as swine flu or Hong Kong flu.
• Coronavirus
  Coronavirus is a family of different viruses. A few viruses were transmitted from animals to humans and are spread between humans through direct contact or air drops. Examples of coronavirus include SARS, MERS and Covid-19.

Older people and young children are more vulnerable to pneumonia than other age groups. The immune system in children is not fully developed and older people often have a weakened immune system. 

This also applies to people who already have respiratory disease, such as asthma or COPD. 

Risk factors that increase the vulnerability to pneumonia include:

• heart diseases
• chronic lung diseases
• diabetes
• impaired immune system due to illness or some medications
• smoking
• age.

Pneumonia affects about 1 in 100 people every year. The most common symptoms of pneumonia are cough, fever and shortness of breath. You may experience chest pain when you cough or take a deep breath. The mucous membrane of the respiratory tract swells and fluid and mucus can accumulate in the lung tissue. Then the lungs get harder to oxygenate the blood and it feels heavier to breathe.

The disease can occur immediately, but often begins as a cold or prolonged cough with fever, which then turns into pneumonia.

The symptoms also differ from person to person and in different age groups. For example, some quickly get high fever and chills, while others have only a slight rise in fever. Others have no fever at all – then a feeling of tiredness or fatigue and shortness of breath may be the only symptoms of pneumonia.

Children who get pneumonia can become pale, tired and lethargic. They can also experience an upset stomach and feel generally unwell.

Common symptoms include:

• fatigue and tiredness
• fever, sometimes with chills
• cough, dry or mucus
• chest pain when you breathe or cough
• shortness of breath and difficulty breathing
• wheezing 
• headache
• confusion, especially in older people.

Abdominal pain, diarrhea, nausea and vomiting can also be symptoms of pneumonia, even in adults. In severe cases, pneumonia associated with cardiac or pulmonary disease can cause shortness of breath or sepsis. 

Bronchitis, often caused by viruses, has similar symptoms to pneumonia, but they are usually mild. Asthma, influenza and other viral infections can sometimes be mistaken for pneumonia.

COPD also causes respiratory distress, shortness of breath and cough. Sometimes, lung congestion and serious diseases such as tuberculosis can cause symptoms similar to pneumonia.

Here’s how you can reduce the risk of getting infected:

• wash your hands frequently
• do not touch your face if you have taken the door handles or handrails in public places
• avoid close contacts with people who have symptoms of cold
• avoid large crowds of people, if possible
• vaccinate yourself against Streptococcus pneumoniae and seasonal flu, if you belong to a risk group.

If you have pneumonia, bed rest is important to give your body the opportunity to recover. It is also important to:

• drink water to replace the fluids lost with fever. Drinking fluids also thins the mucus so it becomes easier to cough up
• rest – allow the body to recover before going to school or work again
• refrain from exercise – physical exertion in case of fever can be harmful; coughing and breathing difficulties are usually exacerbated by exertion.

There are non-prescription analgesic and antipyretic drugs at pharmacies – they do not cure the disease, but can relieve the symptoms.

Important warning for Reye’s syndrome: Children and adolescents under 18 years of age should not use medications which contain aspirin (acetylsalicylic acid) without a doctor’s recommendation, because of the risk of Reye’s syndrome. 

Vaccination against pneumonia

There is no general vaccine for pneumonia, because the disease can be caused by various bacteria and viruses.

If you belong to a so-called “risk group” you should vaccinate yourself against Streptococcus pneumoniae and seasonal influenza. Risk group includes people over the age of 65 and people who have diabetes, heart diseases, lung diseases, or impaired immune systems for any other reason.

To be sure that you have pneumonia and to find out whether viruses or bacteria have caused the problem, a medical examination is required. Blood tests are sometimes supplemented with blood and sputum culture. You also need to do a chest x-ray.

Pneumonia caused by bacteria is often treated with antibiotics. 

If a virus has caused it, the inflammation usually heals by itself, but in some cases, there is reason to treat it with antiviral drugs. 

Severe pneumonia may require hospital care and you will be treated with fluids, nutrients and antibiotics. Sometimes oxygen supplementation is also needed to help to breathe.

If you suspect pneumonia, you should contact a doctor. This is especially important in older people and children, or if you have COPD or any other illness. If your child is unable to play or isn’t able to be distracted, you should also seek urgent help.

If you or your child gets rapidly worse and has high fever or chills – or has difficulty breathing or pressure in the chest – get emergency care.

APPOTEK can help with pneumonia. A doctor or nurse will make an initial diagnosis during the video consultation. They can also give prescriptions or refer you for further examination, if needed. In the case of pneumonia, a physical examination may be required.