Pneumonia: Symptoms, Signs, & Treatment

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
January 12, 2020

With flu season in full swing, other lung infections, such as pneumonia may have you worried. Pneumonia is an infection that can affect one or both of your lungs, and the symptoms can range from mild (also known as walking pneumonia), to more serious, sometimes requiring hospitalization. Pneumonia can occur in infants all the way to senior adults. It’s important to know the signs of pneumonia so you can get the help you need quickly.

What Is Pneumonia?

The main causes of pneumonia include:

  • Viral pneumonia: Responsible for a third of all pneumonia cases, viral pneumonia is caused by viruses such as influenza, RSV, and adenoviruses, which also cause pink eye.
  • Bacterial pneumonia: Bacterial pneumonia tends to occur more commonly when the body’s immune system has already been compromised in some way, such as in the elderly and those suffering from other illnesses. Streptococcus and haemophilus, among others, are common bacterial causes of pneumonia. Mycoplasma pneumonia is a bacteria that typically causes a milder form of the infection, called “walking pneumonia”.
  • Fungal pneumonia: Fungi are a much less common cause of pneumonia, and typically occur in severely immunocompromised individuals, though they can also occur in areas where the fungi are endemic. These infections tend to be more severe and should be considered if other causes of pneumonia have been ruled out.

How long does it take to recover from pneumonia?

Many people are able to recover from pneumonia in approximately one week. Individuals with viral pneumonia can start to see improvement after about three days, while those with bacterial pneumonia can begin to feel better soon after beginning antibiotics. Paradoxically, “walking pneumonia” takes longer to recover from (about six weeks), even though the symptoms are milder.

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Pneumonia Symptoms

Symptoms of pneumonia include the following:

Bronchitis vs. pneumonia

The main difference between bronchitis and pneumonia is the location of their effects. Pneumonia affects the air sacs of the lungs, while bronchitis affects the lung’s air passages. The two have many symptoms in common, such as shortness of breath and coughing, but pneumonia generally leads to more severe symptoms without treatment. Bronchitis is much more common than pneumonia, and the two can occur at the same time, which is called “Bronchopneumonia”.

Is pneumonia contagious?

Pneumonia is very contagious. The organisms causing pneumonia are usually passed through sneezing, coughing, or transferring germs onto an object, such as a door handle. Germs are spread to others through droplets of fluid expelled during sneezing or coughing or when others touch infected surfaces.

Stages of Pneumonia

Pneumonia is generally divided into four stages that occur sequentially.

  • Congestion: This first stage occurs during the first 24 hours of illness. Congestion begins in the lung tissues as the air sacs (alveoli) fill with pus, fluid, and bacteria.
  • Red hepatization: During this stage, your body begins to react to the infection, and Immune cells and red blood cells also enter the air sacs. This stage generally lasts 2-3 days.
  • Gray hepatization: During this period, the body begins to successfully contain the infection, and the pus and bacteria that were initially present begin to disappear. This stage generally occurs on the fourth through sixth day of illness.
  • Resolution: Having resolved the infection and ridding your lungs of the bacteria, the immune cells also clear out, leading to a resolution in symptoms. This stage generally occurs on the sixth day of illness.

Pneumonia in Children

Pneumonia in kids is most common in children under five years of age. They are more likely to contract pneumonia if they have any issues with their airways and lungs, a weakened immune system, or chronic health conditions, such as asthma. Kids with viral pneumonia have symptoms that begin slowly and are usually less severe than bacterial pneumonia. Bacterial pneumonia usually comes on quickly, with the most common symptoms being rapid, difficult breathing and high fever.

Children with pneumonia can exhibit many of the same symptoms as adults, though some may also be more pronounced:

Walking Pneumonia

Walking pneumonia is caused by mycoplasma pneumonia bacteria and is a mild form of pneumonia that usually doesn’t require hospitalization. It is called ‘walking’ pneumonia because of the ability of a person who’s contracted it to walk around and continue their activities of daily living. However, having it can still make you feel quite sick. Walking pneumonia symptoms are similar to other types of pneumonia, though milder, and include:

  • Cough
  • Chest pain
  • Fever/Chills
  • Fatigue
  • Headache

Who Is at Risk for Pneumonia?

Populations at a higher risk of contracting pneumonia include:

  • Infants and children under two years old
  • Individuals that smoke
  • Adults aged 65+
  • People with chronic lung conditions such as asthma and COPD
  • People with medical conditions that compromise their immune systems, such as HIV/AIDS and cancer

Pneumonia Treatment Options

Most cases of pneumonia can be treated without hospitalization. Your care will depend on which type of pneumonia you have, your age, and your general health and other medical conditions. If you have bacterial pneumonia, you’ll be prescribed antibiotics. Viral pneumonia does not have a specific treatment and is generally treated with supportive care.

Home treatment options include:

  • Drinking fluids and gargling with salt water to help break up phlegm and reduce inflammation
  • Controlling a fever with over the counter (OTC) medications like nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or acetaminophen
  • Opening the airways with a humidifier or hot beverage
  • Getting plenty of rest. Make sure to give your body a break so that it can heal
  • In severe cases of pneumonia, or for people with underlying medical conditions, more intensive treatment may be required. This can include hospitalization, IV antibiotics (for bacterial pneumonia), IV fluids, and oxygen.

Pneumonia Prevention

To prevent pneumonia, I recommend following these guidelines:

  • Wash hands often, especially after touching your mouth or nose
  • Use a tissue to sneeze or cough, and throw it away as soon as you’re done
  • Avoid sharing kitchen utensils or glasses with anyone who may be sick
  • Don’t smoke or vape
  • Get your vaccines: You can reduce your risk of contracting bacterial pneumonia with a pneumococcal vaccine. People also have a higher risk of developing pneumonia after having the flu, so getting a yearly flu shot can help.
  • Keep your immune system strong by getting enough sleep, exercising regularly, and eating a good diet.

Other causes of pneumonia and related lung conditions include:

  • Aspiration pneumonia: Aspiration pneumonia is a lung infection that occurs when liquids, saliva, food, or vomit is accidentally inhaled into the airways and lungs. Risk factors for acquiring aspiration pneumonia include old age, having a compromised immune system, being in a coma, and having issues with swallowing, such as after a stroke.
  • Hospital-acquired pneumonia: Hospital-acquired pneumonia is defined as being contracted by a patient 48-72 hours after being admitted to a hospital. It is usually caused by a bacterial infection and often requires intensive treatment.
  • Severe acute respiratory syndrome (SARS): SARS is a viral pneumonia which can be contracted by the SARS coronavirus. You’re at a higher risk of SARS if you’ve had contact with someone infected with the disease or if you have recently traveled to areas where these viruses are endemic.
  • Legionella infection: Also known as Legionnaires’ disease, Legionella infection occurs from inhalation of Legionella bacteria. Symptoms of this form of pneumonia include more pronounced GI problems such as nausea and vomiting, and the disease is more severe than many other types of pneumonia overall.

When to See a Doctor

You should see a doctor right away if you exhibit any of the following symptoms, which may indicate that you have pneumonia or another related respiratory illness:

  • High fever or chills
  • Chest pain after coughing or breathing
  • A cough that doesn’t improve or worsens, or is accompanied by blood or mucus
  • Shortness of breath when lying down or from regular activity
  • Feeling worse following a cold or flu

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How K Health Can Help

Pneumonia is very contagious so if you’re experiencing symptoms you should talk to a doctor to get a diagnosis.

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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.