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Pneumonia

Pneumonia is an infection that inflames the air sacs of the lungs, causing cough, fever, and shortness of breath. It ranges from mild to life-threatening, especially in older adults and people with chronic disease.

Pneumonia is an infection that inflames the air sacs (alveoli) in one or both lungs, which may fill with fluid or pus. It ranges from a mild illness treated at home to a life-threatening disease requiring hospitalization. Older adults, young children, smokers, and people with chronic medical conditions are at the highest risk of severe pneumonia.

Causes and Risk Factors

Pneumonia develops when germs get past the body's defenses and infect the lungs:
  • Bacteria: Streptococcus pneumoniae (pneumococcus) is the most common bacterial cause in adults; "atypical" bacteria such as Mycoplasma cause a milder walking pneumonia.
  • Viruses: Influenza, COVID-19, RSV, and other respiratory viruses can cause pneumonia directly or open the door to a bacterial infection.
  • Aspiration: Food, liquid, or stomach contents inhaled into the lungs can trigger infection, especially in people with swallowing problems.
  • Higher-risk groups: Risk rises with age over 65, smoking, and chronic conditions such as COPD, asthma, bronchiectasis, diabetes, heart disease, and weakened immunity.

Symptoms

  • Cough: Often producing yellow, green, or rust-colored phlegm.
  • Fever, chills, and sweats: Sometimes with shaking chills; older adults may instead have confusion or a low body temperature.
  • Shortness of breath: With everyday activity or even at rest.
  • Chest pain: Sharp pain that worsens with deep breathing or coughing.
  • Fatigue and poor appetite: Weakness can linger for weeks after treatment.

Diagnosis

Your doctor listens for crackles in the lungs and typically confirms the diagnosis with a chest X-ray. Pulse oximetry checks oxygen levels, and blood tests or sputum cultures may identify the germ; rapid swabs can detect influenza and COVID-19 when a virus is suspected. Severity scoring based on age, vital signs, and lab results helps decide whether treatment at home is safe or hospital care is needed — most otherwise-healthy adults can be treated at home.

Treatment

  • Antibiotics: Bacterial pneumonia is treated with oral antibiotics such as amoxicillin-clavulanate, azithromycin, or doxycycline, chosen based on age, health conditions, and local resistance patterns; respiratory fluoroquinolones such as levofloxacin are reserved for selected patients. Most people improve within a few days of starting treatment.
  • Supportive care: Rest, fluids, and fever reducers help recovery; viral pneumonia may also be treated with antivirals when appropriate.
  • Hospital care: Needed when oxygen levels are low, blood pressure drops, or the infection is severe.

Recovery

Fever usually settles within a few days of effective treatment, but fatigue and a lingering cough commonly last several weeks — recovery is a marathon, not a sprint, especially after age 65. Finish the entire antibiotic course even if you feel better, rest, and return gradually to activity. Your doctor may repeat a chest X-ray after six to eight weeks in smokers and older adults to confirm the infection has fully cleared and that no underlying abnormality was hiding behind it.

Prevention

Pneumococcal vaccines are recommended for all adults 50 and older and younger adults with chronic conditions. Yearly flu vaccination, COVID-19 vaccination, RSV vaccination for eligible older adults, quitting smoking, and good hand hygiene all reduce risk.

When to Seek Immediate Care

Seek emergency care for difficulty breathing, chest pain, bluish lips, confusion, or a fever above 103°F that does not respond to medication. If a cough and fever are not improving — or a cold suddenly worsens — do not wait it out. The primary-care team at Zimmer Medical Group diagnoses and treats pneumonia and keeps patients current on pneumococcal vaccination — schedule a visit today.