Pneumonia: Symptoms, Home or Hospital and the Right Treatment

What is pneumonia?

With pneumonia, the lung tissue becomes inflamed, usually due to an infection. The small air sacs, where oxygen normally passes into the blood, fill with inflammatory fluid. This makes breathing harder.

The most common type is community-acquired pneumonia, that is pneumonia caught in everyday life outside hospital. It can run a mild course but can also become serious, especially in older people and with pre-existing conditions. That is why it should always be treated by a doctor.

Symptoms

Pneumonia can show up very differently. Common signs are:

• sudden high fever, often with chills. More on this: Fever.
• cough, often with yellowish, greenish or brownish phlegm.
• shortness of breath and fast breathing.
• pain in the chest when breathing.
• a strong sense of illness with exhaustion.

Not every pneumonia runs such a typical course. Some, above all those caused by so-called atypical pathogens, begin more gradually with a dry cough, headache and aching limbs and only moderate fever.

Causes: bacteria, viruses and more

Pneumonia usually develops from an infection. Possible triggers are:

• bacteria, most often pneumococci. They often cause the typical, suddenly starting form.
• viruses, for example influenza or coronaviruses.
• more rarely other pathogens such as certain fungi, above all with a weakened immune system.

Pneumonia often develops in the context of another respiratory infection. More on this: Respiratory infections. The risk rises with older age, a weakened immune system, chronic lung or heart disease, diabetes and smoking.

Diagnosis: how is it determined?

The doctor raises the suspicion based on your symptoms and on listening to the lungs. To confirm it and gauge its severity, the following are used:

• a chest X-ray, which makes the inflammation visible.
• blood tests, such as inflammation values like CRP.
• measuring the oxygen saturation in the blood, with a small clip on the finger.
• if needed, an examination of the phlegm or further tests to narrow down the pathogen.

Home or hospital? The CRB-65 score

One of the most important questions is whether pneumonia should be treated at home or in hospital. For this, doctors use a simple score: the CRB-65. It gives one point for each of four items:

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The total gives a rough estimate of the risk:

• 0 points: low risk. Treatment at home is usually possible, provided the oxygen saturation is also good (above 92 percent) and there are no unstable underlying conditions.
• 1 to 2 points: increased risk. Treatment in hospital should be considered.
• 3 to 4 points: high risk. As a rule, treatment in hospital, often in a high-dependency or intensive care unit.

Treatment: the right antibiotic decision

Whether and which antibiotic is needed depends on several factors. This is exactly the point that many guides leave out. First of all: antibiotics only work against bacteria. For viral pneumonia (for example from influenza or coronaviruses), they do not help. Here, depending on the pathogen, other medicines and supportive measures come first.

For bacterial pneumonia, the choice of antibiotic depends on the severity and on underlying conditions:

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Two points are especially important:

• Duration: for mild to moderate pneumonia, about 5 days is usually enough, provided you have been stably improving for at least two days. Take the antibiotic for as long as prescribed and do not stop it on your own, even if you already feel better.
• Review: after 48 to 72 hours, an improvement should set in. If not, have yourself reassessed by a doctor.

Recovery: what you can do yourself

Besides the medicines, the following helps your body recover:

• plenty of rest, even when you are slowly getting better.
• drinking enough so that the mucus loosens more easily.
• fever-reducing medicines as needed when you have a fever.
• not smoking.
• watching for warning signs and seeking medical advice if you get worse.

Pneumonia takes time. Tiredness and a lingering cough can persist for a few weeks even after the acute phase has settled. Do not overdo it too early.

Prevention: vaccination and lifestyle

You can lower your risk:

• Vaccinations: there are vaccinations against pneumococci and against influenza. The German vaccination committee recommends the pneumococcal vaccination among others for people aged 60 and over and for certain risk groups.
• not smoking, as smoking weakens the lungs' self-cleaning and defence.
• treating chronic conditions such as diabetes or heart failure well.
• hand hygiene, especially during the cold and flu season.

When to see a doctor urgently

Pneumonia should always be treated by a doctor. Seek medical advice when you have a cough and fever together with shortness of breath or a strong sense of illness. It is especially urgent with:

• shortness of breath, very fast breathing or bluish lips.
• confusion or severe drowsiness.
• circulatory weakness with very low blood pressure.
• a high fever that does not come down, or a rapid deterioration.
• people at risk, for example at an older age, with a weakened immune system or with chronic conditions.

Stay on top of your treatment with brite

An antibiotic only works with regular, complete intake. brite helps you remember every dose and keep the overview.

• Intake reminders: remember every dose until the course is complete.
• Symptom diary: record your fever, cough and how you feel.
• Interaction check: see at a glance whether your medications work well together.
• Medication plan: always up to date and ready for your next appointment.

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