Cough does not always mean pneumonia, but if you have typical pneumonia, the cough will definitely be. Within 2-3 weeks of starting treatment for pneumonia, a healthy body should be able to cope with the disease.
Typical manifestations of pneumonia:
- Cough with sputum
- Elevated temperature above 37.8 C
- Chest pain
- Accelerated breathing over 20 times per minute
- Noises are heard in the lungs when listening to the chest
Atypical pneumonia occurs
- Coughing for more than three weeks
- Gradual onset of the disease
- Low temperature
- There are extrapulmonary symptoms – abdominal problems, runny nose, muscle pain
The new COVID-19 virus has made us think of pneumonia in a much more serious context. Although pneumonia has always been a rapid disease.
It is the third leading cause of death in the world after coronary heart disease and stroke.
This is mainly because of an aging population, harmful habits and antimicrobial resistance.
Although bacterial pneumonia has been treated with antibiotics and antibiotics are available, the irritants of pneumonia have become more resistant to the medication over time.
Pneumonia is an acute inflammation of the lung tissue, most commonly caused by bacteria, but not always.
Sometimes a virus (flu, parainfluenza, COVID-19, etc.), fungal infection, even parasites can also be to blame for pneumonia. However, sometimes pneumonia starts from seemingly nothing.
For example, if a sleeping person chokes on food, food crumbs through the airways gets to the lungs and causes inflammation.
With pneumonia, the cough will not have a single character, but the most difficult situation is with seniors.
In case of pneumonia may not have a cough reflex at all. There is also no elevated temperature, sometimes on the contrary – the temperature can even be lowered.
In such cases, seniors pneumonia can manifest only as fatigue, there may be a feeling of fever, but without the temperature, and shortness of breath.
Why did I get sick?
Why some people have pneumonia repeatedly, but others don’t even know what it is, the answer is Immunity.
It all depends on the body’s defenses. There are microorganisms – pathogens, and there is a human – a macro-organism.
If the macro-organism is powerful enough, it will expel all unnecessary microbes very quickly, a person will not get sick or will get sick slightly.
However, if the microorganism – a virus or a bacterium – is more powerful than the human body’s defenses, the disease will be present.
So, if you have a young person with pneumonia, the first thing to ask is:
- What has changed in your life?
- What are you doing wrong?
- What is different in lifestyle now
- Why has pneumonia developed?
There must be a reason a young person without obvious chronic damage suddenly develops pneumonia.
Smoking is also a very serious risk factor for developing pneumonia. However, it can also be caused by a variety of co-morbidities that we do not always know.
about, because there are “silent chronic diseases”, such as hepatitis C, which may not go away at first.
And another moment of risk – alcohol. Drinking drinks increases the risk of getting pneumonia. In addition, this risk is dose-dependent, ie the more often the throat muscles relax during sleep and aspiration or choking occurs.
The contents of the stomach easily enter the airways after alcohol consumption, causing inflammation.
We also see it in the hospital that alcoholics develop very severe pneumonia after “rafting”, which is difficult to treat because the macrophages, our main protective cells that kill bacteria, are also weakened.
Typical complaints of pneumonia are more likely to occur in younger people. But general complaints may dominate young children and seniors.
The child feels tired, does not want to get up, has no appetite, but the senior will complain about drowsiness, weakness, will say that he does not even have the strength to cough.
When a lung x-ray is performed, we often see extensive pneumonia. If you see a child jumping and coughing, rather think about asthma or viral bronchitis, it is unlikely to be pneumonia.
Steps to take to be healthy
The doctor listens to complaints and listens to the lungs
With pneumonia, the noises in the patient’s lungs will not always be audible and audible to the doctor.
Patients with chronic obstructive pulmonary disease (COPD) who have developed emphysema in the lungs will find it particularly difficult to make noise, which makes them look like bloated, so they hear less noise.
Patients with both asthma and pneumonia will also find it difficult to differentiate between pneumonic noises.
In addition, the inflammation of the lung tissue may be small and localized in a region of the lung where it will not be possible to hear the noise with a stethoscope.
Determines if there is enough oxygen in the blood
If a person complains of shortness of breath, placing a small device called a pulse oximeter on their finger can determine the percentage of oxygen in their blood.
If the rate falls below normal, you need to think about how you can enrich your blood with oxygen.
We should see this more than a screening test, giving only a sign of the amount of oxygen in the blood, but even after measuring the pulse oximeter, the doctor can determine how severe the pneumonia is.
Just remember that reduced oxygen levels in the blood can be due not only to pneumonia but also for other reasons. For example, in case of heart failure or other chronic disorders.
Upon arrival at the hospital, the oxygen content of the patient is determined in the blood and provides more accurate information to decide on the most appropriate oxygen therapy.
What is normal breathing?
1 Respiratory cycle = 1 inhale and 1 exhale
Not only fatigue, but also rapid breathing in combination with malaise, sweating, cough can be a sign of pneumonia. Is your breathing normal?
- From birth to one year of age: 30-60 cycles per minute
- 1-3 years of age: 24-40 cycles per minute
- 3-6 years of age: 22-34 cycles per minute
- 12-18 years old: 12-16 cycles per minute
- Adults: 12-20 cycles per minute
X-Ray is a must
Although the patient’s lungs have been heard by a doctor, pneumonia cannot still be diagnosed. Pneumonia is confirmed by a lung x-ray.
However, the radiologist only sees an X-ray of the patient’s lungs, but does not see the patient himself. If the change is convincing,
there is no doubt, but it is sometimes difficult to assess whether these changes are “fresh”.
Therefore, the radiologist can only express suspicion of pneumonia, but the doctor confirms the diagnosis, either by comparing the patient’s previous X-rays of the lungs, or by considering the entire course and symptoms of the disease.
This is especially true in the elderly, whose changes in the lungs tend to be seen before the onset of complaints, so it is not yet possible to tell if it is pneumonia after one x-ray.
If changes in the lungs that could show pneumonia are confirmed on X-ray and the patient has clinical symptoms, antibacterial therapy is of course prescribed.
But the X-ray shows – there are changes in the lungs, but the person feels good, does not complain. Here, you can wait, do not rush with antibacterial therapy and repeat the X-ray after some time.
Looking for the culprit
The more accurately this can be determined, the more purposefully it will be possible to prescribe the most appropriate therapy.
Unfortunately, it is not possible to immediately prove the cause of pneumonia, because we must perform a sputum examination – inoculation, and we must wait the results for 72 hours.
However, the patient must help as soon as possible, and for this reason, to treat pneumonia, as the medical language says – empirically.
Namely, considering what is most often identified as the cause of pneumonia, listening to the patient’s story about the course of the disease, analyzing the symptoms and trying to prescribe the most appropriate antibiotics.
It is not possible to determine the exact cause of pneumonia based on the symptoms, but a hunch still arises. Therefore, the patient takes the medicine on the same day as the doctor’s appointment.
Next we see: if the well-being improves, everything is fine – so we pinpointed the cause of pneumonia.
However, if the drug does not give the desired result, the symptoms do not decrease; the temperature does not drop, after 48-72 hours we can change antibiotics to others.
We usually expect the results of the tests around that time and we know it what caused the disease.
In the practice of a family doctor, the cause of pneumonia is more often sought if the course of the disease is specific and unclear.
For example, if a dry cough persists for a long time and you cannot cough, then your doctor will order tests to detect antibodies in your blood to atypical
Pneumonia agents such as micro-plasmas, chlamydias or legionella. We need other types of antibiotics to treat these pneumonias.
However, if the X-ray demonstrates pneumonia and the patient’s complaints show that the disease is in a typical course, then it is not important to
determine the cause, it is enough to detect inflammation in the blood leukocytes and C-reactive protein.
There are over 250 causes of pneumonia, but more common are these!
In these cases, treatment is with antibiotics
About 70% of all pneumonia is caused by pneumococcus.
It usually already lives in our airways, most often in the nostrils, and if the body has recently become ill with a viral infection, the pneumococcus is suddenly activated, causing pneumonia.
Pneumonia starts suddenly, symptoms develop rapidly, there is a pronounced high temperature, a loud cough, sometimes rusty sputum.
- Hemophilic rod
Smokers, including those with chronic bronchitis, bronchiectasis (massive bronchodilation), are the most common pneumonias of this agent.
If a person is elderly, he has overate or had an episode of a viral infection, but then as the second wave of the disease joins a high temperature, think that the cause of pneumonia could be pneumococcus or a hemophilic rod.
An atypical air droplet infection that can occur in both the family and work contacts. If one is infected with mycoplasma, it is easy to infect others.
Pneumonia has an atypical course, symptoms are not obvious at first, the temperature is low, there may be non-pneumonia-related complaints, such as
fluid in the abdomen, inflammation of the mucous membranes of the eyes, sweating, joint pain.
If we inhale water particles or dust containing this bacterium, very severe bilateral pneumonia develops with difficulty in breathing.
The pathogen rarely responds to antibacterial therapy (usually amino penicillins). There are also extrapulmonary manifestations, damage to other vital organs. To detect Legionella, antigen or antibodies are detected in the urine.
There is no known treatment for viral pneumonia – it is treated symptomatically.
In children, pneumonia is caused by viruses in 80% of cases, but among adults, viral pneumonia is predominantly caused by immunosuppression due to the treatment of another disease.
- Influenza pneumonia
Respiratory viral infections in these climates are our daily routine, and we have hitherto thought it that viral pneumonia is less common and less severe unless a person has an immunopathology.
As pneumonia caused by other viruses is quite difficult to confirm (except for influenza), the key tactic is infection control and vaccination. Get vaccinated against the flu and you won’t have to get the flu pneumonia.
- COVID-19 pneumonia
The virus, which is currently significantly complicating the situation around the world, can cause very severe bilateral pneumonia for which no effective treatment is available.
All that remains is symptomatic and therapy – gives oxygen therapy, reduces intoxication. The most common virus enters the nose, then the throat.
The most common symptoms in 80% of cases are fever, dry cough, and sometimes abdominal disturbances, lack of smell and taste.
The body fights on its own, but when shortness of breath joins, it shows that inflammatory cytokines, like a storm, reach the lungs and damage the lung tissue, developing life-threatening pneumonia.
We measure inflammation in the blood.
We always take the patient blood tests to look for signs of inflammation.
In the elderly, and in patients with chronic diseases, pneumonia should also be tested for renal function, so creatinine should be tested in blood tests, as the decision on the dose of antibiotics depends on whether the doctor will allow the patient to stay at home or go to hospital.
Sputum analyzes are not performed in the polyclinic, because it is not possible to get a complete examination material. We perform this examination in a hospital for patients with severe pneumonia.
Pneumonia is mostly caused by bacteria, so we will need antibiotics. 5-7 different drugs are available to treat bacterial pneumonia, unfortunately there is no single drug that is effective against any microorganism.
We must consider it that bacteria become resistant to antibiotics used too often and incorrectly, and then we use special antibiotics that are resistant to these “special” bacteria.
Antibiotics as tablets are used to treat community-acquired pneumonia because they provide as good a treatment result as injections. They ask for allergic reactions and intolerance to medicines when starting treatment.
Once the course of antibiotics is over, it is advisable to perform an X-ray again to assess whether the drug has produced results and the inflammatory process in the lungs has decreased.
Recommendations vary from country to country, with many believing that the x-ray changes in the lungs disappear only a month after we start the antibiotic course, and there is no point in having an examination sooner.
However, we believe that it would be worthwhile for a young and able-bodied person to have an X-ray again in a week when starting a course of antibiotics. First, it will be seen whether the medication helps, will advise the person whether to continue living at home or can return safely to work.
If after seven the changes in the lungs have not disappeared, treatment should be continued and the patient should have another X-ray three weeks after the onset of the disease.
There must be a reason why a young person without obvious chronic damage suddenly develops pneumonia.
What should I do now if I suspect pneumonia?
You cough, sneeze, have a sore head, have a sore muscle, have a fever – any of these could be a symptom of pneumonia. Stay at home, do not visit ordinary places.
Call your family doctor. In no case with the symptoms go to a family doctor’s practice – take care of yourself, the doctor and others.
Your doctor will ask you questions over the phone about how high the temperature is, whether you have difficulty breathing, a dry cough, headache or muscle aches, or if you have been in contact with someone who has been confirmed to have COVID-19.
Did your doctor suspect that someone infected you with COVID-19?
Your GP will prescribe a referral or apply for a laboratory test. However, if the complaints are acute, there is shortness of breath, do not hesitate and call an ambulance.
Also when you are still waiting for the results of the analysis, but feel that it is getting worse, call the ambulance.
Have tests confirmed that they infect you with COVID-19?
However, even in situations where the patient does not meet the risk groups, has no chronic illness, has not been abroad, does not work in a hospital or kindergarten, but has symptoms of pneumonia, the family doctor may issue a referral for a COVID-19 test. Each case is assessed individually.
No! The answer is negative, you are not infected with COVID-19, but the cough and other symptoms of pneumonia continue. Contact the family doctor again, make an appointment and go to the consultation in time, so that the doctor can hear your lungs, send you an X-ray, prescribe medication.
Yes! If you received a positive response,
So you are infected with COVID-19. Your family doctor will advise you on a telephone consultation on what you can use to help you feel better. Drink a lot of fluids, eat healthy, rest, think good thoughts, ventilate the premises, be in strict quarantine.
If the temperature is above 38 degrees, we may use paracetamol. When symptoms are no longer present, two follow-up analyzes will be required. After the first negative answer, which tells you they have cured you, the tests should be performed again no sooner than after the day.
You need to get two negative results to confirm that you are healthy. In the case of a virus, the exacerbation usually occurs within 5-10 days.
Do you feel that your symptoms are getting worse?
Shortness of breath, weakness. Call an ambulance.
Get healthy and well faster
What will your doctor recommend curing pneumonia as quickly as possible at home? And then what about prevention so that the lungs can be pampered and never have to experience bad inflammation again?
The worldwide recommended course of antibiotics to treat pneumonia is becoming shorter every year, because we believe it that the body we must allow it to fight the pathogen.
Antibiotics should be taken for 7-8 days, but sometimes the drug is prescribed for only five days. In contrast, for atypical agents such as legionella-induced pneumonia, the course of antibiotics can last up to three weeks or more.
Sometimes people think that injection gives if antibiotics into a vein, recovery will be faster. There is no reason to think so. Faster recovery only occurs if we choose correctly the medicine and the patient follows the treatment regimen.
Sometimes patients complain of a bitter taste in the mouth during a course of antibiotics. Must be patient! When the course of antibiotics is over, this side effect will disappear within 1-2 days.
The improvement in well-being because of successful treatment should be seen as early as two days after starting the course of antibiotics. The temperature should drop, and a person can describe their well-being as “I’m not so sick at all”.
When the temperature is no longer high, bacterial pneumonia should also be treated with a peaceful walk, as the lungs need oxygen. The cough, of course, will continue for some time until the airways clear.
Better before or after meals?
Antibiotics should be taken for several days and the interval between doses should be strictly adhered to.
We should take some antibiotics between meals to be better absorbed from the gastrointestinal tract, while we can take others with or without food, before or after a meal.
However, if you feel that an empty stomach is irritating to the stomach, it is better to take the medicine after a meal, besides using a probiotic to restore the balance of the intestinal microflora.
We recommend it that antibiotics be taken at least two hours before or after taking a dose of antibiotics.
Inflammatory cells kill the pathogen, activate mucous cells in the airways, and produce sputum, the body must remove which.
There is no better tool than pure water for this purpose. No matter how abundantly we are armed with various cough syrups, they will all have to be consumed together with extra liquid – teas, water, which in this case will play a key role.
A healthy person should drink 2-4 liters of fluid a day when treating a cough, but in case of heart failure, we should consult the doctor about the recommended amount of fluid.
Of course, you can also use any folk remedies, use pine bud syrups and teas, green teas – they will not harm. If the sputum is thick and cannot be coughed, cough solvents and acetylcysteine and ambroxol may help to dissolve the sputum.
We recommend using linden, chamomile. Wild raspberry fruits, linden flowers, black elderberry flowers, blackcurrant fruits and flowers, coltsfoot leaves will have a sweating effect.
If cough should be relieved
If a dry cough persists during treatment for pneumonia and you need to cough almost until you vomit, you can temporarily use a cough suppressant. You can buy pine syrup with a small dose of codeine in pharmacies.
However, this will only be for comfort, but not for treatment, so we should not use cough suppressants on your head – consult your doctor.
Menthol, anise, Iceland lichen will also be useful for soothing coughs, and marshmallows also have a cough soothing, antispasmodic effect. Codeine, dextromethorphan and guaifenzine from over-the-counter medications can help in consultation with your doctor.
Moisturize the respiratory tract
Regular fluid drinking is best for this purpose. If you regularly went to the sauna before you got pneumonia and now there is no more fever, you could go to a not too hot sauna now.
Do not breathe water vapor, as it may burn the mucous membranes. Sometimes the doctor prescribes additional products that dilate the airways and moisturize the mucous membranes.
Take care of yourself
During treatment, we must take care to ensure that the treatment of pneumonia does not lead to any infection, and the situation does not become twice as complicated. Therefore, do not freeze or overheat, this is not a good time for experiments with hardening or contrast procedures to which they do not accustom a person.
Respiratory system soft spots
1. Recently cured pneumonia. But how come that at the first cold everything “falls” on the lungs again?
Sometimes there is another diagnosis besides pneumonia. The most common recurrence of pneumonia allows the detection of previously undiagnosed bronchial asthma.
Lung cancer or tuberculosis can also hide behind a pneumonia mask. When you take antibiotics, your health is getting better, but as soon as you stop taking the medicine, your complaints return.
It is better to go to a lung specialist here than to start the next course of antibiotics under the supervision of a family doctor.
The pneumologist will decide on further examinations – computed tomography of the lungs, bronchoscopy, sputum inoculations, which can be performed both in outpatient and specialized hospital departments.
2. I am terrified of getting COVID-19 pneumonia. Maybe it’s worth vaccinating against pneumococcus?
Pneumococcus is the most common cause of pneumonia, and vaccination could prevent severe pneumonia caused by this agent.
We recommend this vaccine for prophylaxis in high-risk patients, including elderly patients and patients with chronic diseases.
Since this vaccine became available, people with pneumonia were less likely to get it, but we should understand it that the pneumococcal vaccine does not protect against infection with COVID-19, nor can it affect the fact that people get sick more easily.
Therefore, if you are not at risk, you do not have chronic lung disease; you are not over 65 years old, pneumococcal vaccine will not be crucial.
3. I am treating pneumonia, but I also have another chronic illness. Is there a special treatment recommendation for me?
The key thing to remember is to continue taking the medication prescribed by your doctor to treat a chronic illness.
For example, asthma patients should never stop taking inhaled anti-inflammatory drugs because they think they could make pneumonia worse.
If an asthma patient persists in successfully treating asthma, the virus is less likely to cause severe lung problems.
A good time to finally quit smoking
Family doctors in England have observed that by quitting smoking before the age of 30, it reduces all the risks posed by smoking to zero and the lungs are able to fully recover.
Clear as day – nicotine-containing tobacco products are a respiratory poison that contributes to both pneumonia and bronchitis.
Which way to quit is better – to cut as with a knife and stop smoking immediately, or better to gradually get rid of by reducing the number of cigarettes smoked?
Quitting smoking one day is much harder and do you need to torture yourself? Long-term smokers can be well helped with medication.
Gradually reduce the frequency of smoking, then take the medication prescribed by your doctor and completely give up cigarettes. The day you take the medicine.
Of course, motivation will always play a key role, but if you feel that your strength will fail, then a person should help with medication if he is addicted to nicotine.
When a person tells me – if I don’t smoke, I feel dizzy; I feel bad around my heart – these are just withdrawal symptoms, which are bright from the 4th to the 6th week and then disappear.
Dress according to the weather
Both appropriate clothing and outdoor physical activity play a role in strengthening immunity. Scandinavians wear hats in cold weather, so cold in winter mortality from respiratory infections is lower than in southern countries, where a sudden onset of cold contributes to morbidity and mortality.
Researchers have concluded that one reason could be the habit of dressing according to the weather. The COVID-19 pandemic also shows what is happening in countries where lifestyle habits are different. In Italy and Spain, as is well known, smoking is highly respected and perhaps this is one reason there are so many deaths here.
Perform breathing exercises
Breathing exercises promote both expectoration and improve chest mobility and physical endurance. Anyone can learn these exercises online if it is not possible to learn them under the supervision of a physiotherapist.
Yoga is also a good way to train diaphragmatic breathing. The main essence of breathing training is to train and prolong your breath. Proper breathing is not fast and shallow, but slow and with exhalation that is longer than inhalation.
Breathing exercises are also an important part of the treatment of pneumonia and are the only treatment that has no side effects.
Breathe the air of the pine forest
One will like the pine forest, the other the sea will give strength and both options will be good, because you have to do what evokes positive emotions.
In any forest, the oxygen content of the air is richer than in the city center. In the past, sanatoriums were in the mountains because we believed it that thin air stimulated the absorption of oxygen.
Before they developed the drug for tuberculosis, patients went to Davos in Switzerland for treatment. Climate is also important with asthma – if a person moves to live in the south, asthma will often no longer cause any problems.
Avoid respiratory irritants
So do not stay in an environment where there is dust, smoke, polluted air. if it is clear that the air is not clean, you should not stay in these areas for a long time, but if the work is related to an environment with high air pollution, use respirators.
Purposefully look for positive emotions
We still know little about the new COVID-19 virus. As one German doctor said, what I’m saying now may sound like a lie in two hours.
COVID-19 makes us constantly learn, and it’s just like getting to know another person who at first seems very nice, but then we notice that he has a sloping nose and a wicked character.
However, you should not worry too much because stress can suppress immunity. I recommend engaging in activities that create positive emotions and watch news only once a day.
Emotional well-being and refreshing sleep are as important a component of health as physical health.