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Pneumonia - adults (community acquired)


Alternative Names:

Bronchopneumonia; Community-acquired pneumonia; CAP

Exams and Tests:

The health care provider will listen for crackles or abnormal breath sounds when listening to your chest with a stethoscope. Tapping on your chest wall (percussion) helps the health care provider listen and feel for abnormal sounds in your chest.

The health care provider will likely order a chest x-ray if pneumonia is suspected.

Other tests that may be ordered include:

Treatment:

Your doctor must first decide whether you need to be in the hospital. If you are treated in the hospital, you will receive:

  • Fluids and antibiotics through your veins
  • Oxygen therapy
  • Breathing treatments (possibly)

It is important that you are started on antibiotics very soon after you are admitted. If you have viral pneumonia, you will not receive antibiotics. This is because antibiotics do not kill viruses. You will receive other medicines, especially if you have the flu. 

You are more likely to be admitted to the hospital if you:

  • Have another serious medical problem
  • Have severe symptoms
  • Are unable to care for yourself at home, or are unable to eat or drink
  • Are older than 65
  • Have been taking antibiotics at home and are not getting better

Many people can be treated at home. If so, your doctor may tell you to take antibiotics. 

When taking antibiotics:

  • Do not miss any doses. Take the medicine until it is gone, even when you start to feel better.
  • Do not take cough medicine or cold medicine unless your doctor says it is OK. Coughing helps your body get rid of mucus from your lungs.

Breathing warm, moist (wet) air helps loosen the sticky mucus that may make you feel like you are choking. These things may help:

  • Place a warm, wet washcloth loosely over your nose and mouth.
  • Fill a humidifier with warm water and breathe in the warm mist.
  • Take a couple of deep breaths two or three times every hour. Deep breaths will help open up your lungs.
  • Tap your chest gently a few times a day while lying with your head lower than your chest. This helps bring up mucus from the lungs so that you can cough it out.

Drink plenty of liquids, as long as your health care provider says it is OK.

  • Drink water, juice, or weak tea
  • Drink at least 6 to 10 cups a day
  • Do not drink alcohol

Get plenty of rest when you go home. If you have trouble sleeping at night, take naps during the day.

Outlook (Prognosis):

With treatment, most patients improve within 2 weeks. Elderly or very sick patients may need longer treatment.

Those who may be more likely to have complicated pneumonia include:

  • Older adults
  • People whose immune system does not work well
  • People with other, serious medical problems such as diabetes or cirrhosis of the liver

In all of the above conditions, pneumonia can lead to death, if it is severe.

In rare cases, more serious problems may develop, including:

  • Life-threatening changes in the lungs that require a breathing machine
  • Fluid around the lung (pleural effusion)
  • Infected fluid around the lung (empyema)
  • Lung abscesses

Your doctor may order another x-ray. This is to make sure your lungs are clear. But it may take many weeks for your x-ray to clear up. You will likely feel better before the x-ray clears up.

When to Contact a Medical Professional:

Call your doctor if you have:

  • Cough that brings up bloody or rust-colored mucus
  • Breathing (respiratory) symptoms that get worse
  • Chest pain that gets worse when you cough or breathe in
  • Fast or painful breathing
  • Night sweats or unexplained weight loss
  • Shortness of breath, shaking chills, or persistent fevers
  • Signs of pneumonia and a weak immune system (for example such as with HIV or chemotherapy)
  • Worsening of symptoms after initial improvement
Prevention:

You can help prevent pneumonia by following the measures below.

Wash your hands often, especially:

  • Before preparing and eating food
  • After blowing your nose
  • After going to the bathroom
  • After changing a baby's diaper
  • After coming in contact with people who are sick

Do not smoke. Tobacco damages your lung's ability to fight infection.

Vaccines may help prevent some types of pneumonia.

Be sure to get the following vaccines:

  • Flu vaccine can help prevent pneumonia caused by the flu virus.
  • Pneumococcal vaccine lowers your chances of getting pneumonia from Streptococcus pneumoniae.

Vaccines are even more important for the elderly and people with diabetes, asthma, emphysema, HIV, cancer, persons with organ transplants, or other long-term conditions.

References:

Limper AH. Overview of pneumonia. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 97.

Watkins RR, Lemonovich TL. Diagnosis and management of community-acquired pneumonia in adults. Am Fam Physician. 2011;83:1299-1306.


Review Date: 4/26/2014
Reviewed By: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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