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Pneumonia - Symptoms

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of pneumonia.

Symptoms:

General Symptoms. The symptoms of some bacterial pneumonias, such as pneumococcal pneumonia, develop very quickly and typically include:

  • A single episode of shaking chills followed by fever
  • Chest pain on the side of the infected lung. Severe abdominal pain sometimes occurs in people with pneumonia in the lower lobes of the lung
  • Cough, which may be dry at first, but eventually produces phlegm (sputum)
  • Nausea, vomiting, and muscle aches
  • Rapid breathing and heartbeat
  • Shortness of breath

Emergency Symptoms. Symptoms of pneumonia indicating a medical emergency include the following:

  • Blood in sputum
  • Bluish-toned (cyanotic) skin
  • High fever
  • Labored and heavy breathing
  • Mental confusion or reduced mental function in the elderly
  • Rapid heart rate
  • Weight loss

Symptoms in the Elderly. It is important to note that older people may have fewer or different symptoms than younger people. Symptoms may come on much more slowly. An elderly person who experiences even a minor cough and weakness for more than a day should seek medical help. Some elderly people may be confused, lethargic, and show general deterioration.

Symptoms of Atypical Pneumonia

General Symptoms of Atypical Pneumonias. Atypical pneumonia is most commonly caused by mycoplasma, Legionnaires' disease, or chlamydia and usually appears in children and young adults.

The disease progresses gradually:

  • General flu-like symptoms often occur first. They may include fatigue, fever, weakness, headache, nasal discharge, sore throat, earache, and stomach and intestinal distress.
  • Vague pain under and around the breastbone may occur, but the severe chest pain associated with typical bacterial pneumonia is uncommon.
  • Patients may have a severe hacking cough, but it usually does not produce sputum.

Resources

References

American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents -- United States, 2008. Pediatrics. 2008;121:219-220.

Barr CE, Schulman K, Iacuzio D, Bradley JS. Effect of oseltamivir on the risk of pneumonia and use of health care services in chidlren with clinically diagnosed influenza. Curr Med Res Opin. 2007;23(3):523-531.

Galobardes B, McCarron P, Jeffreys M, Davey-Smith G. Medical history of respiratory disease in early life relates to morbidity and mortality in adulthood. Thorax. 2008;Epub.

Gleason PP, Shaughnessy AF. STEPS new drug reviews telithromycin (Ketek) for treatment of community-acquired pneumonia. Am Fam Physician. 2007;76.

Grijalva CG, Nuorti JP, Arbogast PG, Martin SW, Edwards KM, Griffin MR. Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time-series analysis. Lancet. 2007;369:1179-1186.

Grijalva CG, et al. Pneumonia hospitalizations among young children before and after introduction of pneumococcal conjugate vaccine -- United States, 1997 - 2006. MMWR. 2009;58:1-4.

Huss A, Scott P, Stuck AE, Trotter C, Egger M. Efficacy of pneumococcal vaccination in adults: a meta-analysis. CMAJ. 2009;180:48-58.

Jackson M, Nelson JC, Weiss NS, Neuzil KM, Barlow W, Jackson LA. Influenza vaccination and risk of community-acquired pneumonia in immunocompetent elderly people: A population-based, nested case-control study. Lancet. 2008;372:352-354.

Johnstone J, Marrie TJ, Eurich DT, Majumdar SR. Effect of pneumococcal vaccine in hospitalized adults with community-acquired pneumonia. Arch Intern Med. 2007;167:1938-1943.

Knol W, van Marum RJ, Jansen PA, Souverein PC, Schobben AF, Egberts AC. Antipsychotic drug use and risk of pneumonia in elderly people. J Am Geriatr Soc. 2008;56:661-666.

Kollef MH, Afessa B, Anzueto A, Veremakis C, Kerr KM, Margolis BD, et al. Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: The NASCENT randomized trial. JAMA. 2008;300:805-813.

Lee TA, Weaver FM, Weiss KB. Impact of pneumococcal vaccination on pneumonia rates in patients with COPD and asthma. J Gen Intern Med. 2007;22(1):62-67.

Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2007;120:783-790.

Limper AH. Overview of Pneumonia. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. Philadelphia, Pa: Saunders; 2007:chap 97.

Lutfiyya MN, Henley E, Chang LF. Diagnosis and treatment of community-acquired pneumonia. Am Fam Physician. 2006;73:442-450.

Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44:S27-S72.

Meissner HC, Long SS. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics. 2003;112:1447-1452.

Muller B, Harbath S, Stolz D, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis. 2007;7:10.

Neuman MI, Willett WC, Curhan GC. Vitamin and micronutrient intake and the risk of community-acquired pneumonia in US women. Am J Med. 2007;120:330-336.

Nisar N, Guleria R, Kuman S, Chand Chawla T, Ranjan Biswas N. Mycoplasma pneumoniae and its role in asthma. Postgrad Med J. 2007;83:100-104.

Reade MC, Yende S, DAngelo G, Milbrandt EB, Kellum JA, Bamato AE, et al. Sex disparities in treatment and outcome of community-acquired pneumonia. Am J Respir Crit Care Med. 2008;177:A770.

Sing S, Amin AV, Loke YK. Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: A meta-analysis. Arch Intern Med. 2009;169:219-229.

Spaude KA, Abrutyn E, Kirchner C, Kim A, Daley J, Fisman DN. Influenza vaccination and risk of mortality among adults hospitalized with community-acquired pneumonia. Arch Intern Med 2007;167(1):53-59.

Venditti M, Falcone M, Corrao S, Licata G, Serra P. Outcomes of patients hospitalized with community-acquired, health-care associated, and hospital-acquired pneumonia. Ann Intern Med. 2009;150:19-26.

  • Reviewed last on: 3/29/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional 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. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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