Respiratory Tract Infections
- Common cold
- Flu
- Sinusitis (Sinus infection)
- Otitis media (Ear infection)
- Bronchitis
- Pneumonia
<Common Cold>
The common cold is a viral infection of your upper respiratory tract — your nose and throat. A common cold is usually harmless, although it may not feel that way at the time. If it's not a runny nose, sore throat and cough, it's the watery eyes, sneezing and congestion — or maybe all of the above. In fact, because any one of more than 100 viruses can cause a common cold, signs and symptoms tend to vary greatly.
Most people recover from a common cold in about a week or two. If symptoms don't improve, see your primary care doctor.
Symptoms of a common cold usually appear about one to three days after exposure to a cold-causing virus. Signs and symptoms of a common cold may include:
- Runny or stuffy nose
- Itchy or sore throat
- Cough
- Congestion
- Slight body aches or a mild headache
- Sneezing
- Watery eyes
- Low-grade fever
- Mild fatigue
The discharge from your nose may become thicker and yellow or green in color as a common cold runs its course. What makes a cold different from other viral infections is that you generally won't have a high fever. You're also unlikely to experience significant fatigue from a common cold.
When to see a doctor
Seek medical attention if you have:
- Fever
- Sweating, chills and a cough with colored phlegm
- Significantly swollen glands
- Severe sinus pain
- Signs of dehydration, such as urinating less often than usual
- Vomiting or abdominal pain
- Unusual sleepiness
- Severe headache
- Stiff neck
- Difficulty breathing
- Ear pain
- Persistent cough
Although more than 100 viruses can cause a common cold, the rhinovirus is the most common culprit, and it's highly contagious.
A cold virus enters your body through your mouth, eyes or nose. The virus can spread through droplets in the air when someone who is sick coughs, sneezes or talks. But it also spreads by hand-to-hand contact with someone who has a cold or by sharing contaminated objects, such as utensils, towels, toys or telephones. If you touch your eyes, nose or mouth after such contact or exposure, you're likely to catch a cold.
Cold viruses are almost always present in the environment. But the following factors can increase your chances of getting a cold:
- Age. Infants and preschool children are especially susceptible to common colds because they haven't yet developed resistance to most of the viruses that cause them. But an immature immune system isn't the only thing that makes kids vulnerable. They also tend to spend lots of time with other children and frequently aren't careful about washing their hands and covering their mouths and noses when they cough and sneeze. Colds in newborns can be problematic if they interfere with nursing or breathing through the nose.
- Immunity. As you age, you develop immunity to many of the viruses that cause common colds. You'll have colds less frequently than you did as a child. However, you can still come down with a cold when you are exposed to cold viruses or have a weakened immune system. All of these factors increase your risk of a cold.
- Time of year. Both children and adults are more susceptible to colds in fall and winter. That's because children are in school and most people spend a lot of time indoors. In warmer climates where cold weather doesn't keep people inside, colds are more frequent in the rainy season.
There's no cure for the common cold. Over-the-counter (OTC) cold preparations won't cure a common cold or make it go away any sooner, and most have side effects. Here's a look at the pros and cons of some common cold remedies.
- Pain relievers. For fever, sore throat and headache, many people turn to acetaminophen (Tylenol, others) or other mild pain relievers. Keep in mind that acetaminophen can cause liver damage, especially if taken frequently or in larger than recommended doses.
- Decongestant nasal sprays. You shouldn't use OTC decongestant drops or sprays for more than a few days because prolonged use can cause chronic rebound inflammation of mucous membranes.
- Cough syrups. Over-the-counter cough and cold medicines don't effectively treat the underlying cause, won't cure cold or make it go away any sooner. These medications also have potential side effects, including rapid heart rate, increased blood pressure and drowsiness.
- Drink lots of fluids. Water, juice, clear broth or warm lemon water are all good choices. They help replace fluids lost during mucus production or fever. Avoid alcohol and caffeine, which can cause dehydration, and cigarette smoke, which can aggravate your symptoms.
- Try chicken soup. Generations of people have spooned chicken soup. Now scientists have put chicken soup to the test, discovering that it does seem to help relieve cold and flu symptoms in two ways. First, it acts as an anti-inflammatory by inhibiting the movement of neutrophils — immune system cells that help the body's response to inflammation. Second, it temporarily speeds up the movement of mucus through the nose, helping relieve congestion and limiting the time viruses are in contact with the nasal lining.
- Get some rest. If possible, stay home from work or school if you have a fever or a bad cough or are drowsy after taking medications. This will give you a chance to rest as well as reduce the chances that you'll infect others. Wear a mask when you have a cold if you live or work with someone with a chronic disease or compromised immune system.
- Adjust your room's temperature and humidity. Keep your room warm, but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
- Soothe your throat. A saltwater gargle — 1/4 to 1/2 teaspoon salt dissolved in an 8-ounce glass of warm water — can temporarily relieve a sore or scratchy throat.
- Use saline nasal rinse. To help relieve nasal congestion, try saline nasal rinse. You can buy these drops over-the-counter, and they're effective, safe and nonirritating, even for children.
In spite of ongoing studies, the scientific jury is still out on common alternative cold remedies such as vitamin C and echinacea. Here's an update on some popular choices:
- Vitamin C. It appears that for the most part taking vitamin C won't help the average person prevent colds. However, taking vitamin C at the onset of cold symptoms may shorten the duration of symptoms.
- Echinacea. Studies on the effectiveness of echinacea at preventing or shortening colds are mixed. Some studies show no benefit. Others show a significant reduction in the severity and duration of cold symptoms when taken in the early stages of a cold. One reason study results have been inconclusive may be that the type of echinacea plant and the preparation used from one study to the next have varied considerably. Research on the role of echinacea in treating the common cold is ongoing. In the meantime, if your immune system is healthy and you are not taking prescription medications, using echinacea supplements is unlikely to cause harm.
- Zinc. The cold-fighting reputation of zinc has had its ups and downs. That's because many zinc studies — both those that find the mineral beneficial and those that do not — are flawed. In studies with positive results, zinc seemed most effective taken within 24 hours of the onset of symptoms. Taking zinc with food may reduce side effects, including a bad taste and nausea. Intranasal zinc may result in permanent damage to the sense of smell. In June 2009, the FDA issued a warning against using zinc-containing nasal cold remedies because they had been associated with a long-lasting or permanent loss of smell (anosmia).
- Wash your hands. Clean your hands thoroughly and often, and teach your children the importance of hand-washing.
- Scrub your stuff. Keep kitchen and bathroom countertops clean, especially when someone in your family has a common cold. Wash children's toys periodically.
- Use tissues. Always sneeze and cough into tissues. Discard used tissues right away, and then wash your hands carefully.
- Don't share. Don't share drinking glasses or utensils with other family members. Use your own glass or disposable cups when you or someone else is sick. Label the cup or glass with the name of the person with the cold.
- Steer clear of colds. Avoid close, prolonged contact with anyone who has a cold.
- Choose your child care center wisely. Look for a child care setting with good hygiene practices and clear policies about keeping sick children at home.
<Sinusitis>
Sinusitis causes the cavities around your nasal passages (sinuses) to become inflamed and swollen. This interferes with drainage and causes mucus to build up.
With sinusitis, it may be difficult to breathe through your nose. The area around your eyes and face may feel swollen, and you may have throbbing facial pain or a headache.
Sinusitis is most often caused by the common cold. Other triggers include allergies, bacterial and fungal infections. Treatment of acute sinusitis depends on the cause. Persistent sinusitis can lead to serious infections and other complications. Sinusitis that lasts more than eight weeks or keeps coming back is called chronic sinusitis.
Sinusitis symptoms often include:
- Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat
- Nasal obstruction or congestion, causing difficulty breathing through your nose
- Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead
- Reduced sense of smell and taste
- Cough, which may be worse at night
Other signs and symptoms can include:
- Ear pain
- Headache
- Aching in your upper jaw and teeth
- Bad breath (halitosis)
- Fatigue
- Fever
When to see a doctor
See your primary care doctor if you have any of the following:
- Symptoms that don't improve within a few days or symptoms that get worse
- A persistent fever
- A history of recurrent or chronic sinusitis
- Pain or swelling around your eyes
- Swollen forehead
- Severe headache
- Confusion
- Double vision or other vision changes
- Stiff neck
- Shortness of breath
When you have sinusitis, the mucous membranes of your nose, sinuses and throat (upper respiratory tract) become inflamed. Swelling obstructs the sinus openings and prevents mucus from draining normally, causing facial pain and other sinusitis symptoms.
Blocked sinuses create a moist environment that makes it easier for infection to take hold. Sinuses that become infected and can't drain become pus filled, leading to signs and symptoms such as thick, yellow or greenish discharge and other symptoms of infection.
Sinusitis can be caused by:
- Viral infection. Most cases of acute sinusitis are caused by the common cold.
- Bacterial infection. When an upper respiratory tract infection persists longer than seven to 10 days, it's more likely to be caused by a bacterial infection than by a viral infection.
Some health conditions can increase your risk of getting a sinus infection that causes sinusitis, or can increase your risk of getting sinusitis that isn't caused by an underlying infection. These conditions include:
- Allergies such as hay fever. Inflammation that occurs with allergies may block your sinuses.
- Nasal polyps or tumors. These tissue growths may block the nasal passages or sinuses.
- Deviated nasal septum. A crooked septum — the wall between the nostrils — may restrict or block sinus passages.
- Tooth infection. A small number of cases of acute sinusitis are caused by an infected tooth.
- Other medical conditions. The complications of cystic fibrosis, gastroesophageal reflux disease (GERD) or immune system disorders may result in blocked sinuses or an increased risk of infection.
- Regular exposure to pollutants such as cigarette smoke
Treatments
Your doctor may recommend treatments to help relieve sinusitis symptoms, including:
- Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
- Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ).
- Antibiotics. Antibiotics used to treat acute sinusitis caused by a bacterial infection include amoxicillin (Amoxil, others), or the combination drug trimethoprim-sulfamethoxazole (Bactrim, Septra, others). If the infection doesn't go away or if the sinusitis comes back, your doctor may try a different antibiotic.
If your doctor does prescribe antibiotics, it's critical to take the entire course of medication. Generally, this means you'll need to take them for 10 to 14 days — even after your symptoms get better. If you stop taking them early, your symptoms may come back.
These self-help steps can help relieve sinusitis symptoms:
- Get plenty of rest. This will help your body fight infection and speed recovery.
- Drink plenty of fluids, such as water or juice. This will help dilute mucous secretions and promote drainage. Avoid beverages that contain caffeine or alcohol, as they can be dehydrating. Drinking alcohol can also worsen the swelling of the lining of the sinuses and nose.
- Moisten your sinus cavities. Drape a towel over your head as you breathe in the vapor from a bowl of hot water. Keep the vapor directed toward your face. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucus drain.
- Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain.
- Rinse out your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others) to rinse your nasal passages. This home remedy, called nasal lavage, can help clear your sinuses. Be sure to rinse the irrigation device after each use with contaminant-free water and leave open to air-dry.
- Sleep with your head elevated. This will help your sinuses drain, reducing congestion.
No alternative therapies have been definitively proven to help ease the symptoms of sinusitis, but products containing certain combinations of herbs may improve your symptoms. These combination therapies, sold under brand names such as Sinupret and SinuGuard, contain a mixture of cowslip, gentian root, elderflower, verbena and sorrel. Possible side effects include stomach upset, diarrhea and allergic skin reactions.
Take these steps to help reduce your risk of getting sinusitis:
- Avoid upper respiratory infections. Minimize contact with people who have colds. Wash your hands frequently with soap and water, especially before your meals.
- Carefully manage your allergies. Work with your doctor to keep symptoms under control.
- Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.
- Use a humidifier. If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis. Be sure the humidifier stays clean and free of mold with regular, thorough cleaning.
<Otitis Media - Ear Infection>
An ear infection (otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.
The onset of signs and symptoms of ear infection is usually rapid.
Signs and symptoms include:
- Ear pain, especially when lying down
- Loss of balance
- Fever
- Drainage of fluid from the ear
- Diminished hearing
- Headache
- Loss of appetite
When to see a doctor
Signs and symptoms of an ear infection can indicate a number of conditions. It's important to get an accurate diagnosis and prompt treatment.
An ear infection is caused by a bacterium or virus in the middle ear. This infection often results from another illness — cold, flu or allergy — that causes congestion and swelling of the nasal passages, throat and eustachian tubes.
Risk factors for ear infections include:
- Age. Children are more susceptible to ear infections because of the size and shape of the eustachian tubes and because of their poorly developed immune systems.
- Group child care. Children cared for in group settings are more likely to get colds and ear infections than are children who stay home because they're exposed to more infections, such as the common cold.
- Seasonal factors. Ear infections are most common during the fall and winter when colds and flu are prevalent. People with seasonal allergies may have a greater risk of ear infections during seasonal high pollen counts.
- Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infection.
Frequent or persistent infections and persistent fluid buildup can result in some serious complications:
- Impaired hearing. Mild hearing loss that comes and goes is fairly common with an ear infection, but it usually returns to what it was before the infection after the infection clears. Persistent infection or persistent fluids in the middle ear may result in more significant hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur.
- Spread of infection. Untreated infections or infections that don't respond well to treatment can spread to nearby tissues. Infection of the mastoid, the bony protrusion behind the ear, is called mastoiditis. This infection can result in damage to the bone and the formation of pus-filled cysts. Rarely, serious middle ear infections spread to other tissues in the skull, including the brain.
- Tearing of the eardrum. Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.
Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an office exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also listen to your child breathe with a stethoscope.
Your doctor will advise you on treatments to lessen pain from an ear infection. These may include the following:
- A warm compress. Placing a warm, moist washcloth over the affected ear may lessen pain.
- Pain medication. Your doctor may advise the use of over-the-counter acetaminophen (Tylenol, others) or ibuprofen (Motrin, Advil, others) to relieve pain. Use the drugs as directed on the label.
- Antibiotic therapy.
Even after symptoms have improved, be sure to use all of the antibiotic as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medications. Talk to your doctor or pharmacist about what to do if you accidentally skip a dose.
The following tips may reduce the risk of developing ear infections:
- Prevent common colds and other illnesses. Teach your children to wash their hands frequently and thoroughly and to not share eating and drinking utensils. Teach your children to cough or sneeze into their arm crook. If possible, limit the time your child spends in group child care. A child care setting with fewer children may help. Try to keep your child home from child care or school when ill.
- Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.
- Talk to your doctor about vaccinations. Ask your doctor about what vaccinations are appropriate for your child. Seasonal flu shots and pneumococcal vaccines may help prevent ear infections.
<Bronchitis>
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic.
Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking.
Acute bronchitis usually improves within a few days without lasting effects, although you may continue to cough for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).
For either acute bronchitis or chronic bronchitis, signs and symptoms may include:
- Cough
- Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood
- Fatigue
- Shortness of breath
- Slight fever and chills
- Chest discomfort
If you have acute bronchitis, you may have a nagging cough that lingers for several weeks after the inflammation resolves. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years.
If you have chronic bronchitis, you're likely to have periods when your signs and symptoms worsen. At those times, you may have acute bronchitis on top of your chronic bronchitis.
When to see a doctor
See your doctor if your cough:
- Lasts more than three weeks
- Prevents you from sleeping
- Is accompanied by fever higher than 100.4 F (38 C)
- Produces discolored mucus
- Produces blood
- Is associated with wheezing or shortness of breath
Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza).
The most common cause of chronic bronchitis is smoking cigarettes. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition.
Factors that increase your risk of bronchitis include:
- Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis.
- Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection.
- Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes.
- Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis.
Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis may indicate that you're developing chronic obstructive pulmonary disease (COPD).
Make an appointment with your primary care doctor if you have symptoms and signs. If you have chronic bronchitis, you may be referred to a doctor who specializes in lung diseases (pulmonologist).
During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe.
In some cases, your doctor may suggest:
- Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker.
- Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema.
Medications
In some circumstances, your doctor may prescribe medications, including:
- Antibiotics. Your doctor might prescribe an antibiotic if he or she suspects that you have a bacterial infection.
- Cough medicine. It's best not to suppress a cough that brings up mucus, because coughing helps remove irritants from your lungs and air passages. If your cough keeps you from sleeping, you might try cough suppressants at bedtime.
- Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs.
To help you feel better, you may want to try the following self-care measures:
- Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes.
- Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container.
- Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside.
To reduce your risk of bronchitis, follow these tips:
- Avoid cigarette smoke. Cigarette smoke increases your risk of chronic bronchitis.
- Get vaccinated. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help protect you from getting the flu. You may also want to consider vaccination that protects against some types of pneumonia.
- Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using hand sanitizers.
- Wear a surgical mask. If you have COPD, you might consider wearing a face mask at work and in crowds.
<Pneumonia>
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Pneumonia can range in seriousness from mild to life-threatening It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.
The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.
Signs and symptoms of pneumonia may include:
- Fever, sweating and shaking chills
- Cough, which may produce phlegm
- Chest pain when you breathe or cough
- Shortness of breath
- Fatigue
- Nausea, vomiting or diarrhea
People older than age 65 and people in poor health or with a weakened immune system may have a lower than normal body temperature. Older people who have pneumonia sometimes have sudden changes in mental awareness.
When to see a doctor
Make an appointment with you primary care doctor if you have symptoms and signs.
It's especially important that people in these high-risk groups see a doctor:
- Children younger than age 2 with signs and symptoms
- Adults older than age 65
- People with an underlying health condition or weakened immune system
- People receiving chemotherapy or taking medication that suppresses the immune system
For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition.
Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your immune system, even if your health is generally good.
Pneumonia may be caused by:
- Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you've had a cold or the flu.
- Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces milder symptoms than do other types of pneumonia. Walking pneumonia, a term used to describe pneumonia that isn't severe enough to require bed rest, may be caused by M. pneumoniae.
- Viruses. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some cases it can become very serious.
- Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings.
Pneumonia can affect anyone. But the two age groups at highest risk are:
- Children who are 2 years old or younger developing
- People who are age 65 or older
Other risk factors include:
- Chronic disease. You're more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease or heart disease.
- Weakened or suppressed immune system. People who have HIV/AIDS, who've had an organ transplant, or who receive chemotherapy or long-term steroids are at risk.
- Smoking. Smoking damages your body's natural defenses against the bacteria and viruses that cause pneumonia.
- Being hospitalized. You're at greater risk of pneumonia if you're in a hospital intensive care unit, especially if you're on a machine that helps you breathe (a ventilator).
Pneumonia can be treated successfully with medication. However, some people, especially those in high-risk groups, may experience complications, including:
- Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.
- Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus.
- Fluid accumulation around your lungs (pleural effusion). Pneumonia may cause fluid to build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to have it drained through a chest tube or removed with surgery.
- Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing machine (ventilator) while your lung heals.
Your doctor will start by asking about your medical history and doing a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that indicate the presence of secretions.
If pneumonia is suspected, your doctor may recommend the following tests:
- Chest X-ray. This helps your doctor diagnose pneumonia and determine the extent and location of the infection. However, it can't tell your doctor what kind of germ is causing the pneumonia.
- Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
- CT scan. If your pneumonia isn't clearing as quickly as expected, your doctor may recommend a chest CT scan to obtain a more detailed image of your lungs.
Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include:
- Antibiotics. These medicines are used to treat bacterial pneumonia. If your symptoms don't improve, your doctor may recommend a different antibiotic.
- Fever reducers. These include drugs such as aspirin, ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others).
- Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely.
Hospitalization
You may need to be hospitalized if:
- You are older than age 65
- You become confused about time, people or places
- Your nausea and vomiting prevent you from keeping down oral antibiotics
- Your blood pressure drops
- Your breathing is rapid
- You need breathing assistance
- Your temperature is below normal
- Your heart rate is below 50 or higher than 100
These tips can help you recover more quickly and decrease your risk of complications:
- Get plenty of rest. Don't go back to school or work until after your temperature returns to normal and you stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Because pneumonia can recur, it's better not to jump back into your routine until you are fully recovered. Ask your doctor if you're not sure.
- Stay hydrated. Drink plenty of fluids, especially water, to help loosen mucus in your lungs.
- Take your medicine as prescribed. Take the entire course of any medications your doctor prescribed for you. If you stop medication too soon, your lungs may continue to harbor bacteria that can multiply and cause your pneumonia to recur.
To help prevent pneumonia:
- Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with your doctor about getting these shots.
- Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease. Children who attend a group child care center should also get the vaccine. Doctors also recommend flu shots for children older than 6 months.
- Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.
- Don't smoke. Smoking damages your lungs' natural defenses against respiratory infections.
- Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.