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JAMA PATIENT PAGE | Pulmonary

Pneumonia

Pneumonia is a lung infection that can be caused by bacteria, viruses, or fungi.

When you breathe in, oxygen-rich air travels into the body through the airways (trachea, bronchi, and bronchioles) in your lungs. At the ends of the airways, oxygen is exchanged for carbon dioxide, which travels out of the body when you breathe out. Alveoli are very small air sacs at the ends of the airway branches where this gas exchange occurs. Pneumonia causes alveoli to become inflamed and to fill up with fluid. Bacteria are the most common cause of pneumonia in adults, while viruses are the most common cause in children younger than 5 years.

Lung anatomy and gas exchange

Bronchiole Alveoli Trachea AIR BLOOD Bronchi (in alveolus) (in capillary) Carbon Bronchioles dioxide Gas
Bronchiole
Alveoli
Trachea
AIR
BLOOD
Bronchi
(in alveolus)
(in capillary)
Carbon
Bronchioles
dioxide
Gas exchange
Oxygen
Healthy alveoli
Air in alveoli
Pneumonia
Inflammatory cells and fluid in alveoli
Bronchiole
Bronchiole
Capillary
Capillary

Treatment is based on what kind of germ is causing the infec- tion and how severe your symptoms are. Bacterial pneumonia is treated with antibiotic medicines. Antibiotics will not help in cases of viral pneumonia, which often improves without treatment. Pneumonia can be acquired in various settings. Causative germs and treatment may differ depending on whether you have commu- nity-acquired pneumonia (CAP), hospital-acquired pneumonia, or health care–associated pneumonia. Many cases of pneumonia can be treated at home. If your symp- toms are severe or you have other health problems, you may need to be treated in the hospital. A study in the February 9, 2016, issue of JAMA reports on antibiotic therapy in adults hospitalizedwith CAP.

Symptoms

The symptoms of pneumonia range from mild to severe. Common symptoms include cough with phlegm (“wet cough”), difficulty breathing, fever, chest pain, fatigue, and confusion.

At-Risk Populations

While anyone can get pneumonia, certain groups are at higher risk of developing thedisease.Childrenyounger than 2yearsandadultsolder than 65 years are at increased risk. Your risk is also higher if you

Have a weakened immune system

Have chronic lung disease, such as COPD, asthma, or cystic fibrosis

Haveotherchronichealthproblems,suchasdiabetesorheartdisease

Smoke cigarettes

Prevention

Vaccines can help prevent pneumonia. Pneumococcal vaccine helps protect you from a common cause of severe pneumonia. Getting the flu vaccine every year helps prevent pneumonia that is caused by the influenza virus or that occurs as a complication of having the flu. Pertussis,measles, varicella (chickenpox), andHib vaccines help pre- vent less common causes of pneumonia. Washing your hands with soap and water or using hand sani- tizer regularly can help prevent the spread of germs that cause pneu- monia. Quitting smoking increases your lungs’ ability to filter out germs and fight infections.

Diagnosis and Treatment

To diagnose pneumonia, your doctor will ask questions about your symptoms and your health history. Certain tests, including chest x-ray, blood tests, and sputum (phlegm) culture, may be per- formed to help make the diagnosis.

Author: Amy E. Thompson, MD

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: Centers for Disease Control and Prevention; National Heart, Lung, and Blood Institute.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

626 JAMA February 9, 2016 Volume 315, Number 6 (Reprinted)

Copyright 2016 American Medical Association. All rights reserved.

Copyright 2016 American Medical Association. All rights reserved.

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