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Infectious Diseases Infectious Disease Basics

Pneumonia: What Lurks in the Lungs


Medically Reviewed On: December 23, 2003

By Christine Haran

Now that fear of the flu has reached SARS-like proportions, it's time to remember that influenza season is also pneumonia season. In fact, some pneumonias can be caused by the flu, or follow an influenza infection.

Pneumonia is an infection of the lungs that most commonly affects older people but can also affect children and younger adults. While pneumonia caused about 62,000 deaths in the United States in 2001, it can usually be treated with antibiotics. And a preventative vaccine exists for pneumococcal pneumonia, the most common type of pneumonia. But like the flu vaccine, this year there is a limited supply of pneumonoccal conjugate vaccine.

Below, pneumonia researcher Michael Fine, MD, a professor of medicine at the University of Pittsburgh and director of the VA-Pittsburgh Center for Health Equity Research and Promotion, discusses the different types of pneumonia and why prevention or early treatment is best.

What is pneumonia?
It's an infection of the respiratory tract that is typically characterized by a broad array of signs and symptoms. The infection is usually termed community-acquired pneumonia to differentiate it from that acquired in the hospital.

The lungs are comprised of very tiny sacs called alveoli. This is where the oxygen that we inhale comes into contact with circulating blood through capillaries, or tiny blood vessels, and where the oxygen is exchanged. In pneumonia, those tiny sacs become filled up with infectious material.

Who is at highest risk for pneumonia?
Among adults, risk increases with age. So the older you are, the greater the likelihood to get pneumonia. If you're a smoker, you have a slightly greater increased risk because smoking diminishes the lung's capacity to fight infection.

Anyone who is a drug abuser or an alcoholic, who has impaired levels of consciousness that can affect the gag reflex, would be at increased risk because they can inhale their own throat secretions. Patients who are immunocompromised for one reason or another, whether they're taking systemic corticosteroids for something like asthma or if they're receiving chemotherapy or radiation therapy for cancer, would be at increased risk.

What are common symptoms?
The symptoms can really be divided into two categories: typical respiratory symptoms and nonrespiratory symptoms. Respiratory symptoms would include cough, coughing up mucus, shortness of breath and chest pain. A less common respiratory symptom would be coughing up blood.

Then there are a variety of nonrespiratory symptoms, the most common of which—and probably the number-one symptom overall—is fatigue, which is present in about 90 percent of patients. You can also get headache, muscle aches, abdominal pain, fever and chills.

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