Dr. M.J. Bazos, MD. Patient Handout

PNEUMONIA, BACTERIAL

About Your Diagnosis
Pneumonia is a term that refers to inflammation of the lung. Bacterial pneumonia means that inflammation is caused by a bacterial infection. Bacteria gain access to the lungs either through inhalation or via the bloodstream. Infections occur when the bacteria overwhelm the defense mechanisms. The following conditions may weaken your body’s defense mechanisms and thus increase the risks for bacterial pneumonia:
• Old age.
• Smoking.
• Chronic alcohol use or misuse.
• Chronic lung disease.
• Congestive heart failure.
• Diabetes.
• Chronic kidney failure.
• Human immunodeficiency virus (HIV) infection.
• Use of drugs that are designed to lower your body’s immune system, such as anticancer agents and prednisone.
• Recent viral respiratory tract infections.
Pneumonia can also occur in usually healthy individuals of all ages. There are many different types of bacteria that can cause pneumonia. Streptococcus and Mycoplasma are common causes for pneumonia in otherwise healthy individuals. Those with chronic illnesses can be affected by Staphylococcus, Haemophilus, Legionella, and types of bacteria that are normally found in the intestinal tract. Bacteria normally found in the mouth can also cause pneumonia when they are accidentally inhaled into the lungs during seizures
or coma. Tests are performed to determine the cause and severity of pneumonia, including chest x-rays and analyses of sputum and blood. Despite these tests, the responsible bacteria is often not identified. Your doctor will then consider the circumstances in which the pneumonia began and the severity of the illness to help guide treatment. Other conditions may cause pneumonia-like symptoms, including heart failure, blood clot to the lungs, and cancer.


Living With Your Diagnosis
Pneumonia can range from a mild illness to a lifethreatening condition. Common symptoms are fever, cough, chest pain, and shortness of breath. Phlegm may be yellow or green and contain blood. With some types of pneumonia, muscle aches, nausea/ vomiting, fatigue, and weakness are prominent. Severe pneumonia is signaled by rapid breathing (greater than 30 breaths per minute), low blood pressure, temperature greater than 102°F, and confusion. Complications of pneumonia include inflammation and infection of the pleura (the layer of cells lining the outside of the lung), lung abscess, spread of infection outside the lung (to the brain, joints, etc.), and lung failure.

Treatment
Antibiotics are the mainstay of treatment and should be started as soon as pneumonia is suspected. For milder disease, oral antibiotics are used. Improvement is usually noted within 48–72 hours from starting therapy. More severely ill patients are hospitalized and receive several types of antibiotics administered intravenously. These patients are then switched to oral antibiotics when their condition stabilizes. Hospitalized patients may also receive supplemental oxygen and special respiratory care to help clear phlegm. If there is fluid buildup around the lung, this will be sampled to look for infection. Mechanical ventilation in an intensive care unit is used if the lungs are temporarily unable to take up oxygen and expel carbon dioxide. Duration of antibiotic therapy ranges from 7 to 10 days in most cases. Therapy for 14–21 days or longer may be necessary for certain types of bacteria and in those individuals with other chronic medical conditions.

The DOs
• Take your antibiotics exactly as prescribed. If you miss a dose, simply resume with the next dose and continue to take the pills as scheduled until they are gone.
• Use acetaminophen and aspirin (except in children) to help decrease fever and to treat pain.
• Drink plenty of fluids (six to eight glasses per day) and/or breathe moist air to help raise phlegm.
• Obtain a pneumococcal vaccine if you are older than 65 years or if you have a chronic illness. This vaccine is designed to improve your defense against Streptococcus pneumoniae, which is one of the most common causes of pneumonia.
• Let your doctor know about any allergic reactions to antibiotics that you have had.

The DON’Ts
• Home treatment of pneumonia with antibiotics should be avoided if the home environment is not stable and conducive to rest and recovery.

When to Call Your Doctor
• You suspect a pneumonia because of fever, green or yellow sputum production, increased shortness of breath, or chest pain.
• Symptoms continue or worsen after 48 hours of antibiotic therapy.
• If you note dusky-colored skin, lips, or fingernails.
• Nausea/vomiting prevent you from taking your antibiotics exactly as prescribed.
• Dehydration develops because of vomiting and/or diarrhea.

Websites:
American Lung Association
www.lungusa.org