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

PNEUMONIA, VIRAL

About Your Diagnosis
Viruses are frequent causes of many types of infections of the respiratory tract, such as the common cold, pharyngitis, laryngitis, and bronchitis. These illnesses are usually brief and resolve without specific therapy. It is thought that viral infections start after you inhale a contaminated droplet from an infectious individual, or that the virus is directly transferred to your nose, mouth, or eyes by your hands, which have previously touched a contaminated object. Viral pneumonia refers to an infection of the lung tissue that can be caused by many different types of viruses. Influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, and varicella virus are some of the most common causes of viral pneumonia. Children and adults of all ages can be affected, sometimes as part of outbreaks. Smokers, the elderly, and those with chronic lung diseases may be most susceptible. Individuals with suppression of the immune system because of chemotherapy or because of drug therapy after organ transplantation are especially vulnerable to pneumonia caused by cytomegalovirus. It is difficult to determine whether pneumonia is caused by a virus, as well as which specific virus is causing the pneumonia, because many viruses produce similar symptoms and there are few specific diagnostic tests. Viral pneumonias, especially those caused by influenza virus, can be followed quickly by the development of bacterial pneumonias because viruses can weaken the lung’s defense mechanisms.

Living With Your Diagnosis
The most common symptoms of viral pneumonia include fever, chills, cough, shortness of breath, chest discomfort, muscle aches, fatigue, and poor appetite. Symptoms of runny nose, irritated eyes, and sore throat may also be present. Symptoms outside the respiratory tract may be present if the virus has infected other parts of the body. For instance, herpesvirus and measles virus may also cause rashes. Some viruses can be found in respiratory secretions, whereas others can be detected by blood tests. However, in most cases, diagnostic tests are not performed to check for a specific viral cause. Instead, once your health care provider has established that pneumonia is present by examination of the chest and x-rays, analyses of the blood and sputum are usually performed to make sure a concomitant bacterial infection is not also present. Viral pneumonias in otherwise healthy individuals resolve within 1–2 weeks, but cough and fatigue may persist for many weeks. Viral pneumonias can be serious and potentially life threatening in those with other medical illnesses.

Treatment
Specific treatments are available for few viruses, so care measures are usually supportive.
Options include:
• Bed rest.
• Acetaminophen or aspirin (not in children) for relief of fever and aches.
• Cough suppressants.
• Decongestant tablets or nasal sprays.
If a specific viral cause is found, antiviral drugs may be prescribed, such as amantadine or rimantadine for influenza A, acyclovir for herpesvirus, or ganciclovir for cytomegalovirus. Antibiotics are prescribed for concurrent bacterial infections. Seriously ill patients are hospitalized for treatment with intravenous fluids, supplemental oxygen, or breathing support by a mechanical ventilator.

The DOs
A vaccine is available to help decrease the risk of illness with influenza virus. Because influenza virus strains change yearly, this vaccine must be updated each fall. The vaccine is recommended for:
• Individuals older than 65 years.
• Adults or children with chronic lung, kidney, or heart disease; diabetes; or chronic anemia.
• Adults or children who live in chronic care facilities, such as nursing homes.
• Community workers such as police officers and firefighters.
• Health care workers.
The vaccine is given as a single injection into the shoulder region. Side effects are rare, but some individuals may experience slight fever and muscle aches shortly after the shot. The influenza vaccine can be given at the same time the pneumococcal vaccine is received. Individuals allergic to eggs and egg products should avoid the vaccine.
If viral pneumonia develops:
• Obtain plenty of bed rest.
• Drink at least six to eight glasses of liquid per day to avoid dehydration.
• Maintain proper nutrition.

The DON’Ts
• If you have viral respiratory tract infections, avoid contact with those who might be very vulnerable to illness such as infants, the elderly, and those with chronic diseases.
• Do not give aspirin to children younger than 16 years of age during viral infections because this may trigger Reye’s syndrome (a rare, potentially life-threatening illness that affects the blood, brain, and liver).

When to Call Your Doctor
• If you have symptoms suggestive of viral pneumonia.
• If you have increasing shortness of breath.
• If your skin, lips, or fingertips are dusky.
• If there is blood in your sputum.
• If you have difficulty maintaining adequate liquid intake.
• If symptoms of fever and cough return after initially improving (this may signal the development of a new bacterial infection).