What Is Pneumonia? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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Your doctors will try to classify your type of pneumonia to help guide your treatment.

Community-Acquired Pneumonia (CAP)

This is the most common form of pneumonia. You can catch it in public places, such as at school or work.

You can also develop CAP after you get a viral infection, such as a cold, the flu, or COVID-19.

CAP ranges from mild to serious. If left untreated, it can lead to respiratory failure or death.

Bacterial CAP

Bacterial CAP is usually more serious than other types and is more common among adults. Atypical pneumonia, often called walking pneumonia, is a milder form often caused by the bacteria-like organism, Mycoplasma pneumoniae. Walking pneumonia symptoms include sore throat, persistent dry cough, fatigue, headaches, and fever.

Various types of bacteria can be responsible for the illness. In most cases, the bacteria will enter the lung during inhalation, or by aspiration from the oropharynx, then travel into the bloodstream, potentially causing damage to other organs and systems in the body.

The bacterium Streptococcus pneumoniae, also known as pneumococcus, can be treated with antibiotics. But many types of bacteria, including some S. pneumoniae (pneumococcus), are resistant to those antibiotics, which can lead to treatment failures. Pneumococcal pneumonia causes an estimated 150,000 hospital admissions a year in the United States.

Risk factors for bacterial CAP include:

  • An underlying lung disease, like asthma or COPD
  • A systemic disease, such as diabetes
  • A weakened immune system
  • Alcohol abuse
  • Smoking

Depending on how sick you are and whether you have any other health conditions, your doctor may treat you with antibiotics for presumptive bacterial pneumonia either at home or in the hospital.

A vaccination against pneumococcal pneumonia reduces your risk of bacterial CAP.

 There are several different pneumococccal vaccines; ask your doctor if you qualify for either.

Viral CAP

Viral CAP, particularly caused by influenza or by the respiratory syncytial virus (RSV), is the most common cause of pneumonia in children younger than 1 year old.

Although cases of viral pneumonia are often relatively mild, infections caused by certain flu viruses can be very serious.

So can infections caused by coronaviruses, such as severe acute respiratory syndrome (SARS) and SARS-CoV-2, the virus that causes COVID-19. (See the section below for information on COVID-19 and pneumonia.)

Antibiotics are ineffective against viral pneumonia. Your doctor will most likely treat the symptoms — fever, cough, and dehydration.

You or your child may need to be hospitalized if your viral pneumonia symptoms become severe.

Fungal CAP

Fungal CAP is most common in people with an underlying health problem or a weakened immune system, including those with HIV or acquired immunodeficiency syndrome (AIDS) and people undergoing treatment for cancer.

There are also fungi, such as histoplasmosis and coccidioidomycosis that are common in specific parts of the United States that can cause fungal CAP.

Hospital-Acquired Pneumonia

As the name suggests, this develops after at least 48 hours of a hospital stay for a different health problem. People who are on machines to help them breathe are particularly prone to developing hospital-acquired pneumonia.

Hospital-acquired pneumonia usually needs to be treated in the hospital with intravenous antibiotics.

Aspiration Pneumonia

This can develop after a person inhales food, drink, vomit, or saliva into their lungs. Once your lungs have been irritated by breathing in food or stomach contents, a bacterial infection can develop.

A strong gag reflex or cough will usually prevent aspiration pneumonia, but you may be at risk if you have a hard time swallowing or have a decreased level of alertness.

Aspiration pneumonia can be the result of bacterial infection or can be caused by inflammation without bacterial infection. These pneumonias can sometimes be difficult to treat, especially because the patients are often sicker to begin with.

Some conditions that may put you at risk for aspiration pneumonia include:

  • Loss of alertness due to medicines, illness, or surgery (getting anesthesia)
  • Overuse of alcohol
  • Old age
  • Poor gag reflex due to brain injury or stroke
  • Coma

Symptoms of aspiration pneumonia include cough, increased sputum, fever, confusion, and shortness of breath.

Treatment may include breathing assistance and intravenous antibiotics given in the hospital.

You can prevent complications by not eating or drinking before surgery, working with a therapist to learn how to swallow without aspirating , especially following a stroke, and avoiding heavy use of alcohol.

Opportunistic Infection

Pneumocystis pneumonia is a fungal pneumonia that is extremely rare in healthy people, according to the CDC, but develops in people with a weakened immune system; it’s often referred to as an opportunistic infection.

You’re at risk for this type of pneumonia if you have a chronic lung disease or other conditions treated with high-dose steroids, have HIV or AIDS, or have had an organ transplant.

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