Pneumonia: diagnosis and treatment

Diagnosis of pneumonia

If your doctor suspects you have pneumonia you will probably need to have a chest X-ray. The chest X-ray will help confirm the diagnosis of pneumonia. Your doctor will also be able to see the extent and distribution of the pneumonia in your lungs which will reveal the severity of the disease and sometimes can give a clue to the cause. Occasionally a CT scan of the chest is required, in addition to plain chest X-rays.

Samples of your sputum may also be examined to look for the organism causing your pneumonia. However, this takes time and for many people, the precise cause of their pneumonia can’t be identified, so usually treatment is started immediately based on observation and experience.

If you are being assessed in a hospital, doctors may measure the amount of oxygen in your blood to see if you need supplemental oxygen therapy. Sometimes they may take blood samples to try to isolate the organism that is causing your pneumonia but this is difficult to do. Blood tests can also give an idea as to how well your body is responding to the infection.

Treatment of pneumonia

The treatment will depend on what is causing your pneumonia and how severe it is.

Antibiotics

Antibiotics are commonly used for bacterial pneumonia. If your pneumonia is severe you may be given intravenous antibiotics (by infusion into a vein).

Viral pneumonia

Antibiotics aren’t effective against viruses so are given only in viral pneumonia if there is also a secondary bacterial infection (that is in addition to the viral infection). Occasionally anti-viral drugs are used in treating viral pneumonia but mostly treatment is supportive, such as pain relief and oxygen.

Pain relief

Painkillers are often needed and will take away the chest pain so that you can cough and bring up secretions from your chest.

Oxygen

Oxygen therapy may be needed if you have a low concentration of oxygen in your blood. This is because the air spaces in your lungs have filled with fluid and the oxygen you breathe is not getting across into your bloodstream.

Recovery

A fit, young person who takes antibiotics and remains at home may recover fairly quickly from pneumonia — in a week or so. However, older people may feel very weak for some time while recovering and might need an extended period of bed rest before they feel fully recovered.

Pneumonia is a common cause of hospital admission in the elderly. People with other forms of lung disease, such as emphysema, or other medical problems, such as diabetes or heart problems, are likely to have a more severe course and require a hospital stay.

It’s very important you take all prescribed medicines exactly according to your doctor’s instructions, even if you feel better, because pneumonia can come back quickly and often relapses are more serious than the first infection.

Pneumococcal vaccination

A vaccine called Pneumovax is available in Australia that can help prevent pneumonia due to the pneumococcus bacterium (pneumococcal pneumonia). It is usually given to those most at risk such as the over-65s, people whose immune systems don’t function fully (immunocompromised), Aboriginal and Torres Strait Islander people over 50 years of age, and people with chronic illness that would put them at high risk if they got pneumococcal pneumonia.

Another pneumococcal vaccine (Prevenar) is recommended for all Australian children to prevent pneumonia and other pneumococcal infections.

Flu vaccination

A flu vaccination (e.g. Fluvax, Fluarix or Vaxigrip) every year before winter comes is a sensible precaution for those at risk of flu. Pneumonia can be a complication of flu in people who are immunocompromised (e.g. whose immune systems are suppressed by drugs) or who are not in optimal health.

Act quickly

Early diagnosis and treatment are important for pneumonia. If you think you have the symptoms of pneumonia, call your doctor immediately. The good news is that most otherwise healthy people can be treated at home and won’t develop any serious complications from their illness.


 
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