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The Signs and Symptoms of Pneumonia

Updated on October 10, 2012
Streptococcus pneumoniae
Streptococcus pneumoniae | Source

The signs and symptoms of pneumonia are often not easy to identify. Pneumonia symptoms are much like any other body infection. The only exception is that pneumonia is typically accompanied by sharp chest pains and the presence of sputum. Pneumonia can be a deadly condition if left untreated. It is important to know what pneumonia is and the symptoms of pneumonia to receive treatment in the early stages.

What Is Pneumonia?

Pneumonia is characterized by cough with phlegm or sputum in the chest. The infection originates in the lungs and can be caused by bacteria, viruses, fungi, parasites or microorganisms. Lung inflammation, sharp chest pains, fever or difficulty breathing may accompany pneumonia. When these symptoms of pneumonia occur, a physician should be contacted and tests should be conducted.

Pneumonia can be identified in several ways. One common way to identify pneumonia is to X-ray the chest and determine the lung capacity of the patient. If there is a lack of air space or consolidation, this is one of the signs of pneumonia. Examination of the sputum may also indicate the presence of pneumonia in the body.

How is Pneumonia Classified?

Pneumonia can be classified in the following ways: community-acquired, hospital-acquired, ventilator-associated pneumonia, healthcare-associated pneumonia or aspiration. Pneumonia can also be classified based the area of the lung that is affected. For instance, bronchial pneumonia affects the bronchial tubes of the lungs. Signs of pneumonia may also be classified as non-severe, severe or very severe.

How to Test for Pneumonia

If pneumonia signs and symptoms are present, several tests may be ordered. Through a chest X-ray, physicians can determine the air capacity of the lungs, breathing difficulties and respiratory rates. A normal child’s breathing rate will be between 40 breaths per minute and 60 breaths per minute. If the breathing rates are not within these limits, he or she may have pneumonia. Chest crackles may be present when listening to the chest with a stethoscope if the patient has pneumonia.

Left lower lobe pneumonia at 2010, probable mycoplasma.
Left lower lobe pneumonia at 2010, probable mycoplasma. | Source

If a person is admitted to the hospital for pneumonia, he or she may also receive chest radiography, blood tests, a complete blood count, pulse oximetry, C-reactive protein tests, serum electrolytes tests, liver function tests or a rapid influenza test. These tests will determine if pneumonia is present in the body. If the immune system is functioning properly and all vital signs are low, the risk of developing pneumonia is low.

X-rays may show lung consolidation in the presence of bacterial pneumonia. In the presence of aspiration pneumonia, there may be bilateral opacities in the base of the lungs. Viral pneumonia may be identified by bilateral patchy areas that are also hyper-inflated. Lobar consolidation may also be present.

The chest radiograph is the most common test used to verify the presence of the virus or bacteria after the signs and symptoms of pneumonia are verified. This type of imaging is required if there are complications. This test cannot reliably deliver distinguishing results between a bacterial infection and a viral infection.

If the findings on the X-rays are inconclusive, doctors may order a CT scan. Inconclusive findings may occur when a person is dehydrated. Under these conditions, it becomes difficult for physicians to make the proper diagnosis of pneumonia. Ten to 39 percent of patients with Pneumocystis carinii pneumonia are incorrectly diagnosed after an X-ray is completed.

Physicians may also test sputum if there is a chronic productive cough. If there is a public outbreak, this test is ordered. This is especially true if Mycobacterium tuberculosis is present. Blood cultures are also recommended. Viral infections can be determined with a polymerase chain reaction (PCR) and by measuring antigens in the blood. A microbiological test may only reveal a causative agent in 15 percent of cases.

How is Pneumonia Treated?

Treatment of pneumonia depends on whether it was caused by a virus, parasite, bacteria or other microorganism. Bacterial pneumonia, for instance, is treated with antibiotics. Vaccinations are also available to prevent certain pneumonias. Vaccinations lower the chance of elderly people, young children and people from third world countries dying of pneumonia.

Symptoms and Signs of Pneumonia

The most common symptoms of pneumonia include:


Ninety percent of people with pneumonia are fatigued.


Of all the patients that develop pneumonia, only 79 percent to 91 percent also have a cough accompanying the illness. In children less than two months old, a cough is typically absent with pneumonia. Thus, coughing may or may not be an indicator of pneumonia. In children less than two months in age, signs and symptoms of pneumonia may include central cyanosis, convulsions, decreased thirst and persistent vomiting.


Sputum forms in 60 to 65 percent of patients with pneumonia.


Only 71 percent to 75 percent develop a fever when they have pneumonia. Most people with a fever also have shaking chills that accompany pneumonia. People severe disease or malnutrition may not experience a fever.

Chest Pain

Chest pain only occurs in 39 percent to 49 percent patients with pneumonia.

Shortness of Breath

Only 67 percent to 75 percent of patients experience shortness of breath when evaluating the signs of pneumonia. Children, under the age of five, often experience fast and difficulty breathing.

Pneumonia that is caused by Legionella may also be accompanied by: abdominal pain, confusion or diarrhea. Streptococcus pneumonia is characterized by rusty-colored sputum. Pneumonia caused by Klebsiella may often have bloody sputum. The symptoms or signs of pneumonia are not always evident, but those listed are some of the more common signs.

Aspiration pneumonia
Aspiration pneumonia | Source

When To Contact a Physician

If a patient is struggling to breathe or confused, a physician should be contacted immediately. Blue-tinged skin is also a sign of an emergency, and a physician should be contacted immediately.

What To Expect During a Physical Examination

Physical examination of patients with pneumonia may reveal a higher heart rate, lower blood pressure or lower oxygen saturation. Most physicians report a higher respiratory rate than normal in patients with pneumonia. During inspiration, rales or crackling may be heard. Percussion may also be muffled over the affected lung.


Types of Pneumonia

Bacterial Pneumonia

Streptococcus pneumoniae is the most common type of community-acquired pneumonia. It is isolated in nearly 50 percent of all cases. Alcoholism and smoking increase the risk for pneumonia. Most people develop this form of pneumonia in the winter.

Viral Pneumonia

Viral pneumonia comprises only one-third of pneumonia cases. Influenza virus, adenovirus, parainfluenza, coronaviruses, rhinoviruses and respiratory syncytial virus (RSV) are all common culprits in viral pneumonia. Herpes simplex virus is a type of pneumonia that is rare, but it may occur in newborns. Cytomeglovirus (CMV) may have an increased risk of pneumonia because of weak immune systems.

Fungal Pneumonia

Fungal pneumonia most often occurs in people with weak immune systems. People with AIDs or who are on immunosuppressive drugs are more likely to develop fungal pneumonia. Fungal pneumonia is caused by blastomyces, Histoplasma capsulatum, Pneumocystis jiroveci, Cryptococcus neofromans and Coccidioides immitis.

Parasitic Pneumonia

Parasites can enter the body through the mouth or skin and can affect the mouth. This type of pneumonia is similar to other types of pneumonia. It destroys cells, and the immune response disrupts the oxygen transportation. When eosinophils or white blood cells enter the lungs, an immune reaction is triggered, and it leads to eosinophilic pneumonia. Toxoplasma gondii, Ascariasis and Strongyloides stercoralis are common parasites that cause pneumonia.

Idiopathic Interstitial Pneumonia

This non-infectious pneumonia is a member of the diffuse lung diseases which include: organizing pneumonia, lymphocytic interstitial pneumonia, usual interstitial pneumonia and nonspecific interstitial pneumonia.


How to Prevent Pneumonia

To prevent pneumonia, certain precautions must be taken. A vaccination is required as one of the precautions. Vaccinations can prevent bacterial and viral pneumonia. Both children and adults benefit from vaccination.

Children and adults should get a vaccination annually if they are over the age of six months. Influenza vaccines are effective against influenza A and B. The most common medications used in prevention of influenza include amantadine, zanamivir, oseltamivir and rimantadine. Vaccinations reduce the risk of developing symptoms of pneumonia. The risk of Streptococcus pneumoniae and Haemophilus influenza is reduced when vaccinations are used. Vaccines also protect against invasive pneumococcal disease.

To further reduce the risk of developing the signs and symptoms of pneumonia, reduction of indoor air pollution is recommended. Indoor air pollution may include: dust, mold, mildew, pet dander, smoking and countless other allergens. These allergens increase the risk of developing symptoms of pneumonia. Smoking cessation is also recommended in the fight against pneumonia.

Have a Plan to Prevent Pneumonia

Since some forms of pneumonia are present in the winter, everyone should have a strategy to protect against pneumonia. An awareness of the disease and the signs and symptoms of pneumonia will help patients protect against the disease. If symptoms of pneumonia arise, speak with a doctor for a formal diagnosis. Recognizing the signs of pneumonia is the first step to recovery.


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    • tobusiness profile image

      Jo Alexis-Hagues 

      6 years ago from Lincolnshire, U.K

      This is very comprehensive, I like your layout and presentation a well written and informative article.


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