Pneumonia

Pneumonia is an infection of the lung tissue. It can be caused by bacteria, viruses, or (less often) fungi. Pneumonia remains a leading cause of illness and death among children under 5 and older adults in India. Most people recover fully with treatment, but severe pneumonia can be life-threatening — especially in the very young, very old, and those with chronic conditions.

Symptoms

• Cough — often with yellow, green, or sometimes blood-streaked phlegm
• Fever, chills
• Chest pain, worse with breathing or coughing
• Shortness of breath, rapid breathing
• Fatigue, weakness
• Loss of appetite
• Sometimes nausea, vomiting
• Muscle aches
• In older adults — may present just as confusion or feeling "off", without prominent fever
• In babies — fast breathing, grunting, difficulty feeding, drowsiness

When to go to hospital

Dial 112 or go to hospital urgently for:

• Severe breathlessness — can't speak in full sentences
• Blue lips or face
• Confusion
• Coughing up blood
• High fever with chills, shivering, or very poor condition
• Chest pain
• A baby with fast breathing, grunting, or difficulty feeding
• An elderly person who suddenly becomes confused or cannot stay awake

Who is at higher risk?

• Children under 2 and adults over 65
• People with chronic lung, heart, kidney, or liver disease
• Diabetes
• Smokers
• People with weakened immunity (HIV, cancer treatment, transplant)
• People exposed to significant indoor or outdoor air pollution
• Hospitalised patients (hospital-acquired pneumonia)

Diagnosis

Diagnosis is usually clinical — examination plus a chest X-ray. Blood tests and sputum tests help identify severity and cause. In India, persistent pneumonia or pneumonia with weight loss / night sweats should prompt TB testing.

Treatment

• Bacterial pneumonia — antibiotics. Mild cases can be treated at home; severe cases need hospital IV antibiotics
• Viral pneumonia — supportive care; some viruses (influenza, COVID-19) have specific antivirals
• Fungal pneumonia — antifungal medicines; more common in people with weakened immunity
• Supportive care — rest, fluids, paracetamol, oxygen for low saturation
• Hospital admission for severe cases, high-risk groups, or failure of outpatient treatment

Prevention

• Vaccination — pneumococcal vaccine (PCV in the childhood programme; also for older adults and at-risk groups), annual flu vaccine, COVID-19 vaccine, Hib vaccine in infants
• Don't smoke; avoid secondhand smoke
• Good hand hygiene
• Manage chronic conditions well
• Reduce indoor air pollution — improved cookstoves, LPG instead of biomass
• Treat respiratory infections early