What Are the First Warning Signs of Pneumonia?

Older people

Older people and those with compromised immune systems may experience less severe pneumonia symptoms, such as:

• Lower body temperature
• Sudden changes in mental awareness
• Fever and chills in some cases

If you suspect pneumonia in an older person, consider asking the following questions:

• Do you feel extremely tired or weak?
• Do you experience chest or rib pain when breathing or coughing?
• Do you feel nauseated?
• Have you been vomiting?
• Are you getting loose stools?

A person with dementia may occasionally be unable to accurately describe their symptoms, which adds to the difficulty of diagnosing pneumonia. The severity of the illness may go unnoticed as well, since symptoms may be similar to those of a cold.

Children

Pneumonia symptoms in children vary from child to child. Infants and newborns may not exhibit any signs of infection. Others may have symptoms such as:

• Coughing (that usually produces phlegm)
• Vomiting
• Fever
• Noisy, heavy, or faster-than-normal breathing
• Tiredness or lethargy
• Lack of appetite or inadequate feeding
• Restlessness

Because very young children cannot communicate their symptoms, it can be challenging to identify signs of infection.

Pneumonia can be caused by bacteria, viruses, and fungi. The most common cause is bacteria. However, pneumonia sometimes develops after a viral infection, such as a cold or the flu. 

Bacteria that can cause pneumonia include:

• Streptococcus pneumoniae
• Legionella pneumophila (Legionnaires' disease)
• Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Haemophilus influenzae

Viruses that can cause pneumonia include

• Respiratory syncytial virus 
• Common cold and flu viruses
• SARS-CoV-2, the virus that causes COVID-19

Virus-induced pneumonia often causes mild symptoms and resolves in a few weeks. However, it may be necessary to seek medical attention since viral pneumonia increases the risk of bacterial pneumonia.

People with chronic health problems or compromised immune systems are more likely to develop fungal pneumonia, which includes:

• Pneumocystis pneumonia 
• Coccidioidomycosis, which causes valley fever
• Histoplasmosis
• Cryptococcus

Anyone can get pneumonia, but certain factors can make you more susceptible to developing the disease:

• Age (the risk is higher for adults aged 65 or older and children younger than 2 years)
• Exposure to chemicals, pollutants, or toxic fumes
• Lifestyle habits, such as smoking, heavy alcohol use, and malnourishment
• Hospitalization (especially if you are in the intensive care unit) under sedation and/or on a ventilator
• Recently being sick with a cold or the flu
• Weakened immune system
• History of lung disease
• Experiencing trouble coughing or swallowing after a stroke or other condition

Potential complications of pneumonia include the following:

• Bacteremia, which occurs when bacteria enter the bloodstream (can result in septic shock)
• Lung abscesses (pus-filled spaces in the lungs)
• Pleural disorders (affects the tissue that lines the inside of the chest cavity and covers the outside of the lungs)
• Kidney failure
• Respiratory failure

Pneumonia can be challenging to diagnose because the symptoms can be mistaken for a cold or flu. Doctors use the following to diagnose pneumonia:

• Medical history
• Physical exam, including listening to your lungs with a stethoscope
• Chest X-ray
• Blood tests, such as a complete blood count, to see if your immune system is actively fighting an infection
• Blood culture to determine whether you have a bacterial infection that has spread to your bloodstream

If you are in the hospital, have serious symptoms, are older, or have other health issues, you may be subjected to further testing, such as:

• Sputum test: Examines a sample of your sputum (spit) or phlegm for microorganisms (a slimy substance from deep in your lungs)
• Chest CT scan: Determines the extent of the lung damage. It might reveal any issues, such as lung abscesses or pleural effusions
• Pleural fluid culture: Examines a fluid sample collected from the pleural space for germs
• Blood oxygen level tests: Includes pulse oximetry or blood oxygen level checks and determine how much oxygen is in your blood

Treatment for pneumonia varies depending on the cause and severity of the infection:

• Antibiotics are used to treat several bacterial and fungal infections. They are ineffective against viral pneumonia.
• Your doctor may recommend antiviral medications for viral pneumonia.
• Other types of fungal pneumonia are treated with antifungal medications.

If your symptoms are severe or you are at risk of complications, you may require hospitalization. You may undergo oxygen therapy if your blood oxygen levels are low. Recovery from pneumonia may take between a week to a month.

Vaccines can help prevent pneumonia caused by the flu virus or pneumococcal bacteria. Additionally, maintaining good hygiene, quitting smoking, and leading a healthy lifestyle may help prevent pneumonia.

People with minor symptoms are occasionally referred to as having “walking pneumonia.” This means that even if you have symptoms of the illness, you can go about your daily activities. The symptoms may go away after a while, but if they worsen, you will need to receive other treatments.

In some cases, your doctor may recommend a “wait and see” approach because the infection may resolve on its own without further treatment. 

Contact a doctor immediately if you have any of the following pneumonia symptoms:

• Breathing difficulties
• Feeling light-headed when you stand up
• Severe chest pain that squeezes or feels crushing
• Blood in mucus
• Chills or fever of 101 F or higher
• Vomiting