Pneumonia - NHS Inform

Pneumonia

Pneumonia is inflammation of the lung tissue. It’s usually caused by a bacterial infection. There are clusters of tiny air sacs in your lungs. If you have pneumonia, these tiny sacs become inflamed and fill up with fluid.

The symptoms of pneumonia can develop suddenly over 24 to 48 hours, or they may come on more slowly over several days.

Pneumonia is more widespread in autumn and winter.

When to get medical advice

Phone 999 or go to A&E if:

• you have severe difficulty breathing – for example, you struggle to speak without pausing, gasping or choking
• you have severe chest pain in the middle of your chest that isn’t going away – it may feel like pressure, tightness or squeezing
• you have pain that spreads to your arms, back, neck and jaw
• you feel more drowsy than usual or find it more difficult to wake up
• your lips or skin are turning very pale, blue or grey – on brown or black skin this is easier to see on the palms of your hands

Information on breathing problems in children

Contact your GP practice urgently if you:

• are more short of breath than usual
• have pain when breathing in or coughing
• are feeling confused, dizzy, or lightheaded
• feel sick or are being sick – for example, you can’t keep food or fluids down
• are coughing up blood (haemoptysis)
• have heart palpitations – this may feel like your heart is racing, going too slowly or skipping a beat or like a fluttering feeling in your chest
• are peeing less than usual – this can be a sign of dehydration
• have a very high or low temperature – for example, you feel either hot or cold to touch or you’re shivering

If your GP practice is closed, phone 111.

Speak to your GP practice if:

• you have breathlessness which is not improving
• you have had a cough for more than 3 weeks
• your symptoms are not improving or they are affecting your daily life

Diagnosing pneumonia

Your GP may be able to diagnose pneumonia by asking about your symptoms and examining your chest. Further tests may be needed in some cases.

Pneumonia can be difficult to diagnose because it has similar symptoms to other conditions. For example the common cold, bronchitis and asthma.

To help make a diagnosis, your GP may ask you:

• whether you feel breathless
• if you’re breathing faster than usual
• how long you’ve had your cough
• whether you’re coughing up mucus and if so, what colour it is
• if the pain in your chest is worse when you breathe in or out

Your GP may also take your temperature and listen to your chest and back with a stethoscope to check for any crackling or rattling sounds.

They may also listen to your chest by tapping it. Lungs filled with fluid produce a different sound from normal healthy lungs.

If you have mild pneumonia, you may need a chest X-ray and some blood tests. You will not need a sputum sample unless you have recurrent infections, or persistent infections that don’t respond to treatments.

Treatment for pneumonia

Mild pneumonia can usually be treated at home.

Pneumonia isn’t usually passed from one person to another. So it’s safe to be around others, including family members. But people with a weakened immune system should avoid close contact with a person with pneumonia until they start to get better.

Things you can do to help your symptoms

Do

• get plenty of rest
• take antibiotics if prescribed them – always finish the course, even if you feel better, unless you’re told otherwise by a healthcare professional
• drink plenty of fluids
• take pain relief such as paracetamol if needed – always follow the manufacturer’s instructions

Cough medicines aren’t recommended. A warm honey and lemon drink can help relieve discomfort caused by coughing.

If you smoke, it’s more important than ever to stop, as smoking damages your lungs.

Full recovery from pneumonia can take up to 3 months.

Speak to your GP if your symptoms don’t improve within 3 days of starting antibiotics.

Treatment in hospital

You may need treatment in hospital if your symptoms are severe. You may be given antibiotics and fluids intravenously through a drip, and you may need oxygen if your blood oxygen levels are low.

In very serious cases of pneumonia, breathing assistance through a ventilator in a high dependency unit (HDU) or an intensive care unit (ICU) may be required.

Follow-up

Your GP may arrange a follow-up appointment for you. In some cases, they may arrange follow-up tests if:

• your symptoms haven’t improved
• your symptoms have come back
• you smoke
• you’re over the age of 50

Some people may be advised to have a flu vaccination or pneumococcal vaccination after recovering.

What causes pneumonia?

Pneumonia is commonly the result of pneumococcal infection. A bacteria called Streptococcus pneumoniae causes pneumococcal infection. Other causes of pneumonia are:

• other types of bacteria including Haemophilus influenzae and Staphylococcus aureus
• viruses
• fungi (rarely)

As well as bacterial pneumonia, other types include:

• viral pneumonia – viruses including the respiratory syncytial virus (RSV), coronavirus (COVID-19) and sometimes influenza type A or B; viruses are a common cause of pneumonia in young children
• aspiration pneumonia – caused by breathing in vomit, a foreign object, such as a peanut, or a harmful substance, such as smoke or a chemical
• fungal pneumonia – rare in the UK and more likely to affect people with a weakened immune system
• hospital-acquired pneumonia – pneumonia that develops in hospital while being treated for another condition or having an operation; people in intensive care on breathing machines are particularly at risk of developing ventilator-associated pneumonia

Who’s most at risk of pneumonia?

Pneumonia can affect people of any age. It’s more common – and can be more serious – in certain groups of people. People in these risk groups are more likely to need hospital treatment.

The groups with an increased risk of developing pneumonia are:

• babies and very young children
• elderly people
• people who smoke
• people with other health conditions, such as asthma, cystic fibrosis, or a heart, kidney or liver condition
• people with a weakened immune system