Pneumonia: Symptoms (w/ Online Quiz ), Types & Treatment

Pneumonia is a lung infection that is characterized by inflammation of the bronchioles. It leads to symptoms such as high grade fever, chills, dry or productive cough, shortness of breath and chest pain.

Pneumonia can be caused by bacteria, viruses or fungi, which are transmitted through direct or indirect contact with contaminated saliva or droplets in the air. Once inhaled or ingested, these microorganisms reach the lungs and infect them, leading to swelling and other symptoms.

Treatment for pneumonia depends on the underlying cause of infection and the severity of symptoms. Your doctor may consider prescribing antibiotics, painkillers, nebulizers and respiratory physiotherapy.

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Common symptoms 

The main symptoms of pneumonia are:

  • Persistent low-grade or high-grade fever;
  • Fatigue;
  • Shortness of breath, difficulty breathing or rapid breathing;
  • Dry or productive cough
  • Headache;
  • Chest pain;
  • Sore throat.

A person with pneumonia may also experience loss of appetite, weight loss and confusion. Symptoms of pneumonia can be mild, moderate and severe, and may vary depending on the person's age and type of infection. 

In babies and children, the main signs and symptoms of pneumonia include vomiting, fever, coughing, irritation, tiredness, difficulty breathing and eating.

Online symptom checker

If you are currently experiencing pneumonia symptoms, complete our quiz below to determine your risk for pneumonia: 

  1. 1. Fever over 37.5°C or 99.5ºF
  2. 2. Difficulty breathing or shortness of breath
  3. 3. Breathing faster than normal
  4. 4. Dry cough
  5. 5. Cough with green or bloody phlegm
  6. 6. Chest pain
  7. 7. Constant headache
  8. 8. Persistent fatigue or muscle pain
  9. 9. Intense night sweats

This symptoms quiz is only a guidance tool and, therefore, does not serve as a diagnosis nor should it replace a consultation with a lung specialist or general practitioner.

Confirming a diagnosis

Pneumonia should be diagnosed by a general practitioner or lung specialist. The doctor will start with an assessment of the person's signs and symptoms, as well as consider their health history. A chest auscultation will also be performed to assess the lungs and  check for noises during breathing.

The doctor may also request additional tests, like a chest X-ray, blood test, oxymetry (to check oxygen levels) and a sputum test. The sputum test involves collecting mucus or phlegm that has been coughed up, and can be useful for identifying the microorganism causing the infection. 

Other possible tests include a chest CT scan, a bronchoscopy or a pleural fluid culture, which is a test in which a sample of the fluid between the lungs and the chest is removed with a needle and syringe. Similar to the sputum test, this test can also help to identify the microorganism that is causing the pneumonia.

Main causes

Pneumonia is an inflammation of one or both lungs that can be caused by viral, fungal or bacterial infection. The harmful microorganisms that cause infection can be transmitted through the air, soil, feces of contaminated birds, or droplets of saliva or nasal secretion.

Pneumonia can also be caused by the aspiration or inhalation of food, drinks or vomit into the lungs.

Types of pneumonia

The main types of pneumonia, depending on their cause, are:

1. Viral pneumonia

Viral pneumonia is a lung infection caused by viruses like influenza A, B or C, H1N1, H5N5, or COVID-19. This type of pneumonia can be transmitted from person to person through droplets of saliva or respiratory secretions. It is most common in older adults and children.

2. Bacterial pneumonia

Streptococcus pneumoniae bacteria is the main cause of this type of pneumonia. However, other bacteria, such as Klebsiella pneumoniae and Staphylococcus aureus, can also cause this disease.

Bacterial pneumonia is not transmissible and is usually acquired when a cold or flu worsens, from the entry of bacteria from other infections into the lungs, or from choking on food and drinks.

3. Atypical pneumonia

This type of pneumonia is caused by infection with less common microorganisms, such as Mycoplasma pneumoniae and Legionella pneumophila. This type of pneumonia is transmitted from person to person through droplets of saliva. 

4. Hospital-acquired pneumonia

Hospital-acquired pneumonia, also referred to as nosocomial pneumonia, is caused by bacteria that is acquired from a hospital or clinical environment. It mainly affects people using mechanical ventilation, which can increase the risk for the entry of bacteria that are naturally present in the mouth and nose and into the lungs.

5. Aspiration pneumonia

Aspirating or inhaling drinks, food or vomit into the lungs can lead to aspiration pneumonia. It is more common in people who have difficulty swallowing, like older adults or babies, and people can also occur in people who require mechanical ventilation.

6. Fungal pneumonia

Fungal pneumonia is not contagious. It is the most common type of pneumonia in people with a weakened immune system from conditions like an organ transplant, cancer or HIV.

This type of pneumonia is caused by fungi, like Aspergillus, Candida and Coccidioides, which are present in the air, soil and bird droppings.

7. Silent pneumonia

Silent pneumonia can be caused by viruses, bacteria or fungi, and can lead to symptoms that are milder than a typical pneumonia. 

This type of pneumonia, also called "asymptomatic" pneumonia, can affect people of any age, and is more severe in people with weakened immune systems, older adults, children, or babies.

8. Bilateral pneumonia

Bilateral pneumonia is a lung infection that affects both lungs, instead of just one. This condition is more serious and can lead to more intense symptoms such as a high-grade fever, increased difficulty breathing, heavy fatigue, and increased respiratory rate.

Treatment options

The main ways to treat pneumonia include:

1. Medication

Antibiotics, like amoxicillin, azithromycin, and penicillin, can be prescribed for courses of 7 to 21 days to treat bacterial and atypical pneumonia. Severe cases of viral pneumonia caused by the influenza virus can be treated with antivirals, such as oseltamivir, peramivir, or zanamivir.

To treat fungal pneumonia, the doctor can prescribe antifungals, such as voriconazole, amphotericin B, caspofungin, sulfamethoxazole and fluconazole.

The doctor may also advise the use of analgesics and anti-inflammatories, like ibuprofen and acteaminophen, to help manage fever and discomfort.

2. Respiratory physiotherapy

Respiratory physiotherapy is a set of exercises that can help to strengthen the respiratory muscles. It is aimed at promoting the elimination of mucus and improving breathing mechanisms. It can be indicated for all types of pneumonia.

3. Nebulizers

Nebulizers help to moisten the respiratory tract and dilute respiratory secretions. This can help to promote the elimination of secretion, which can help make breathing easier. 

4. Hospitalization

In more serious cases, such as difficulty breathing, low blood pressure, and confusion, or if symptoms do not improve within 7 days after starting treatment, hospitalization may be necessary for IV medication and oxygen therapy. 

Older adults, babies under 2 months old, lethargic children or patients who are at risk for dehydration or respiratory failure may also require ongoing monitoring in the hospital to ensure symptoms improve.

Other tips for recovery

Other measures that can help to promote recovery include a balanced and varied diet that can help to speed-up recovery should be made-up of:

  • High-fiber and nutrient-dense foods, like fruits, legumes, whole grains, vegetables and greens
  • Lean proteins, such as fish, chicken and eggs

You should also avoid foods rich in sugar and fat, which can hinder your natural defense mechanisms.

You should also get a good night's sleep, and aim for 7 to 9 hours a night in order to strengthen your immune system and help to eliminate the microorganisms causing the pneumonia. 

Staying well-hydrated is also essential for thinning out respiratory secretions and promoting breathing. You can drink water, coconut water and natural juices. Some teas, such as guaco and eucalyptus tea have naturally anti-inflammatory, bronchodilator and expectorant properties, that help to relieve coughing, fever and chest pain. These can be prepared to complement the medical treatment prescribed by your doctor.