Bacterial Pneumonia

What is bacterial pneumonia?

Bacterial pneumonia is a lung infection that some people may get in the community, the hospital, or a long-term care facility. With bacterial pneumonia, a person's lungs become inflamed (swollen) and do not work as well as they should.

What causes bacterial pneumonia?

Bacterial pneumonia is caused by germs called bacteria. You may get bacterial pneumonia by breathing in the germs. The germs are easily spread from an infected person to others by coughing or sneezing or through close contact.

What may increase my risk of having bacterial pneumonia?

Any of the following may increase your risk of having bacterial pneumonia or may make bacterial pneumonia worse:

• Age: In the elderly, the body changes and you may get sick more easily. Newborn babies or very young children also have an increased risk of being infected.
  
  
• Alcoholism: Drinking too much alcohol for many years may increase your risk of having bacterial pneumonia. Alcohol is found in beer, wine, vodka, whiskey, and other adult drinks.
  
  
• Exposure: Certain animals may carry germs that put you at risk of getting bacterial pneumonia. Some of these animals include birds, rabbits, farm animals, and bats. You also have a greater chance of having bacterial pneumonia if you care for children in a daycare center.
  
  
• Medical problems: Having heart, liver, brain, or kidney disease increases your risk of getting bacterial pneumonia or of the disease getting worse. Having cancer or diabetes also increases this risk. You also may be more likely to get bacterial pneumonia if you have a lung disease, such as asthma. Having had bacterial pneumonia in the past also may put you at risk.
  
  
• Smoking: Smoking damages the lungs. This makes it easier to get lung infections, such as bacterial pneumonia.
  
  
• Weak immune system: The immune system is the part of your body that fights infection. It may be weakened by HIV, asplenia (removed spleen), poor nutrition, recent antibiotic use, and certain other medicines. These medicines include steroids, chemotherapy, or anti-rejection medicines taken after an organ transplant.

What are the signs and symptoms of bacterial pneumonia?

• Cough, which may be dry or have phlegm (mucus from your lungs). The phlegm may have streaks of blood in it.
  
  
• Feeling tired easily.
  
  
• Fever, chills, or severe shaking.
  
  
• Headache, muscle pain, or abdominal (stomach) pain or discomfort.
  
  
• Increased or fast heartbeat.
  
  
• Shortness of breath, trouble breathing, or chest pain, especially when coughing or taking a deep breath. You may also have noisy breathing or wheezing (high-pitched noise heard when breathing out).
  
  
• Trouble thinking clearly.

How is bacterial pneumonia diagnosed?

Your caregiver may ask you many questions about your signs and symptoms. Tell your caregiver if you have been around any sick people or animals or have traveled recently. Tell him if you have other medical problems or are taking medicines. Your caregiver will listen to your heart and lungs using a stethoscope. You may need one or more of the following tests:

• Chest x-ray: This shows a picture of your lungs. This may help show signs of infection, and how well your lungs are working. A chest x-ray may also show other problems, such as fluid around your lungs. You may need more than one chest x-ray.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Blood and urine tests: Blood and urine tests may be done to check for infection. These tests may help your caregivers learn more about your health condition. You may need to have these tests done more than once.
  
  
• Sputum sample: Sputum (mucus from your lungs) is collected in a special cup when you cough. It is sent to a lab for tests. The sputum may show what germ is causing your illness. It can also help your caregiver choose what medicine is best for you.

If your symptoms are very bad, or you are being treated in the hospital, you may also need the following tests:

• Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
  
  
• Computed tomography scan: This test is also called a CT scan. A special x-ray machine uses a computer to take pictures of your lungs.
  
  
• Bronchoscopy: This test may be done to look inside your airways and lungs. Caregivers use a bronchoscope to do this test. It is a long tube with a light and magnifying glass on the end. The scope goes in your mouth and into your lungs. Your caregiver may give you medicine for pain or to help you relax during the bronchoscopy. Caregivers may also do a bronchoalveolar lavage through the scope. This is when fluid and cells are sucked up from your lungs to be sent to the lab for tests.
  
  
• Thoracentesis: This procedure is done to remove extra pleural fluid from your chest. Pleural fluid is the fluid between the two layers of tissue lining your lungs. You are given numbing medicine, and then a needle is put between two of your ribs. The extra pleural fluid is pulled out through the needle and sent to the lab for tests. You may find it easier to breathe when the fluid is removed.

How is bacterial pneumonia treated?

Treatment depends on what caused your bacterial pneumonia and on how bad your symptoms are. You may need one or more of the following:

• Medicines: These include medicines that may be given to decrease your signs and symptoms. They also include medicines that may help treat serious problems that can be caused by bacterial pneumonia.
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Bronchodilators: You may need bronchodilators to help open the air passages in your lungs, and help you breathe more easily.
    
    
  • Expectorants: Expectorant medicine helps thin your sputum (mucus from the lungs). When sputum is thin, it may be easier for you to cough it up and spit it out. This may make your breathing easier, and may help you get better faster.
    
    
  • Antipyretics: This medicine is given to decrease a fever.
    
    
  • Immunomodulatory medicine: This medicine may help your immune system work better. It may also weaken your immune system to prevent it from attacking your own body. Your caregiver may give you this medicine to prevent or treat sepsis (widespread infection in the body).
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
  • Steroids: Steroid medicine may help to open your air passages so you can breathe easier. Do not stop taking this medicine without your caregiver's OK. Stopping on your own can cause problems.
    
    
  • Vasopressors: If your blood pressure has dropped too low, this medicine may be needed to increase it to a normal range.
  
  
• Breathing treatments and support:
  
  
  • Breathing treatments: You may need breathing treatments to help open your airways so you can breathe easier. A machine may be used to help you breathe in medicine. A caregiver will help you with these treatments. At first you may need breathing treatments more often. As you get better, you may only need the treatments when you are having trouble breathing.
    
    
  • Deep breathing and coughing: Your caregiver may want you to breathe deeply and cough. Deep breathing helps to open the air passages in your lungs. Coughing helps to bring up mucus from your lungs. Sitting up regularly or getting out of bed may help you breathe more easily and help you get better faster.
    
    
  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
    
    
  • Ventilator: This is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your airway through your mouth or nose. You may need a trach if an ET tube cannot be placed. A trach is an airway tube put into an incision (cut) in the front of your neck. The ET tube or trach is attached to the ventilator.

What can be done to prevent or help treat bacterial pneumonia?

• Avoid spreading germs: You can decrease your chance of getting lung infections and other illnesses by doing the following:
  
  
  • Wash your hands often with soap and water. Carry germ-killing hand lotion or gel with you when you leave the house. You can use the lotion or gel to clean your hands when there is no water available.
    
    
  • Do not touch your eyes, nose, or mouth unless you have washed your hands first.
    
    
  • Always cover your mouth when you cough. It is best to cough into a tissue or your shirtsleeve, rather than into your hand. People around you should also cover their mouths when they cough.
    
    
  • Try to avoid people who have a cold or the flu. If you are sick, stay away from others as much as possible.
  
  
• Drink plenty of liquids: Men 19 years old and older should drink about 3 liters of liquid each day (close to thirteen 8 ounce cups). Women 19 years old and older should drink about 2.2 liters of liquid each day (close to nine 8 ounce cups). Follow your caregiver's advice if you must limit the amount of liquid you drink. Liquids help thin your mucus, which may make it easier for you to cough it up. While you are sick, do not drink alcohol. Alcohol is found in beer, wine, vodka, whiskey, and other adult drinks.
  
  
• Vaccines: To prevent influenza (flu), all adults should get the influenza vaccine. They should get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older to prevent pneumococcal disease, such as pneumonia. People aged 19 to 64 years at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.
  
  
• Quit smoking: Do not smoke and do not allow others to smoke around you. Smoking increases your risk of lung infections and bacterial pneumonia. Smoking also makes it harder for you to get better after having a lung infection. Talk to your caregiver if you need help quitting smoking.

When should I call my caregiver?

Call your caregiver if:

• You are urinating less or not at all.
  
  
• You cannot eat or have loss of appetite, nausea (upset stomach), or vomiting (throwing up).
  
  
• Your cough comes back or does not go away, or you begin to cough up blood.
  
  
• You feel very tired or weak or are sleeping more than usual.
  
  
• You have a fever and chills.
  
  
• Your heart or pulse beats more than 100 times in one minute.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You are confused and cannot think clearly.
  
  
• You have more trouble breathing, or your breathing seems faster than normal.
  
  
• Your symptoms do not get better, or they get worse.

Where can I find more information?

• Centers for Disease Control and Preventions
  1600 Clifton Rd.
  Atlanta , GA 30333
  Phone: 1- 800 - 232-4636
  Web Address: http://www.cdc.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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