Community-acquired Pneumonia

What is community-acquired pneumonia and what causes it?

Community-acquired pneumonia (CAP) is a lung infection that you get from being around other people in the community. When you have CAP, your lungs become inflamed and cannot work well. CAP is caused by different germs, including bacteria, viruses, and fungi (yeasts). The germs are easily spread from an infected person to others by coughing, sneezing, or close contact.


What increases my risk for community-acquired pneumonia?

Any of the following may increase your risk of CAP, or may make your CAP worse:

  • Age: If you are elderly, you may get sick more easily. Newborn babies and very young children also have an increased risk of being infected.

  • Alcoholism: Too much alcohol for many years may increase your risk of CAP.

  • Exposure: You are at greater risk of CAP if you care for children in a daycare center. Certain animals may carry germs that put you at risk for CAP. Some examples are birds, rabbits, farm animals, and bats.

  • Medical problems: These include long-term heart, liver, brain, or kidney disease, cancer, and diabetes. You may also be more likely to get CAP if you have a lung disease, such as asthma. You may also be at risk if you have had CAP before.

  • Smoking: Smoking can harm your lungs and make it easier to get lung infections.

  • Weak immune system: Your immune system may be weakened by HIV infection, 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 community-acquired pneumonia?

  • Dry cough or coughing up mucus, which may be streaked with blood

  • Fever, chills, or severe shaking

  • Shortness of breath, wheezing (high-pitched noise when you breathe out), or chest pain

  • Feeling tired easily

  • Fast heartbeat

  • Headache, muscle pain, or abdominal pain or discomfort

  • Trouble thinking clearly

How is community-acquired pneumonia diagnosed?

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

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood.

  • 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.

  • 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.

  • Sputum sample: Sputum (mucus from your lungs) is collected and tested for the germ that is causing your illness. It can help your caregiver choose the best medicine to treat the infection.

  • Thoracentesis: This procedure is done to remove extra pleural fluid from your chest. Pleural fluid is the fluid between the 2 layers of tissue lining your lungs. You are given numbing medicine, and then a needle is put between 2 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 community-acquired pneumonia treated?

Treatment will depend on what type of germ is causing your CAP, and how bad your symptoms are. You may need one or more of the following:

  • Medicines:

    • Antibiotics: This medicine is given to help treat your pneumonia if it is caused by bacteria.

    • Antipyretics: This medicine is given to decrease a fever.

    • 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.

    • Bronchodilators: You may need bronchodilators to help open the air passages in your lungs, and help you breathe more easily.

    • Steroids: Steroid medicine may help open your air passages so you can breathe easier. Do not stop taking this medicine without your caregiver's okay. Stopping on your own can cause problems.

    • Antifungal medicine: This medicine helps kill fungus that may be causing your pneumonia.

    • Antiviral medicine: This is given to treat pneumonia if it is caused by a virus.

  • Treatments:

    • Deep breathing and coughing: Deep breathing helps to open the air passages in your lungs. Coughing helps to bring up mucus from your lungs.

    • Breathing treatments: You may need breathing treatments to help open your airways so you can breathe easier. A machine is used to change liquid medicine into a mist. You will breathe the mist into your lungs through tubing and a mouthpiece. Inhaled mist medicines act quickly on your airways and lungs to relieve your symptoms.

    • 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.

    • Thoracentesis: This procedure is done to remove extra pleural fluid from your chest. Pleural fluid is the fluid between the 2 layers of tissue lining your lungs. You are given numbing medicine, and then a needle is put between 2 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.

What can I do to prevent or manage community-acquired pneumonia?

  • Avoid the spread of germs: Wash your hands often with soap and water. Use gel hand cleanser when there is no soap and water available. Do not touch your eyes, nose, or mouth unless you have washed your hands first. Cover your mouth when you cough. Cough into a tissue or your shirtsleeve so you do not spread germs from your hands. If you are sick, stay away from others as much as possible.

  • Drink enough liquids: Men 19 years old or older should drink about 3 liters of liquid each day (close to thirteen 8 ounce cups). Women 19 years old or older should drink about 2.2 liters of liquid each day (close to nine 8 ounce cups). Liquids help thin your mucus, which may make it easier for you to cough it up. While you are sick, do not drink alcohol.

  • Get vaccinated: 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. Get an influenza (flu) vaccine every year as soon as it becomes available.

  • Quit smoking: Do not smoke, and do not allow others to smoke around you. Smoking increases your risk of lung infections and CAP. Smoking also makes it harder for you to get better after a lung infection. Talk to your caregiver if you need help to quit smoking.

What are the risks of community-acquired pneumonia?

  • Even with treatment, your CAP infection may not go away, or your symptoms may get worse.

  • Without treatment, your CAP infection may get worse and become more serious. You may have breathing problems, or the infection can spread to other areas of your body. Pus or extra fluid may pool in the space around your lungs, or your lungs may be badly damaged. You may not be able to get enough oxygen if your lungs are inflamed or damaged. Low oxygen can cause damage to other body organs, such as your kidneys, heart, and brain. You may die from CAP if you do not get treatment, or you do not respond to treatment and the infection worsens.

When should I contact my caregiver?

Contact your caregiver if:

  • You have fever and chills.

  • Your cough comes back, does not go away, or you begin to cough up blood.

  • You feel very tired or weak, or are sleeping more than usual.

  • You cannot eat or have loss of appetite, nausea, or vomiting.

  • You are urinating less, or not at all.

  • Your heart or pulse beats more than 100 times in 1 minute.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately of call 911 if:

  • Your symptoms do not get better, or get worse.

  • You are confused and cannot think clearly.

  • You have more trouble breathing, or your breathing seems faster than normal.

  • Your lips or fingernails turn gray or blue.

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. 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.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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