Centers of Excellence

The Lung Center

Pneumonia

Pneumonia is an infection in one or both lungs caused by bacteria, viruses, fungi, allergic reaction or chemical irritants. When these germs reach your lungs, your immune system sends cells to attack the germs. These cells cause the alveoli (air sacs) to become inflamed and to fill up with mucus and other liquids. This leads to breathing difficulty, fever, cough and fatigue.

Pneumonia is common in the United States, and many cases can be treated at home with antibiotics. More serious cases, such as cryptogenic organizing pneumonia (COP), require the attention of specialists. Pneumonia can cause serious complications such as respiratory failure, acute respiratory distress syndrome, sepsis and lung abscesses, and can even be deadly.

Pulmonologists and thoracic surgeons who specialize in pneumonia at the Brigham and Women’s Hospital (BWH) Lung Center provide comprehensive, specialized care for patients experiencing pneumonia. Their expertise and collaboration with other specialists throughout BWH provides patients with a highly-informed diagnosis and a cohesive treatment plan.

What are the risk factors for pneumonia?

While pneumonia can affect people of all ages, the following age groups face a greater risk:

  • Infants who are two years old or younger
  • Adults who are 65 years old or older

Several conditions place people at risk for pneumonia, as they often result in a weakened or suppressed immune system. These include:

Other risk factors for pneumonia include:

  • Abusing alcohol
  • Being undernourished
  • Exposure to some chemicals, toxic fumes or pollutants
  • Smoking cigarettes
  • Staying in a hospital intensive care unit, especially if using a ventilator

What are the types of pneumonia, and what causes it?

The body typically protects the lungs from infection by filtering germs out of the air we breathe. Pneumonia occurs when germs such as bacteria, viruses, or fungi manage to enter the lungs and your immune system attempts to combat the infection. The main types of pneumonia are:

  • Bacterial pneumonia, such streptococcus pneumoniae, which usually occurs when the body is weakened in some way
  • Viral pneumonia, caused by viruses such as influenza (flu)
  • Mycoplasma pneumonia, caused by the bacterium mycoplasma pneumoniae
  • Fungal pneumonia, caused by the inhalation of fungi spores
  • Other pneumonias may be caused by infections due to inhaling food, liquid, gases or allergic reactions

What are the symptoms of pneumonia?

The symptoms of pneumonia vary depending on the severity of your condition. Immediate medical attention is necessary if you have any of the following symptoms:

  • Cough with bloody or discolored mucus
  • Chest pain
  • High fever
  • Shaking and chills
  • Shortness of breath that worsens with activity
  • Loss of energy and exhaustion
  • Loss of appetite
  • Rapid pulse
  • Nausea
  • Vomiting
  • Diarrhea
  • Confused mental state or delirium
  • Muscle pain or weakness

How is pneumonia diagnosed?

Pneumonia can often be challenging to diagnose as its symptoms resemble that of a cold or the flu. To diagnose pneumonia, your physician will carefully review your medical history, ask questions regarding your symptoms and conduct a full physical examination. He or she may also order additional tests, including:

What is the treatment for pneumonia at Brigham and Women's Hospital?

Treatment for pneumonia requires curing the infection and preventing further complications. Your physician will create a tailored treatment plan depending on the type and severity of pneumonia, your overall health and your age. Treatment plans typically include lifestyle recommendations and medication, although hospitalization and/or surgery may be required.

Lifestyle changes

  • Quit smoking
  • Increase fluid intake
  • Get plenty of rest

Medications

  • Antibiotics are commonly used to treat bacterial pneumonia
  • Fever reducers such as aspirin, ibuprofen and acetaminophen
  • Cough medicine to calm your cough to allow you to rest

Hospitalization

Hospitalization may be required for several reasons. This includes experiencing nausea and vomiting that prevent you from keeping oral antibiotics in your system, your temperature is below normal, your blood pressure drops or your heart rate is irregular. Your physician may elect to admit you to the intensive care unit if your symptoms are particularly severe or should you need to be placed on a breathing machine (ventilator).

Surgery

While most patients with pneumonia do not require surgery, it may be necessary if complications such as lung abscesses or empyema arise. Surgical interventions may include:

  • Chest tubes to drain infected plural fluid.
  • Thoracotomy, which involves an incision to open the chest and view the lungs so that dead and damaged lung tissue can be removed.
  • Lobectomy, removing a part of the lung affected by pneumonia.

What can I expect?

A multidisciplinary team will work with you every step of the way, from diagnosis through evaluation, to create a cohesive and comprehensive treatment plan. Our unique approach features same-day consultations with multiple specialists and fosters seamless, expert care. Your medical condition will be closely monitored and managed to promote optimal lung functioning and an improved quality of life.

If you require surgery, you will meet with your health care team first for pre-operative information and tests. On the day of your surgery, you will receive care from surgeons, anesthesiologists and nurses who specialize in thoracic surgery and interventional pulmonary procedures. After surgery, you will recover in our designated thoracic post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Team-based Care

Pneumonia patients benefit from the wide range of specialists at The Lung Center, including thoracic surgeons, pulmonologists and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.

Any recommended surgery or procedure will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with pneumonia.

Where are you located and how can I book an appointment?

Do you have additional resources?

Learn more about pneumonia in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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