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Pneumonia: More than just a cough

I have been battling an awful cold recently and am starting to worry that it might be something worse. How can I tell the difference between a cold and pneumonia?

A serious infection of the lungs, pneumonia kills more than 40,000 people in the United States annually, most of them over the age of 65. Even for a normally healthy person, the condition can be very dangerous.

Bacteria, viruses, and other microorganisms can all cause pneumonia. Certain pneumonias, such as influenza, Legionnaires' disease, and tuberculosis, result from breathing in the microorganism. Sometimes a viral pneumonia, like influenza, weakens the lungs' defense mechanisms and allows a bacterial pneumonia to take hold.

"Fever, productive cough, and shortness of breath are typical symptoms of pneumonia," says Helen Hollingsworth, M.D., associate professor of medicine at Boston University School of Medicine and director of adult allergy and asthma services in the department of medicine at Boston Medical Center. Additional symptoms of bacterial pneumonia include chills, fatigue, and chest pain.

Viral pneumonia, which usually hits in the winter months, starts with headache, fever, muscle pain, and fatigue, then progresses to a persistent cough, usually not phlegm-producing, and shortness of breath. "If you have a cold or the flu, and three or four days into it you start feeling significantly worse rather than better - it may be an indication that something else is going on. A high fever is another sign that it may be more than a cold," Hollingsworth says. Mycoplasmal pneumonia has symptoms similar to both bacterial and viral pneumonia, but the symptoms are milder and last longer.

While most cases of pneumonia don't require hospitalization, Hollingsworth stresses that the condition should not be taken lightly. If you suspect you may be developing pneumonia, see your doctor immediately. Early diagnosis and treatment are important in order to ensure a speedy recovery.

"In general, treatment for viral pneumonia is the same as for influenza," Hollingsworth explains. "Drink a lot of fluids, get plenty of rest and try to keep the fever down." The treatment for bacterial pneumonia is antibiotic therapy, usually over a 10-day period, perhaps longer, depending on the severity. Mycoplasmal pneumonia is also treated with antibiotics.

The key to a complete recovery is to follow your physician's advice exactly. Hollingsworth says it is vital for a person with pneumonia to continue taking medication throughout the prescription period in order to avoid a relapse, even if symptoms have resolved.

Certain people are at higher risk for catching pneumonia. Senior citizens, people with asthma, emphysema, or chronic bronchitis, those with immune deficiencies, and those undergoing medical treatments (like chemotherapy) that weaken the body's immune system are all more likely to develop the condition than others.

Steps can also be taken to strengthen your resistance to pneumonia. "Viral pneumonia can develop from a bad case of influenza, so get our flu shots every year," Hollingsworth stresses. "You can also be vaccinated against a common type of bacterial pneumonia called pneumococcal pneumonia. This booster shot is only needed about once every six years."

Other precautions include avoiding other people with respiratory infection and getting enough rest and exercise. Finally, Hollingsworth advises cigarette smokers to think seriously about quitting because smoking damages the lungs' natural defenses against infections.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on pneumonia or other health matters, call 617-638-6767.

15 December 2000
Boston University
Office of University Relations