Pneumonia

What is pneumonia?

Pneumonia is inflammation of the lungs, usually caused by infection. It may be bacterial or viral; occasionally other organisms or material entering the lungs during swallowing are involved. Severity ranges from an illness treated at home to one needing hospital care.

Symptoms and urgent advice

Symptoms include cough, fever, breathlessness, chest pain on breathing, tiredness and loss of appetite. Older people may develop confusion. Seek prompt GP or NHS 111 advice if you are breathless, have pain on breathing or are becoming more unwell.

Call 999 for severe breathing difficulty, inability to speak normally, blue or blotchy lips or skin, collapse or sudden confusion. Coughing up blood needs urgent assessment. Do not wait for a routine clinic appointment if symptoms are severe.

How is it assessed?

Your clinician checks symptoms, breathing rate, oxygen levels, blood pressure and other health conditions. A chest X-ray is commonly used in hospital to support the diagnosis; blood tests and selected infection samples may help. Clinical assessment and severity scores guide whether home treatment or hospital care is appropriate.

Treatment

Suspected bacterial pneumonia is treated with antibiotics chosen for the severity, allergies, recent treatment and other clinical factors. Take the course exactly as prescribed. Some people need intravenous medicines, fluids, oxygen or other breathing support in hospital. Steroids may be considered for selected adults with high-severity pneumonia in hospital.

Rest, drink fluids as advised and use suitable pain or fever relief. Seek reassessment if symptoms worsen or do not start to improve within about three days of starting treatment.

Recovery and follow-up

Recovery can take several weeks, and tiredness may last longer. Increase activity gradually. A repeat chest X-ray is not needed for everyone. NICE advises considering one around six weeks after hospital discharge when symptoms persist or worsen, there is unexplained weight loss, or risk factors for underlying disease such as smoking or age over 50. Your clinician will agree the follow-up plan with you.

Discuss stopping smoking and recommended vaccinations with your healthcare team to reduce future risk.