Diagnosis
Your doctor will start by asking about your medical history and doing a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia.
If pneumonia is suspected, your doctor may recommend the following tests:
- Blood tests. Blood tests are used to confirm an infection and to try to identify the type of organism causing the infection. However, precise identification isn't always possible.
- Chest X-ray. This helps your doctor diagnose pneumonia and determine the extent and location of the infection. However, it can't tell your doctor what kind of germ is causing the pneumonia.
- Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
- Sputum test. A sample of fluid from your lungs (sputum) is taken after a deep cough and analyzed to help pinpoint the cause of the infection.
Your doctor might order additional tests if you're older than age 65, are in the hospital, or have serious symptoms or health conditions. These may include:
- CT scan. If your pneumonia isn't clearing as quickly as expected, your doctor may recommend a chest CT scan to obtain a more detailed image of your lungs.
- Pleural fluid culture. A fluid sample is taken by putting a needle between your ribs from the pleural area and analyzed to help determine the type of infection.
Treatment
Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more.
Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include:
- Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic.
- Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest.
- Fever reducers/pain relievers. You may take these as needed for fever and discomfort. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).
Hospitalization
You may need to be hospitalized if:
- You are older than age 65
- You are confused about time, people or places
- Your kidney function has declined
- Your systolic blood pressure is below 90 millimeters of mercury (mm Hg) or your diastolic blood pressure is 60 mm Hg or below
- Your breathing is rapid (30 breaths or more a minute)
- You need breathing assistance
- Your temperature is below normal
- Your heart rate is below 50 or above 100
You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe.
Children may be hospitalized if:
- They are younger than age 2 months
- They are lethargic or excessively sleepy
- They have trouble breathing
- They have low blood oxygen levels
- They appear dehydrated
Lifestyle and home remedies
These tips can help you recover more quickly and decrease your risk of complications:
- Get plenty of rest. Don't go back to school or work until after your temperature returns to normal and you stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Because pneumonia can recur, it's better not to jump back into your routine until you are fully recovered. Ask your doctor if you're not sure.
- Stay hydrated. Drink plenty of fluids, especially water, to help loosen mucus in your lungs.
- Take your medicine as prescribed. Take the entire course of any medications your doctor prescribed for you. If you stop taking medication too soon, your lungs may continue to harbor bacteria that can multiply and cause your pneumonia to recur.
Preparing for your appointment
You may start by seeing a primary care doctor or an emergency care doctor, or you may be referred to a doctor who specializes in infectious diseases or in lung disease (pulmonologist).
Here's some information to help you get ready for your appointment and know what to expect.
What you can do
- Keep a record of any symptoms, including your temperature.
- Write down key medical information, including recent hospitalizations and any medical conditions you have.
- Write down key personal information, including exposure to any chemicals or toxins, or any recent travel.
- Make a list of all medications, vitamins and supplements that you're taking, especially an antibiotic left over from a previous infection, as this can lead to a drug-resistant pneumonia.
- Bring a family member or friend along, if possible, to help you remember questions to ask and what your doctor said.
- Write down questions to ask the doctor.
Some basic questions to ask the doctor include:
- What is likely causing my symptoms?
- What kinds of tests do I need?
- What treatment do you recommend?
- Will I need to be hospitalized?
- I have other health conditions. How will my pneumonia affect them?
- Are there any restrictions that I need to follow?
Don't hesitate to ask other questions.
What to expect from the doctor
Be ready to answer questions your doctor may ask:
- When did you first start having symptoms?
- Have you had pneumonia before? If so, in which lung?
- Have your symptoms been continuous or occasional? How severe are they?
- What, if anything, seems to improve or worsen your symptoms?
- Have you traveled or been exposed to chemicals or toxic substances?
- Have you been exposed to sick people at home, school or work?
- Do you smoke? Or have you ever smoked?
- How much alcohol do you consume in a week?
- Have you had flu or pneumonia vaccines?
What you can do in the meantime
To avoid making your condition worse:
- Don't smoke or be around smoke
- Drink plenty of fluids and get plenty of rest