JAMA PATIENT PAGE | Pulmonary

Pneumonia
Pneumonia is a lung infection that can be caused by bacteria,
viruses, or fungi.
When you breathe in, oxygen-rich air travels into the body through
the airways (trachea, bronchi, and bronchioles) in your lungs. At the
ends of the airways, oxygen is exchanged for carbon dioxide, which
travels out of the body when you breathe out. Alveoli are very small
air sacs at the ends of the airway branches where this gas exchange
occurs. Pneumonia causes alveoli to become inflamed and to fill up
with fluid.
Bacteria are the most common cause of pneumonia in adults,
while viruses are the most common cause in children younger than
5 years.

Lung anatomy and gas exchange

Bronchiole
Alveoli

Trachea
AIR
BLOOD
(in alveolus) (in capillary)

Bronchi

Carbon
dioxide
Gas exchange

Bronchioles

Symptoms

Oxygen

The symptoms of pneumonia range from mild to severe. Common

symptoms include cough with phlegm (wet cough), difficulty
breathing, fever, chest pain, fatigue, and confusion.

Healthy alveoli
Air in alveoli

Pneumonia
Inflammatory cells and fluid in alveoli
Bronchiole

Capillary

At-Risk Populations
While anyone can get pneumonia, certain groups are at higher risk of
developing the disease. Children younger than 2 years and adults older
than 65 years are at increased risk. Your risk is also higher if you
Have a weakened immune system
Have chronic lung disease, such as COPD, asthma, or cystic fibrosis
Haveotherchronichealthproblems,suchasdiabetesorheartdisease
Smoke cigarettes

Prevention
Vaccines can help prevent pneumonia. Pneumococcal vaccine helps
protect you from a common cause of severe pneumonia. Getting the
flu vaccine every year helps prevent pneumonia that is caused by
the influenza virus or that occurs as a complication of having the flu.
Pertussis, measles, varicella (chickenpox), and Hib vaccines help prevent less common causes of pneumonia.
Washing your hands with soap and water or using hand sanitizer regularly can help prevent the spread of germs that cause pneumonia. Quitting smoking increases your lungs ability to filter out
germs and fight infections.

Treatment is based on what kind of germ is causing the infection and how severe your symptoms are. Bacterial pneumonia is
treated with antibiotic medicines. Antibiotics will not help in cases
of viral pneumonia, which often improves without treatment.
Pneumonia can be acquired in various settings. Causative germs
and treatment may differ depending on whether you have community-acquired pneumonia (CAP), hospital-acquired pneumonia, or
health careassociated pneumonia.
Many cases of pneumonia can be treated at home. If your symptoms are severe or you have other health problems, you may need
to be treated in the hospital. A study in the February 9, 2016, issue
of JAMA reports on antibiotic therapy in adults hospitalized with CAP.
FOR MORE INFORMATION

Diagnosis and Treatment

To diagnose pneumonia, your doctor will ask questions about your
symptoms and your health history. Certain tests, including chest
x-ray, blood tests, and sputum (phlegm) culture, may be performed to help make the diagnosis.
Author: Amy E. Thompson, MD
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE
Form for Disclosure of Potential Conflicts of Interest and none were reported.
Sources: Centers for Disease Control and Prevention; National Heart, Lung, and Blood
Institute.

626

Bronchiole
Capillary

National Heart, Lung, and Blood Institute

www.nhlbi.nih.gov/health/health-topics/topics/hlw/system
www.nhlbi.nih.gov/health/health-topics/topics/pnu

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JAMA February 9, 2016 Volume 315, Number 6 (Reprinted)

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