Infections caused by the Mycoplasma pneumoniae species of bacteria and viruses tend to develop more slowly, after a few days of flu-like symptoms. They can cause a hacky or barky cough, headache, and pain under the breastbone.

The Physical Examination

The most important diagnostic tool for pneumonia may be the stethoscope. In pneumonia, as air passes through mucous and fluids in the lungs, it creates sounds called rales and rhonchi. The doctor will strongly suspect pneumonia if rales are heard on one side of the chest and while the patient is lying down.

The doctor may also tap lightly on the person's chest, a diagnostic tool called "percussion". A dull thud instead of a hollow drum-like sound may indicate that the lung has become firm and inelastic from inflammation, called consolidation; or that fluid may be collecting in between the layers of the lung membrane, called pleural effusion.

Several tests may be ordered to help in the diagnosis:

• Chest x-rays may show signs of infection in the lungs. Different types of pneumonia often will have different patterns on the x-ray.

• Blood and sputum tests may be performed to collect a specimen if the doctor needs to determine the organism causing the pneumonia.

• A lung biopsy may be performed in severe cases.

Other Diagnostic Procedures

In persons with life-threatening pneumonias more aggressive diagnostic procedures may be required.

• Thoracentesis is done to remove and analyze fluid from the pleura, the thin membrane that lines the outside of the lung and the chest cavity. Any accumulation of fluid between the layers of the pleura is called a pleural effusion. Fluid in the pleura is withdrawn using a long thin needle inserted between the ribs and analyzed in the laboratory.

• A bronchoscopy may be performed if the physician wants to see inside the lung. In this test, a tube is inserted through the nose or mouth. The tube acts like a telescope into the body, allowing the physician to view the wind-pipe and major airways for pus, abnormal mucous, or other problems.

• The physician may ask you to breathe into an instrument called a spirometer that measures the amount of air you breathe. This test, called a spirometry, can help to determine how well the lungs are functioning.

• Some of the bacteria that can cause pneumonia, such as Legionella, Mycoplasma, and Chlamydia, cannot be seen with an ordinary microscope. They are found using special culture techniques or by performing blood tests that detect antibodies to the organisms.

• Aspiration pneumonias cause changes in the chest x-ray that can be seen six to 24 hours after inhalation. Symptoms include respiratory distress indicated by grunting, cough, and fever after the aspiration of hydrocarbons, foreign substances, or bodily fluids. Symptoms may develop in minutes or hours depending on the volume and nature of the aspirated substance.

Treatment:

Treatment depends on the cause and severity of the pneumonia. Antibiotics are the first line of attack to get rid of bacterial pneumonia. They are very effective if taken as prescribed, but are ineffective against viral pneumonia. If the pneumonia is severe, the antibiotics may be given over the course of a few weeks instead of the standard 10 days. The infected patient must also get plenty of rest to give his body time to heal. Patients should drink plenty of clear liquids and eat as they can. If the patient is not progressively getting better, he may need some extra attention from the hospital. This can include oxygen treatments and stronger antibiotics.


Treating Infective Pneumonia

Although the treatment for infective pneumonia depends on the cause of the condition, some simple steps can help speed recovery from pneumonia:

• Medications should be taken exactly as prescribed by a physician. If it is not helping, call the doctor. Do not quit taking it unless told to do so by a doctor.

• Take over-the-counter medicines such as acetaminophen or ibuprofen to help control pain and fever.

• Use a cool-mist humidifier or vaporizer to increase air moisture and to make it easier to breathe. DO NOT use hot steam.

• Rest in bed until body core temperature returns to normal (98.6 degrees F or 37 degrees C) and chest pains and breathing problems are gone. Drink six to eight glasses of liquids daily to help keep mucous thin and easy to cough up.

Treatments For Aspiration Pneumonia

Treatments for aspiration pneumonia focus on breathing support. A breathing tube called an endotracheal tube is usually inserted into the trachea and oxygen is pumped into the lungs.

Suction may be used to clear the airways and to get any remaining chemical or vomit out of the way. Antibiotics are given only if a secondary lung infection develops.

Recovery From Pneumonia

How well a person recovers from pneumonia depends on the type of pneumonia and the person's general health. Most people with pneumonia recover completely. However, in infants under one year of age, the elderly, and those who are already seriously ill, pneumonia can sometimes be fatal.

Prevention:

Some forms of bacterial pneumonia can be prevented with a vaccine (pneumococcal vaccine). The vaccine does not protect against most types of viral pneumonia or the pneumonia that people with low immunity tend to develop.

In most people, vaccination is needed only once in a lifetime. However, others, including those people at highest risk for serious disease, may need to be vaccinated a second time. Individuals should consult their physicians to determine if a second vaccination is recommended.

Those who should get vaccinated include:

• People over age 65

• Anyone with a serious chronic illness, such as diabetes or heart disease.

Nice To Know: Pregnant or nursing women and children under 2 years old should not be vaccinated with the pneumococcal vaccine. Routine revaccination of adults is not recommended. The vaccine for the flu (pneumovax) can help prevent one type of viral pneumonia. Since the flu virus changes from year to year, this shot needs to be given once each year in order to be effective and should also be given to people who are over 65 or who have serious illnesses. Pneumococcal vaccination is appropriate at any time of the year but is most often given at the same time as the influenza vaccine in the early to mid-Fall.

How-To Information: Personal methods to avoid pneumonia Prevent pneumonia by taking measures to avoid the organisms that cause respiratory infections, including colds and flu. Always wash hands before eating and after going outside. Ordinary soap is okay. Expensive antibacterial soaps add little protection, particularly against viruses. Eat a daily diet that includes foods rich in antioxidants, such as fresh, dark-colored fruits and vegetables and other nutrients. Increase lung capacity through brisk walking and other aerobic exercises. Breathing exercises, which train us to take slow, deep, relaxed breaths and exhale through pursed lips, may also be helpful. Do not smoke. To avoid aspiration pneumonia: Open a window when you use cleaning products, especially when you are in a small room. Do not spray or use chemicals outside when it's windy. If you must work in the wind, make sure the chemicals are blowing away from you instead of toward you. Wear a mask over your mouth and nose, and wear clothing that protects your skin. Read and follow all safety directions on the labels of any chemical you use.