Pneumonia

Pneumonia is a serious medical condition causing inflammation of the lungs.

Common types of pneumonia

Older people and anyone with a compromised immune system are at risk of pneumonia. Many frail older people with chronic illness or near the end of life die of complications of pneumonia.

Older people living in the community or an aged care home generally get community-acquired pneumonia. Recovery from community-acquired pneumonia can be good if diagnosed and treated promptly.

End-of-life pneumonia is generally seen in people at the end stage of a debilitating illness such as end stage dementia. Treatment with antibiotics may have little impact. Depending on the individual's overall condition the prognosis can be very poor.

People suffering from stroke, advanced Parkinson's or dementia or any condition that impairs swallowing are at risk of aspiration pneumonia.

Aspiration pneumonia is also common in people who are fed via a nasogastric tube or gastroscopy feed and can be harder to detect.

What causes pneumonia?

There are a number of different types and causes of pneumonia.
Pneumonia is caused by bacteria, fungi or parasites. Pneumonia generally develops from an infection such as the flu.

Our bodies can usually fight infection. If our immune system is down harmful organisms can penetrate the lungs and damage the airways. Pneumonia causes the air sacs in the lungs to fill with pus and other liquid making it difficult to breath. 

The infection can spread into the blood stream and throughout the body lowering the bodies defences. Pneumonia can be life-threatening.

Risk factors for pneumonia

Risk factors associated with an increase risk of pneumonia include;

• Aged over 65
• Chronic disease especially emphysema, COPD, bronchitis, diabetes, heart disease and heart failure
• Smoking
• Recent surgery and hospitalisation
• Exposure to chemicals and pollutants

Symptoms of pneumonia

Symptoms of pneumonia are similar to those of the flu. Pneumonia symptoms can happen suddenly or gradually worsen.

People with dementia or other degenerative diseases often cannot communicate how they are feeling. Carers need to be alert for signs of pneumonia. Increased confusion or a change in behaviour may be a sign of infection.

People living in residential care are susceptible to pneumonia. Symptoms of pneumonia may be more subtle in older people. They may have a lower than normal temperature or no noticeable cough.

Symptoms of pneumonia include:

• Fever
• Headache
• Dry cough
• Sore throat
• Runny nose
• Muscle aches
• Shortness of breath
• Fatigue
• Chest pain
• Sweating
• Increased confusion or drowsiness

Anyone experiencing symptoms of pneumonia should see a doctor immediately.

For older people with chronic illness or weakened immune systems symptoms of pneumonia can develop quickly and turn life-threatening.

Prompt diagnosis and early treatment can help prevent serious complications of pneumonia.

Regular immunisation helps protect elderly people from  pneumonia and is recommended for most residents of aged care homes.

Related articles

• Diagnosing pneumonia
• Treatment of pneumonia
• What is aspiration pneumonia?

References

North West Melbourne Division of General Practice
Clinical Information sheet- Respiratory:Pneumonia
Accessed 29/05/09

Mayo Clinic.com
Pneumonia
Accessed 29/05/09

American Family physician
Pneumonia in Older Residents of Long-Term Facilities
Accessed 29/05/09