What is pneumonia?
Pneumonia is an infection of the lungs. Most infections are due to bacteria or viruses, but some are caused by fungi.
Pneumonia can be a mild illness or it can be something much more serious. Pneumonia can be life threatening, especially in babies, young children and people older than 60, so it’s important to see a doctor right away.
If you or someone in your care is recovering well from a cold or flu but then it becomes worse, it may be pneumonia. If the affected person has trouble breathing, they should go to the nearest Emergency Department.
What are the symptoms of pneumonia?
Quite often, people with pneumonia have previously had cold or flu symptoms for a few days or weeks that have got worse, not better.
The most common symptoms of pneumonia are:
- cough — can be dry or may produce thick mucus (cough can last for several weeks after pneumonia has been treated successfully)
- fever (a temperature of 38°C or higher), sweating and shivering — though in older people it can cause lower than normal body temperature
- difficulty breathing, or rapid breathing (especially in young children) or shortness of breath. In children, the ribs or the skin under the neck can suck in, or babies may bob their heads while breathing
- feeling generally tired and unwell
- loss of appetite
People with pneumonia may also:
- have a headache
- have pain in the chest that is worse with breathing or coughing
- cough up blood
- have abdominal (tummy) pain
- feel nauseous and maybe even vomit
- ache all over
- be confused or disorientated (especially older people)
- have a blue colour around the mouth (cyanosis), due to lack of oxygen in more serious cases
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What causes pneumonia?
Pneumonia is caused by an infection of the lung. Most infections are caused by bacteria or viruses, although often a cause is never found. It can be triggered by a cold or the flu, which allows the germs to gain access to the lungs.
In severe cases of the coronavirus (COVID-19), breathing difficulties can develop into pneumonia. COVID-19 pneumonia is a serious illness that can be life-threatening.
Bacterial pneumonia may be caused by the pneumococcal bacteria, called Streptococcus pneumoniae. This is one of the most severe and potentially life-threatening types of pneumonia. Other types of bacteria that cause pneumonia are Haemophilus influenzae and Moraxella catarrhalis.
Viral pneumonia is caused by different viruses. The most common are the influenza virus, human adenovirus and the respiratory syncytial virus. It is thought about half of pneumonia cases are caused by a virus.
Another common cause of pneumonia is infection by mycoplasma, a kind of bacterium. Pneumonia caused by mycoplasma organisms is usually milder, but recovery can be longer.
Other organisms, such as fungi, can also cause pneumonia. This is more common in people whose immune systems are not working properly, such as those with HIV infection or people being treated for cancer.
Some people are more likely to get pneumonia or develop a more severe illness, including:
- babies and young children under 2
- people over 65
- people with medical conditions, such as diabetes, cancer or chronic diseases, affecting the lungs, heart, kidney or liver
- people with weak immune systems or who are taking medicines that suppress their immune systems
- Aboriginal and Torres Strait Islander people
- people who smoke
- people with feeding problems, such as those with intellectual disabilities at risk of aspiration (drawing food or liquid into the airway)
- people who are being treated in hospital, especially if they are having help to breathe
If you suspect that you or someone in your care may have pneumonia, it is important to see a doctor as soon as possible. If the affected person has trouble breathing, they should go to the nearest hospital emergency department.
How is pneumonia diagnosed?
Doctors diagnose pneumonia mainly by talking to the person who is unwell and examining them.
Tests for pneumonia include blood samples, a swab from inside the nose or throat, urine or sputum (phlegm) to try to identify the cause of the pneumonia. A chest x-ray is usually also taken. If you are in hospital, doctors will also monitor to see if there is enough oxygen in your blood.
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How is pneumonia treated?
Treatment will depend on whether the pneumonia is caused by bacteria or a virus.
If bacteria have caused the infection, the main treatment is antibiotics. In milder cases, antibiotics can be taken by mouth. In more severe cases, they’ll need to injected, at least at first. Antibiotics are usually given at the first sign of pneumonia, before it’s clear whether the pneumonia is caused by a virus or bacteria.
Viral pneumonia cannot be treated with antibiotics.
Most people who have pneumonia will be able to stay home. If your symptoms haven’t improved within the first 5 days of taking antibiotics or your symptoms get worse, contact the doctor. Sometimes you may need a change in the dose or type of antibiotic, or you may need more than one medicine.
Some people will need to be treated in hospital. This is more common for people who are very old, very young or who have other illnesses. A person in hospital for pneumonia may need oxygen therapy, or other more intense forms of treatment.
Cough medicine is not recommended for people with pneumonia. Coughing can help move mucous plugs from the tubes and help clear the infection.
People with pneumonia should quit smoking and keep well away from things that will irritate their lungs, such as smoke. Drink plenty of fluids and get lots of rest to help you recover.
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Can pneumonia be prevented?
Vaccinations can help prevent some types of pneumonia. It’s a good idea to speak to your doctor about whether vaccination is recommended for you or for your children.
One vaccination that reduces the risk of pneumonia is the pneumococcal vaccine. Pneumococcal vaccines are free in Australia under the National Immunisation Program for some people (see below).
Vaccination is your best protection against pneumonia. This table explains how the pneumococcal vaccine is given, who should get it, and whether it is on the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.
What age is it recommended?
2, 4 and 12 months. At risk children may receive extra doses.
Over 70 (or over 50 if you are Aboriginal or Torres Strait Islander).
Any age if you have medical conditions that put you at risk of pneumococcal disease.
How many doses are required?
1, 2, 3 or 4, depending on the age and medical situation of the individual.
How is it administered?
Is it free?
The vaccine is free for:
For everyone else, there is a cost for the vaccine.
Find out more on the Department of Health website and the National Immunisation Program Schedule, and ask your doctor if you are eligible for additional free vaccines based on your situation or location.
Common side effects
The vaccine is very safe. Side effects may include pain, redness and swelling where the needle went in, fever, feeling irritable, feeling drowsy, reduced appetite or body aches.
You can also consider getting vaccinated against influenza. Pneumonia is one of the possible complications of influenza. A new influenza vaccine is available every year. It is free to some people who are at increased risk, including children under 5 years, pregnant women, people aged 65 and over, Aboriginal and Torres Strait Islander people, and people with certain medical conditions. For more information about the influenza vaccine, visit the Department of Health website.
Vaccination can also prevent other illnesses that can lead to pneumonia. These are all available for children as part of routine childhood vaccinations in Australia under the National Immunisation Program Schedule and include:
Not smoking will also help protect against pneumonia. Eating healthily and keeping your immune system strong are other ways to protect your health.
If you or someone near you has an infection, you can reduce the risk of passing that infection on by:
- limiting your exposure to others while unwell
- washing your hands frequently with soap and water
- coughing and sneezing into a tissue then throwing it away
- covering your mouth when sneezing or coughing, preferably with your inner elbow
- keeping your hands away from your eyes, nose and mouth
- avoiding sharing food, drink and utensils
Resources and support
- If you need to know more about pneumonia or need advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).
- For more information about pneumonia, visit the Lung Foundation’s pneumonia web page.
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Last reviewed: April 2021