Pneumonia Diagnosis and Treatment

Helpful Highlights

• Pneumonia symptoms vary and differ from person to person, so should be checked by a provider.

• Older adults and the elderly may not mount a fever in response to pneumonia (or any infection). They may actually have a drop in temperature.

• Treatment depends on the type of pneumonia, though aside from medications, interventions are much the same - namely, loss of rest and fluids.

Is it pneumonia?

How do you know if your loved one has pneumonia? The difficult thing is that pneumonia can mimic a bad cold, bronchitis, or the flu. Regardless of the diagnosis, especially in the older adult (over 65), these symptoms are ones you'll want to have checked by their provider.

• Chest pain with coughing or deep breathing

• Shallow breathing because of chest pain

• Confusion or changes in mental awareness

• Cough that produces dark yellow, green, brown, or bloody phlegm

• Persistent fatigue

• Fever, sweating, and shaking chills

• Lower than normal body temperature

• Nausea, vomiting, or diarrhea

• Shortness of breath

How Is pneumonia diagnosed?

Sometimes pneumonia can be difficult to diagnose because the symptoms are so variable, and are often similar to those seen with a cold or the flu.

Diagnosis is usually made based on recent health history (such as surgery, a cold, or travel exposures) and the extent of the illness. Based on these factors, the healthcare provider may diagnose pneumonia simply by a thorough history and physical exam. They’ll listen to all the lung fields and take a pulse oximetry measurement (oxygen levels in the blood). At that point, they may order additional diagnostics such as a chest x-ray and blood or sputum tests. The additional tests may be to confirm a diagnosis of pneumonia and determine how well the lungs are working, though they are also to try and find the cause of pneumonia.

But even if the provider confirms that your loved one has pneumonia, sometimes they can’t find the exact cause.

How is pneumonia treated?

Treatment depends on the type of pneumonia. Most of the time, pneumonia is treated at home, but severe cases may be treated in the hospital. Antibiotics are used for bacterial pneumonia. Other medications include antivirals, antifungals, and intravenous fluids. Most viral pneumonias don’t have a specific treatment and usually resolve on their own with time; however, always follow the provider's recommendations to reduce the risk of serious complications or long-term problems.

Other treatments may include a diet rich in fresh fruits and vegetables, an increase in fluid intake, lots of rest, breathing treatments, oxygen therapy, and medicine for pain, cough, and fever control.

Treatment is focused on managing symptoms and making sure your loved one's condition doesn’t get worse.

When should we see a provider?

If your loved one is over 65, they should see a provider if they have any of the symptoms listed above. This is especially true if they have heart issues, chronic lung problems, or other sensitive underlying conditions (diabetes, autoimmune disorders).

When is hospitalization needed?

A severe case of pneumonia, or serious complications from pneumonia, may require hospitalization for treatment. Hospitalization is more likely if your loved one:

• Is under age 2 or over age 65

• Has a weakened immune system

• Has health conditions that affect the heart and lungs

It may 1 to 2 months for your loved one to feel back to normal if they've been hospitalized with pneumonia.

Pneumonia in older adults and elderly

Older adults and elderly with pneumonia - or any type of infection - may only have a low-grade fever (a slight increase from their normal) or even a normal temperature. It is also likely that the very ill older adult will have a drop in their normal temperature. They may also be less alert, show signs of confusion, or experience changes in mental awareness. If you suspect your aging loved one has pneumonia, see a provider to start treatment as early as possible.

A senior diagnosed with pneumonia may be given antibiotics, cough medicine, or a pain reliever, along with oxygen therapy or another breathing treatment. Due to the high risk for complications, ensure they take the full course of each medication rather than stopping when symptoms appear to improve.