Pneumonia can be devastating. This illness strikes with little warning, inflaming the air sacs in one or both lungs, filling them with fluid or pus, and making every breath a struggle.
“My condition with pneumonia was so severe that it led to misconceptions and it had people talking about me saying I had HIV but it was just pneumonia. That’s how bad it was,” says Alex Sithole from Gauteng describing the severity of his pneumonia symptoms.
For Sithole, pneumonia is something that built up over time as he disliked wearing warm clothes. According to him, the flu and colds built up, and later developed into pneumonia.
“I can’t stand the cold anymore because I over feel it, so I keep warm to never experience it again.”
Alex Sithole
Difficult to breathe
Sharing her experience with pneumonia, Neliswa Simuku from the Eastern Cape says, “Pneumonia is painful and makes you feel restless. Sometimes I would be afraid to fall asleep, thinking that I might have difficulty breathing.
“I would feel cold at one moment, and the next moment I’m hot. I had a wheezing chest and a runny nose, and I lost my appetite too. I was assisted by the family GP through medication to recover and was on strict bed rest.”
Dr Emmanuel Taban, a pulmonologist (a doctor who specialises in lung conditions) from Mpumalanga, defines pneumonia as a process in the lung that follows inflammation and infection of lung tissue, usually caused by bacterial or viral organisms.
He explains that the result of this inflammation and infection is swelling and filling of the lung’s air spaces with fluid, pus, and other debris, causing the lung to become solid and impairing its ability to function.
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Infectious and non-infectious
Although most causes of pneumonia are infectious, Taban notes that non-infectious causes also occur, and other processes may also mimic pneumonia, both in symptomatology and appearance on X-rays.
“Non-infective pneumonia includes a group of conditions that mimic the infective pneumonias but are themselves not caused by infection.”
Dr Emmanuel Taban
“These types of pneumonia do not require treatment with antibiotics but rather with other forms of therapy, such as immunosuppressive therapies or chemotherapeutic agents, in association with reversing the entity or removing the agent that caused it.”
According to him, cold weather itself does not increase the risk of developing pneumonia; however, there is a high burden of seasonal infections that come with the onset of colder seasons.
“Individuals are more likely to spend time indoors with poor ventilation (closed windows and doors, etc.) owing to the cold, which increases the possibility of person-to-person spread of infection. Cold air can also increase the risk of bronchospasm in asthmatic individuals and can increase the production of mucous, which may increase the susceptibility to infection.”
Symptoms of pneumonia
Taban underlines common symptoms of pneumonia as:
- Coughing (which may produce greenish, yellow, or even bloody mucous)
- Fever
- Sweating and shaking chills
- Shortness of breath or rapid, shallow breathing
- Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
- Loss of appetite
- Low energy and fatigue
“Pneumonia is usually diagnosed using imaging, such as a chest X-ray or CT scan, in association with typical symptoms and medical history. Testing for specific causes of pneumonia may then follow, depending on the circumstances.”
Treating the causes of pneumonia
Taban explains that the treatment of the pneumonia depends on what is causing the pneumonia.
“Bacterial pneumonia is treated with specific antibiotics, but different bacterial causes respond to different antibiotics.
Dr Emmanuel Taban
” Initially, the doctor will give therapy that targets the more common and more likely causes and may give you a combination of antibiotics for typical and atypical bacterial causes.”
“If the patient is not responding to this initial therapy, further investigations need to be done, including sending samples to the laboratory to determine the precise cause of the infection.”
He adds that elderly individuals and people with certain other co-existing illnesses may require more intensive regimens. Furthermore, the more severe the infection, the more intensive the therapeutic regimen.
Taban admits that no known or proven home remedy can be used to manage or prevent pneumonia. “Most pneumonia will improve with bed rest and time. Antibiotics are prescribed to shorten the duration of the pneumonia. A person should not overly exert themselves or participate in sport while recovering from infection.”
“However, lifestyle changes that can help reduce the risk for a person to get pneumonia include living a healthy lifestyle that incorporates regular exercise, healthy eating habits, cessation from smoking (and vaping), and ensuring immunisation for common respiratory pathogens such as pneumococcus, influenza, and more recently, Covid-19.”
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Beware of complications
Mpumalanga-based pulmonologist and specialist physician Dr Darren Joseph emphasises the potential complications of pneumonia:
- Initial treatment can fail and the pneumonia can progress.
- The infection can spread outside of the lung to the pleural space, creating a pleural effusion, which may require a surgical drainage procedure.
- Infection can also spread outside the lung and involve unusual sites such as the heart valves.
- Septic shock can occur and can lead to dysfunction in multiple other organs. Intensive supportive care and adjunctive medical therapies may be required.
- Respiratory failure may result in the individual being unable to breathe and hence requiring life support in the form of assistance to breathe from invasive mechanical ventilation.
- Part of the lung may “collapse”; this may contribute to respiratory failure.
- There is also an association between cardiac events and pneumonia, such that a person with pneumonia may develop myocardial infarction (heart attack), abnormal heart rhythm, or heart failure.
- Death is unfortunately a potential outcome, and pneumonia remains a leading cause of mortality.
“Vaccination can greatly assist in the prevention of pneumonia,” says Joseph. “It is highly advisable for individuals with at-risk medical conditions to ensure they are immunised.
“Influenza vaccination is advised annually. Pneumococcal vaccination is advised for individuals with certain chronic medical conditions. Advice from a doctor should always be sought before using any new medical therapy.”
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