Hopkins ABX Guide

Pneumonia (Community-Acquired)

Community-Acquired vs Hospital-Acquired Pneumonia

Pneumonia is said to be community-acquired when it is developed outside the hospital setting. Hospital-acquired pneumonia, on the other hand, refers to bacterial infections affecting the air sacs in the lungs that occur after being hospitalised. Community-acquired pneumonia accounts for most cases of pneumonia and can be caused by different pathogens including bacteria, atypical bacterium known as Mycoplasma pneumoniae (it often causes the so-called Walking pneumonia), viruses (usually the same ones that are responsible for common cold and flu), and some types of fungi. In contrast, hospital-acquired pneumonia is almost always caused by bacteria. To make things worse, it is often caused by bacteria that are resistant to the commonly used antibiotics. As a result, it can be very difficult to treat.

Signs and Symptoms of Pneumonia

No matter if being community- or hospital-acquired, symptoms of pneumonia range from very mild (similar to those in cold and flu) to very severe. Some of the most common signs of pneumonia include fever, cough, chest pain, headache, fatigue, nausea with or without vomiting, and shortness of breath.

Instead of having elevated body temperature, older adults with pneumonia may have lower than normal temperature. The same counts for patients who are at increased risk of complications including immunocompromised individuals. Young children may not have any signs of symptoms either but they may develop elevated body temperature, vomiting, cough, fatigue, restlessness, loss of appetite and difficulties breathing.

Who is at Increased Risk of Pneumonia?

Pneumonia can be developed by anyone who was exposed by pneumonia-causing pathogens. However, it is most common in young children (below the age of 2 years) and older adults due to immature and weakened immune systems, respectively. At increased risk of developing pneumonia are also people with certain underlying medical conditions such asthma and chronic obstructive lung disease (COLD), immunocompromised individuals (HIV/AIDS and cancer patients) and tobacco smokers. The risk of pneumonia is also high in hospitalised individuals, especially if being on a ventilator (breathing machine). But they are at increased risk of hospital-acquired pneumonia.

Treatment Options

Treatment of pneumonia depends on its severity and the underlying cause. While bacterial pneumonia requires treatment with antibiotics, viral pneumonia is treated with antivirals. Symptoms improve within a few days after the beginning of antibiotic therapy, while recovery from viral pneumonias lasts a little bit longer - from about 7 to 21 days, depending on its severity.