Bacterial Pneumonia

Bacterial pneumonia is an infection that causes irritation, swelling, and congestion in the lungs. It is also called bacterial pneumonitis (new-mo-NI-tis). It occurs most often in the winter.

Causes

This type of pneumonia results when bacteria are inhaled and settle in the lungs.

Signs/Symptoms

This illness usually follows a cold. It often starts suddenly with a high fever (over 102 degrees F or 38.9 degrees C) and chills. Difficult or painful breathing and a cough with bloody or yellow sputum are common symptoms. Other signs may include fast breathing, tiredness, abdominal pain, and blue or pale lips and nailbeds.

Care

If you have no other illnesses or problems, you can be treated at home. This care will include antibiotics, a humidifier to loosen your sputum (making it easier to cough up), and rest.
   If your condition gets worse, or if you have other problems (such as diabetes or heart failure), you may need a stay in the hospital. There your care will be similar, but you can be carefully watched.

Risks

Without treatment, the infection could spread and become a threat to your life. Your lung problems could become worse--possibly even fatal.

WHAT YOU SHOULD KNOW

• Take your antibiotics as directed until they are all gone--even if you feel well. If you don't think they are helping, call your doctor. Do not quit taking them on your own.
• If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.
• If you are coughing up sputum and milk seems to make the sputum thicker, do not eat or drink foods that contain milk.
• To help free your lungs of infection, take 2 or 3 deep breaths and then cough. Do this often during the day.
• If you do not have to limit the amount of liquids you drink, drink 8 to 10 (soda-can sized) glasses of water each day. This helps thin the sputum so it can be coughed up more easily.
• Use a humidifier to help keep the air moist and your sputum thin. This makes it easier to cough up the sputum. You must keep the humidifier free of fungus. Clean it every day.
• Stay inside during very cold or hot weather, or on days when the air pollution is high. This will make it easier to breathe and will help control your cough.
• Rest at home until you feel better. You may return to work or school when your temperature is around 98.6 degrees F (37 degrees C). Slowly increase your activity. You may feel weak and tired for up to 6 weeks after your illness.
• If you have chest pain, apply a heating pad (set on low) or warm cloths to the sore area for 10 to 20 minutes, 2 to 3 times a day. This may ease the pain, making it easier to breathe.
• Because you have had pneumonia, it may be easier for you to get other lung infections. Try to stay away from people who have colds or the flu. Get shots against flu and pneumonia.
• Quit smoking. It harms the lungs. If you are having trouble quitting, ask your doctor for help.
• Make an appointment for another chest x-ray, if your doctor thinks one is necessary.

Call Your Doctor If...

• You have a high temperature.
• Your medicine does not relieve your chest pain within a few days.
• You get nauseated, or have vomiting or diarrhea.
• You are coughing up bloody or pink, frothy sputum.
• You have problems, such as a rash, itching, swelling, or stomach pain, that may be caused by your medicine.
• Another family member shows signs of pneumonia.

Seek Care Immediately If...

• You have a lot of trouble breathing or have blue or pale skin, lips, or nailbeds.
• You have a severe headache, neck stiffness, or feel confused.
• You continue to have fever and chills and feel worse even when taking your medicine.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Activity: At first you will need to rest in bed, with a few pillows to keep you sitting up a little. This will help your breathing. Do not lie flat. Once you are breathing more easily, you will be allowed to increase your exercise.
• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Oxygen: Your body may need extra oxygen at this time. It is given either by a mask or nasal prongs. Tell your doctor if the oxygen is drying out your nose or if the nasal prongs bother you.
• Pulse Oximeter: While you are getting oxygen, you may be hooked up to a pulse oximeter (ox-IM-ih-ter). It is placed on your ear, finger, or toe and is connected to a machine that measures the oxygen in your blood.
• ECG: Also called a heart monitor, an electrocardiograph (e-LEK-tro-CAR-dee-o-graf), or EKG. The patches on your chest are hooked up to a TV-type screen or a small portable box (telemetry unit). This screen shows a tracing of each heartbeat. Your heart will be watched for signs of injury or damage that could be related to your illness.
• 12 Lead ECG: This test makes tracings from different parts of your heart. It can help your doctor decide whether there is a heart problem.
• Chest X-ray: This picture of your lungs and heart shows how well they are handling your illness.
• Blood: Usually taken from a vein in your hand or from the bend in your elbow. Tests will be done on the blood.
• Blood Gases: Blood is taken from an artery in your wrist, elbow, or groin and tested for the amount of oxygen it contains.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Medicines:
  • Antibiotics are given to fight infection. They may be given in your IV, in a shot, or by mouth.
  • Expectorants (ex-PEK-ter-ants) may also be given to help thin your sputum so it is easier to cough up.
• Coughing and Deep Breathing: It is important to do this often because it helps clear your lungs of infection.
  • To ease your pain during coughing and deep breathing, you may need to loosely wrap your rib cage with a 6-inch elastic bandage.
  • Holding a pillow tightly against your chest when you cough can help reduce the pain. Lying on the side that is hurting may also help ease the pain.
• Heat: A warm towel or heating pad (set on low) may help ease your chest pain.
• Sputum Sample: If you are coughing up sputum, your doctor may need to send a sample to the lab. From this sample, the lab can determine which kind of bacteria are causing your illness. This helps the doctor choose the medicine you need.

Postural Drainage: Periodically, a nurse may tap briskly on your back with his or her hands. This helps loosen the sputum in your lungs so you can cough it up more easily.