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Viral pneumonia

Pneumonia - viral; Walking pneumonia - viral

 

Pneumonia is inflamed or swollen lung tissue due to infection with a germ.

Viral pneumonia is caused by a virus.

Causes

 

Viral pneumonia is more likely to occur in young children and older adults. This is because their bodies have a harder time fighting off the virus than people with a strong immune system.

Viral pneumonia is most often caused by one of several viruses:

  • Adenovirus
  • Influenza
  • Parainfluenza
  • Respiratory syncytial virus (RSV)
  • Measles

Serious viral pneumonia is more likely to happen in those with a weakened immune system, such as:

  • Babies who are born too early
  • Children with heart and lung problems
  • People who have HIV/AIDS
  • People receiving chemotherapy for cancer, or other medicines that weaken the immune system
  • People who have had an organ transplant

 

Symptoms

 

Symptoms of viral pneumonia often begin slowly and may not be severe at first.

The most common symptoms of pneumonia are:

  • Cough (with some pneumonias you may cough up mucus, or even bloody mucus)
  • Fever , which may be mild or high
  • Shaking chills
  • Shortness of breath (may only occur when you exert yourself)

Other symptoms include:

  • Confusion, often in older people
  • Excessive sweating and clammy skin
  • Headache
  • Loss of appetite, low energy, and fatigue
  • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
  • Fatigue

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about the symptoms.

If the provider thinks you have pneumonia, you will also have a  chest x-ray . This is because the physical exam may not be able to tell pneumonia from other respiratory infections.

Depending on how severe your symptoms are, other tests may be done, including:

  • Complete blood count (CBC)
  • CT scan of the chest
  • Blood cultures to check for viruses in the blood
  • Bronchoscopy (rarely needed)
  • Throat and nose swab tests to check for viruses such as the flu
  • Open lung biopsy (only done in very serious illnesses when the diagnosis cannot be made from other sources)
  • Sputum culture  (to rule out other causes)
  • Measuring levels of oxygen and carbon dioxide in the blood

 

Treatment

 

Antibiotics do not treat this type of lung infection. Medicines that treat viruses may work against some pneumonias caused by influenza and the herpes family of viruses. These medicines may be tried if the infection is caught early.

Treatment may also involve:

  • Corticosteroid medicines
  • Increased fluids
  • Oxygen
  • Use of humidified air

A hospital stay may be needed if you are unable to drink enough and to help with breathing if oxygen levels are too low.

People are more likely to be admitted to the hospital if they:

  • Are older than 65 years or are children
  • Are unable to care for themselves at home, eat, or drink
  • Have another serious medical problem, such as a heart or kidney problem
  • Have been taking antibiotics at home and are not getting better
  • Have severe symptoms

However, many people can be treated at home. You can take these steps at home:

  • Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome .
  • DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up sputum.
  • Drink plenty of fluids to help loosen secretions and bring up phlegm.
  • Get a lot of rest. Have someone else do chores.

 

Outlook (Prognosis)

 

Most cases of viral pneumonia are mild and get better without treatment within 1 to 3 weeks. Some cases are more serious and require a hospital stay.

 

Possible Complications

 

More serious infections can result in respiratory failure, liver failure, and heart failure. Sometimes, bacterial infections occur during or just after viral pneumonia, which may lead to more serious forms of pneumonia.

 

When to Contact a Medical Professional

 

Call your provider if symptoms of viral pneumonia develop or your condition gets worse after starting to improve.

 

Prevention

 

Wash your hands often, after blowing your nose, going to the bathroom, diapering a baby, and before eating or preparing food.

DO NOT smoke. Tobacco damages your lungs' ability to ward off infection.

A drug called palivizumab (Synagis) may be given to children under 24 months old to prevent RSV.

The flu vaccine , is given each year to prevent pneumonia caused by the flu virus. Those who are older and those with diabetes, asthma, chronic obstructive pulmonary disease (COPD), cancer, or weakened immune systems should be sure to get the flu vaccine.

If your immune system is weak, stay away from crowds. Ask visitors who have a cold to wear a mask and wash their hands.

 

 

Open References

References

Lee FE, Treanor JJ. Viral infections. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 32.

Parameswaran GI, Sethi S. Viral pneumonia. In: Spiro SG, Silvestri GA, Agustí A, eds. Clinical Respiratory Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 25.

 
  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Lungs

      Lungs - illustration

      The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

      Lungs

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Viral pneumonia

           
             

            Review Date: 8/21/2016

            Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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