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Health Protocols


Signs And Symptoms


The usual symptoms of pneumonia are (UMMC 2012; Torres 2013; Sethi 2014):

  • Fever and chills (though fever is often not present in older individuals)
  • Chest or abdominal pain
  • Pain with breathing (pleurisy)
  • Cough, dry or with phlegm; cough producing green or yellow sputum
  • Night sweats
  • Flu-like symptoms such as nausea, vomiting, muscle aches, fatigue, headache, and loss of appetite
  • Shortness of breath
  • Rapid heart and breathing rate
  • Weight loss
  • Nausea, vomiting, diarrhea
  • Confusion may occur among older individuals

Symptoms often come on rapidly and may be severe. However, older patients with a weakened immune response may not have the usual array of pneumonia symptoms, instead presenting with fatigue, disorientation, or confusion (Musher 2012).


In severe pneumonia, bacterial infection can spread to the surrounding lung tissue, causing an abscess. Pneumonia can also cause fluid accumulation between the pleura (membranes that surround the lungs), a condition known as pleural effusion. In empyema, the fluid between the pleura becomes infected, which can lead to permanent scarring (UMMC 2012).

Pneumonia-causing bacteria can enter the bloodstream (bacteremia) and spread infection to other parts of the body including joints, bones, muscle groups, heart valves, the abdominal cavity, and the meninges that surround the brain and spinal cord (Musher 2012).

Respiratory failure, including acute respiratory distress syndrome, is a dangerous complication in which the lungs are unable to function properly, resulting in life-threateningly-low blood oxygen concentrations (UMMC 2012).

Pneumonia is associated with kidney complications including end stage renal failure (Huang 2014), and studies have linked pneumonia to increased risk of arrhythmias, heart attack, and worsening of heart failure (Musher 2012; Aliberti 2014). Prolonged bed rest resulting from pneumonia can lead to blood clots (Torres 2013).