Types and Causes of Pneumonia

Health Professional

Pneumonia, often called bronchopneumonia or bronchial pneumonia, can be a serious, even life-threatening, complication of COPD. When you have a chronic disease, your immune system is already compromised, making it harder to fight infections. Add to that the weakened airways and lung tissue that is part of COPD, and it is obvious how much of a threat a respiratory infection like pneumonia can be to someone who has COPD.

What Is Pneumonia?

Pneumonia is a respiratory infection that leads to inflammation and swelling in the bronchial tubes, known as bronchioles, and also tiny cells or airsacs at the end of the airways, called alveoli. Because COPD already causes similar issues, pneumonia results in an acute exacerbation of COPD.

What does that mean? Well, it means that there is an acute deterioration of respiratory symptoms. In particular, there will be increased breathlessness and cough, and an increase in the amount of sputum, as well as a change in the quality of the sputum (thick greenish or yellowish, rather than thin and clear).

Eventually, these symptoms can lead to what is called consolidation of the lung tissue. Consolidation is when the tiny air sacs, or alveoli, fill with fluid rather than air. When that happens, oxygen cannot get to the parts of your body where it is needed.

Causes of Pneumonia

Pneumonia, as with all infections, is caused by one of two kinds of microscopic organisms, commonly called germs. Germs can be either viral in nature or bacterial.

Viral pneumonia tends to be relatively mild and, in healthy people at least, resolves fairly quickly without treatment and without lasting effects. According to the American Lung Association, about 50% of pneumonia cases are the viral type.

Bacterial pneumonia is of much greater concern. Each year, there are more than 3 million cases of bacterial pneumonia in the U.S. These infections can usually be treated effectively with antibiotics, but if left untreated, can be a cause of death, particularly in those who have compromised immune systems and airways, such as people with COPD.

So, although bacterial pneumonia is more easily treatable than the viral type, it is also the greater threat to health and life.

It's also important to note that sometimes viral pneumonia, or another milder viral infection such as the common cold or influenza, can weaken already inflamed COPD airways and lead to infection with bacteria.

The Types of Pneumonia, Defined By Location Another way to look at types of pneumonia is by where the actual infection is located in the airways. Sometimes, it affects an individual section of a lung, called a lobe. We each have five different lobes in our lungs. This type is called** lobar pneumonia**. But it can also affect scattered areas throughout the walls of the bronchiole tubes and smaller cells. This is the type commonly referred to as** bronchopneumonia**.

Where the infection is located though is not that important, as lobar pneumonia can often lead to bronchopneumonia and vice versa. This is especially true in people with COPD. The symptoms and treatment are the same, regardless.

The Types of Pneumonia, Defined By How It Was Acquired

Yet another way to classify pneumonia is by how a person actually "catches" the infection. It can be community-acquired, when you are exposed to the pneumonia bacteria in the course of everyday life and interactions with family, friends and the public. Common bacteria at fault with community-acquired pneumonia include:

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis (less common)

Or pneumonia can be hospital-acquired. When people with COPD are hospitalized, they are at great risk of coming into contact with certain bacteria that are commonly found in hospitals and on hospital staff, such as staphylococcus aurea. This would cause what is sometimes called "staph pneumonia."

Other common culprits in hospital-acquired pneumonia include:

  • E-coli
  • Klebsiella pneumoniae
  • Pseudomonas (also occurs in the community, especially with the flu)

How to Know If You Have Pneumonia

Bacterial pneumonia can have a gradual OR a sudden onset. But the common symptoms are:

  • Chills/shaking and/or sweats, with a rapidly rising high fever (>101 degrees)
  • Stabbing chest pain
  • Increased difficulty breathing (more rapid breaths, grunting, straining to breathe)
  • Productive cough, yielding rust-colored or greenish mucus
  • Bluish-colored lips and/or nails

If you even suspect that you have pneumonia when are already dealing with COPD, don't delay. Get yourself examined and diagnosed by a health care professional as soon as possible.

Treatment of Pneumonia

As I explained above, bacterial pneumonia is very treatable, even in people who have COPD, but the key is to get treatment as soon as you realize that you're having symptoms.

Some examples of antibiotics used to treat bronchopneumonia are:

  • Amoxacillin
  • Erythromycin
  • Vancomycin
  • Levaquin
  • Augmentin
  • Avelox
  • Rocephin

However, pneumonia is becoming more resistant to these drugs, so it may take some trial and error to find the right combination for you. The earlier you get started, the better.

Other supportive measures can include:

  • Supplemental oxygen and/or an increase in the amount/frequency of oxygen used to help ease breathing difficulty.

  • Drinking plenty of fluids to prevent dehydration and to keep mucus as thin as possible.

  • Pain relievers to help lessen chest pain; nonsteroidal anti-inflammatory drugs (NSAIDs for short) are preferred.

  • Use of a nebulizer with saline and possibly a bronchodilator medicine to help loosen secretions.

  • Staying as active as possible. Long periods lying down in a bed or recliner can worsen your condition.

If you do not show improvement within the first 48 hours or so after diagnosis of pneumonia is made, you may need to be hospitalized for more aggressive monitoring and treatment.

Prevention Tips

Since people who have COPD are at such high risk for infection and also for severe complications of infections like pneumonia, it is highly recommended that they get periodic pneumonia vaccines, as well as yearly influenza vaccines. Both are covered by Medicare (and many other health insurance policies) and readily available.

The pneumonia vaccine protects against 23 types of pneumococcal bacteria and is effective in approximately 60 to 80 percent of adults over 65 years of age with immune systems that are not compromised. Unfortunately, the vaccine may be less effective for certain people in high-risk groups, such as COPD patients. But, you should still be vaccinated as you are more likely to have serious complications from pneumococcal disease. Any protection is better than none.

Annual flu shots in the fall are also an important measure that can help you from getting pneumonia. If you get the flu on top of having COPD, it can further lead to a respiratory infection such as pneumonia. So preventing the flu is one more way to arm yourself against pneumonia.

Read more about immunizations for flu and pneumonia