Pneumonia is a leading cause of death worldwide. Our specialist from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital (SGH) shares its common causes, symptoms, prevention tips and more.
Pneumonia, a serious inflammatory condition of the lungs, is a leading cause of death in Singapore and worldwide.
Pneumonia accounted for 20 per cent of deaths in Singapore in 2022, just behind cancer, the top killer, which caused 23.9 per cent of deaths, according to this Ministry of Health (MOH) report on principal causes of death. To protect yourself and your loved ones, there are steps you can take.
Pneumonia: How to prevent
Get vaccinated. Young children, seniors 65 years of age and above, and anyone with chronic medical conditions or on long-term medications should speak to their doctor to ensure all their vaccinations are up-to-date. Several vaccines can prevent the most common causes of pneumonia in young children, older adults and high-risk groups. Stay up to date with the following vaccinations:
Practice good hygiene and wash hands frequently and thoroughly.
Avoid contact with live animals including poultry and birds, and consumption of raw and undercooked meats.
Avoid close contact with people who are unwell or showing symptoms of illness.
Observe good personal hygiene.
Practise frequent hand washing with soap - we can't emphasise this enough (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing).
Wear a mask if you have respiratory symptoms such as a cough or runny nose.
Unwell but don't have a mask? Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately.
Seek medical attention promptly if you are feeling unwell.
Get an annual flu shot.
Stop smoking (if you haven't quit).
Eat a balanced diet and get regular exercise.
Pneumonia: How to treat
"Pneumonia is diagnosed with the help of a physical exam, blood tests, sputum test and a chest x-ray. Treatment is most effective when the condition is diagnosed early. Patients who have mild community-acquired pneumonia are typically treated at home with oral medication, e.g. antibiotics, anti-viral drugs, cough medicine, fever and pain relievers. Rest and a balanced diet can help patients recover," says Associate Professor Loo Chian Min, Senior Consultant from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital (SGH), a member of the SingHealth group.
"However, more severe infection will require hospitalisation," he added.
Symptoms are likely to ease a few days after the start of pneumonia treatment, with full recovery taking a couple of weeks.
If appropriate pneumonia treatment is not provided, patients may develop complications such as:
Lung abscess (death of lung tissue which gets replaced by pus),
Fluid accumulation around the lungs,
Severe breathing difficulty and
Bacteria in the bloodstream
The latter can cause organ failure and death. “About 15 per cent of patients with pneumonia require hospitalisation,” added Assoc Prof Loo.
What is pneumonia?
In pneumonia, the air-filled tiny sacs in the lungs get inflamed. These sacs, called alveoli, fill with pus and other fluids, making it difficult for oxygen to reach the blood and be transported everywhere in the body. This lung inflammation is usually caused by an infection.
Pneumonia can affect one or both lobes of the lungs. This correlates with the severity of the disease and it is also dependent on the cause of pneumonia. For example, viral pneumonia tends to involve a few lobes (called diffuse) whereas bacterial tends to be more localised unless it is severe, in which case a few lobes can be involved.
“Infants and young children, people over the age of 65, and people with chronic diseases such as
chronic obstructive pulmonary disease (COPD),
diabetes, cancer and heart disease, are at greatest risk of developing severe pneumonia which can be life-threatening,” says Assoc Prof Loo.
Pneumonia: Common causes
Pneumonia is usually caused by the following:
Bacteria: The most common type is Streptococcus pneumoniae, followed by Haemophilus influenzae and other bacteria like Escherichia coli and Klebsiella pneumoniae. Infection from Mycoplasma pneumoniae, a bacteria-like organism, typically produces mild symptoms. This milder pneumonia is referred to as ‘walking pneumonia’ because it does not require bed rest.
Viruses: These are viruses similar to those causing common cold and influenza. Viral pneumonia is usually mild and is common in small children. Occasionally they may be severe and cause life threatening infection, like MERS-CoV (Middle East Respiratory Syndrome), Influenza H5N1 (bird flu), influenza H1N1, and the recent COVID-19 (Coronavirus Disease 2019).
Fungi: Fungi spores can be inhaled and cause infection in people with an underlying health problem or a weak immune system. It is uncommon in normal individuals.
Chemical and physical injury
Frequent causes include the common cold (e.g. rhinovirus infection), Influenza (flu), COVID-19, pneumococcal disease or respiratory syncytial viral (RSV) infection.
Symptoms of pneumonia
Pneumonia symptoms vary depending on the cause, age of the patient, and the severity of the condition. Common pneumonia symptoms in adults are:
Cough with phlegm
Body and muscle pain
“In bacterial pneumonia, the cough produces thick greenish/yellowish phlegm while in viral pneumonia, the phlegm is white or clear,” says Assoc Prof Loo. “A patient suffering from bacterial pneumonia usually presents with a sudden onset of symptoms and high-grade fever.”
Pneumonia symptoms in children
Ref: I23 (ed)
Check out other articles on respiratory conditions:
Tuberculosis: Types, Symptoms and Risks
Coughing for Weeks? This Could Be Causing It
Asthma Facts and Myths
Tips to Manage Asthma
Adult Asthma: Frequently Asked Questions
How to Survive an Asthma Attack without Your Inhaler
What is Chronic Obstructive Pulmonary Disease (COPD)?
COPD: How the Flu Vaccine Can Help
Protect Yourself (and Loved Ones) from the Haze