Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

The basics

Fred Burke, MD, an emergency medicine physician who treats people at OSF HealthCare, says pneumonia is a lung infection caused by a virus or bacteria.

“The most common bacteria that causes it is strep pneumonia [in medical terms, streptococcus pneumoniae or pneumococcus]. The viruses that cause it are things like RSV [respiratory syncytial virus], flu [influenza] and COVID-19 [coronavirus],” Dr. Burke says.

In other words, you could get the flu, and it could progress to pneumonia. The phrase double pneumonia means it’s impacting both lungs. Dr. Burke says people with pneumonia could experience coughing, fever, chills and weakness.

“It can cause a consolidation in the lungs. That interferes with air movement,” Dr. Burke says. “You can also get fluid buildup and scarring in the lungs.” Consolidation refers to inflamed cells that form a mass.

Diagnosis and treatment

Dr. Burke says when someone comes to the emergency department with pneumonia symptoms, a health care provider could do a chest X-ray or CAT scan to confirm the diagnosis.

“If we find it’s from a viral infection, people have to ride it out. There’s no treatment for [the ailment itself]. But we can treat the symptoms. We can give Tylenol for fever or an inhaler for shortness of breath or wheezing,” Dr. Burke explains. “If it’s from a bacterial infection, we give antibiotic medication.”

The person could take antibiotics by mouth for one to two weeks. Or, if they are having trouble breathing, the medicine would be given through intravenous (IV) therapy. Either way, the goal is to stop the bacteria in the lungs from growing.

Another tactic is a bronchoscope, where a pulmonologist inserts a tube down your throat to break up mucus in your airways.

But Dr. Burke cautions: don’t let the guidance of some “ride it out” fool you. Pneumonia is a common cause of hospitalization and death worldwide.

“One complication is sepsis, when the infection spreads to the blood. That can cause organ failure,” Dr. Burke warns. “Pneumonia can also cause respiratory failure [when the lungs aren’t working properly]. Those people might require additional oxygen. Or if it serious enough, they might require intubation [a breathing tube down the throat] or be placed on life support.”



Is it contagious?

Yes, pneumonia can spread from person to person, Dr. Burke says. It’s often transmitted through respiratory droplets (coughing or sneezing on someone), but it can spread on surfaces as well. A child could touch a dirty doorknob then put their hands in their mouth, for example.

That’s why everyday hygiene is important. Wash your hands with soap and warm water thoroughly and often. Cough or sneeze into your elbow or a tissue. Stay home and away from others if you’re sick. These are especially important for people at higher risk for pneumonia: people with a history of strokes or seizures, people suffering from substance abuse, people with a compromised immune system (those with HIV or a transplanted organ, for example), smokers and people with chronic obstructive pulmonary disease (COPD).

The United States Centers for Disease Control and Prevention also outlines the guidelines for the pneumococcal vaccine. Talk to your primary care provider if you have questions about the shot.

“The vaccine comes from evidence-based medicine. Experts have done studies. It’s shown to be very effective in decreasing the severity of pneumonia,” Dr. Burke explains. “I would recommend people take the vaccine.”

Interview clips

Related stories

OSF HealthCare library: Pneumonia
Walking pneumonia strolling into little lungs
Protecting infants from RSV
Can't stop coughing?
Better breathing: How we treat COPD
‘Sepsis does not discriminate’
Do you really need that antibiotic?

With temperatures cooling, Awad Alyami, MD, an OSF HealthCare pediatrician, says we’re approaching the peak season for sore throats. Many cases have time-tested treatments, but some can have serious complications.

Dr. Alyami says a sore throat is an infection that causes inflammation in your throat. They’re annoying and painful, bringing symptoms like difficulty swallowing or talking and swelling of glands and tonsils. Causes can include tonsil stones, heartburn and allergies. But most commonly, causes break down into two groups: viral and bacterial.

Viral infections

Dr. Alyami says many viruses can cause sore throats – the common cold, influenza, coronavirus and others. Dr. Alyami says if your sore throat comes with coughing or a runny nose, that’s a sign it’s a viral infection. You can start treatment at home with over-the-counter medicine like Tylenol and ibuprofen. You can also gargle salt water and, generally, stay hydrated. Water is good for all ages, and Pedialyte can help hydrate kids.

If your symptoms include fever and neck swelling, it’s a more serious situation. You should see a health care provider.

Bacterial infections

The main bacterial infection that causes sore throats is group A streptococcus (commonly known as strep or strep throat). Strep throat may bring the hallmark sore throat symptoms, but you should also watch for fever and white patches toward the back of your mouth.

“This is a bacterial infection that’s common in kids,” Dr. Alyami says of strep throat.  “About 30% of sore throats are strep, and about 70% are viral. It’s a big deal. We need to treat to prevent complications.”

The most common complication is dehydration, Dr. Alyami says.

“The sore throat is so bad, the child doesn’t want to eat or drink,” he explains.

Other times, untreated strep throat can lead to abscesses, or pus pockets.

“If that abscess gets big enough, it can go toward other structures in the body that are very important. That infection can spread and progress very quickly,” Dr. Alyami says. Life-threatening conditions like difficulty breathing can result.

Dr. Alyami says providers can diagnose strep throat with a throat swab. They treat strep throat with 10 days of antibiotic medication, either injected or taken orally. He says most kids will take the medicine orally unless that’s troublesome. For example, some kids have a tough time swallowing pills due to throat pain.

Prevention

It’s advice you’ve heard before, but it’s worth repeating. Dr. Alyami says good hand hygiene goes a long way to preventing sore throats. Wash your hands thoroughly, and keep them away from your face.

Early detection is also key.

“If the child is sick, especially with symptoms that could be strep, it’s better to get them to a health care professional early,” Dr. Alyami implores. “They can get checked and isolated for 12 to 24 hours before they start antibiotics.

“If you’re sure about what they have, it’s better to just bring them in and get them checked,” he adds. Or, a virtual visit is an option.

Interview clips

Related stories

Dirty nails and mouths don't mix
Another “bronch” to know
Allergic rhinitis is a year round concern

December through April is prime time for strep throat season. But it hasn’t been the amount of cases this month that has OSF HealthCare providers and infectious disease leaders concerned, it’s the severity of the cases. In fact, two children under the age of 10 in central Illinois have died due to strep infections recently. 

“Cases that can cause sepsis or a blood stream infection,” Jamie Almasy, the Director of Infection Prevention for OSF HealthCare says. “Invasive infections caused by the group A Strep bacteria are what we’re seeing more cases of. Invasive means that germs invade parts of the body that are normally free from germs.” 

So how can you prevent getting strep throat? Almasy says the steps are straight forward.

“It’s back to your basics. Really good hand hygiene, make sure you’re covering your cough,” Almasy says. “If you are sick or have symptoms of strep throat, make sure you go and get tested.”

Almasy says strep throat is spread through droplets. Symptoms include a sore throat and fever. She recommends keeping your distance from other people when you are feeling ill and staying up-to-date on your vaccinations.

“Diseases like the flu or chicken pox can increase your risk for catching an invasive strep infection,” she says.

Dr. Brian Curtis, vice president of the clinical specialty services at OSF HealthCare, says the throat isn’t the only place to keep an eye on when looking for strep infection.

“Group A strep can also cause skin infections,” Dr. Curtis says. “It can cause necrotizing fasciitis and then it can also cause an erysipelas, which are very fast-spreading skin and soft tissue infections which people can get very sick very quickly from.”

Dr. Curtis says most strep throat cases are mild, but there are other risk factors that spread quickly, and require a quick response from the patient. If your child has a skin infection or high fever, Dr. Curtis says to have them seen right away.

“They seem to be acting right, then they’re not acting right in a very short period of time,” he says. “If you have a child that has a skin or soft tissue infection that seems to be spreading fairly rapidly, it is best to get them checked out.”

“People who are pre-disposed to that are people who have chicken pox (varicella). It’s a common source of infected pox lesions. That’s why we really encourage people to get the varicella vaccine in their children when they’re able to get it," Dr. Curtis adds.

People who are immunocompromised are also at a higher risk for a more severe strep infection, in addition to individuals undergoing chemotherapy, children under age 1, pregnant women and the elderly, Dr. Curtis says.

“Pregnant women are very susceptible to group A strep,” Dr. Curtis adds.

So why does strep spread so quickly during the December-April timeframe?

“It tends to be a time where people are very close together,” Dr. Curtis says. “Especially in the Midwest or the northern climates with the snow and cold weather. Strep throat is very easy to spread. You can have someone who is an asymptomatic carrier and that can spread it to you. That’s where we recommend people wash their hands frequently, don’t share utensils, and don’t share cups.”

Wondering if you have strep throat versus a sore throat? Dr. Curtis offers some tips on how to tell the difference. “Strep throat tends to be very isolated on sore throat, fever, swollen glands.”

Dr. Curtis adds if you have red eyes and nasal congestion along with the cough and sore throat, that’s normally a viral infection.

Video Interview Clips