Pneumonia is more frequent in the elderly and results in higher mortality. Primary viral pneumonia is not so common but important in severe cases. Chest X-ray shows grand-glass appearance or linear shadow in pure viral pneumonia cases. That is sometimes specific and clearly different from consolidation or infiltration with bacterial pneumonia. We can try to decrease pneumonia and influenza mortality, if we prevent influenza infections by vaccination and treat by anti-influenza drugs. Secondary bacterial pneumonias are more common, caused by such as Streptococcus pneumonia, Hemophilus influenzae, Branhamella catarrhalis. Gram staining and the culture of purulent sputum was useful for treatment by antibiotics.