World Pneumonia Day: Don't ignore minor signs; visit a doctor if sharp chest pain, dry cough persist

By Dr Nimish Shah

Legendary singer Lata Mangeshkar was admitted to a Mumbai hospital on Monday after she complained of breathlessness. The 90-year-old is suffering from pneumonia, and is currently on ventilator, according to the doctors treating her. On World Pneumonia Day, we tell you everything about the condition.

Lungs, the primary organ for oxygenation, are the vital organs of our body and are made up of small balloon-like units which contain air. They transfer the oxygen to body and exhale the CO2 with circulating blood. A human lung contains approximately 400 million alveoli, compactly arranged in our thorax.

Pneumonia is a type of respiratory infection which is associated with fever, cough, shortness of breath and chest pain at times. This condition takes some time to develop. In pneumonia, the air-filled sacs are filled with pus and fluid, resulting in improper oxygenation and making it difficult to breathe.

According to consensus of WHO published in 2016, pneumonia is the most common infectious cause of death in the world and is the fourth most common among all causes of death. Though pneumonia can affect all ages, children and adults over the age of 65 years, people with pre-existing lung diseases and those who smoke or drink come under the risk group.

Constant exposure to contaminated air and frequent aspiration of nasopharyngeal flora make lungs susceptible to infectious microorganisms. The occurrence of pneumonia is decided on the complex interactions between virulence and quantum of aspirated or inhaled microorganisms that reach the lung.


According to the causative organisms, pneumonia can be classified as bacterial, viral, parasitic, fungal and aspiration. According to radiological pattern and part of the lung involved, it can be classified as bronchopneumonia, lobar pneumonia and interstitial pneumonia. The typical signs that accompanies any pneumonia are:

• Fever
• Cough mostly productive with mucoid, purulent or blood-tinged sputum. However, it can be dry and non-productive
• Chest pain like a sharp stabbing is experienced
• While doing the normal daily routine, shortness of breath is observed
• Other symptoms include fatigue, headache, myalgia, and arthralgia, confusion, delirium

The physical findings also vary from patient to patient and mainly depend on the severity of lung infection. People having severe infection usually have higher respiratory rate, accessory muscle of respiration being used, fall in blood pressure, altered mental status and deranged organ functions ( respiratory, kidney and liver failure).

There is a relatively poorer prognosis than young adults observed in patients older than 60 years or younger than four years of age. Antibiotic resistance, presence of comorbidities like diabetes, hypertension, and neurological disorders like stroke or seizures, alcoholic liver disease, tobacco chewing add to the risk of having a severe infection.

As aptly said, prevention is always better than cure. There are certain things we can do to avoid getting pneumonia. These can be classified as follows:

• Promoting healthy habits that keep immune system strong
• Good hygiene also helps
• Avoid smoking
• Wash hands often with warm or soapy water
• Alcohol-based hand sanitisers should be used
• Exposure to people who are ill whenever possible should be avoided
• Get enough rest and have a balanced diet
• Avoid pollution and overly crowded places
• Taking appropriate antibiotics or antivirals for the duration as prescribed by the doctor
• Avoid self-medicating and purchasing antibiotics over the counter
• Using annual dose of influenza vaccine for the at-risk group
• Children less than five years and elderly older than 65 should be vaccinated for pneumococcal vaccine

A patient presenting in the early stage of the disease has a far better prognosis than those who present later in the course of the disease. The awareness amongst the masses regarding the signs and symptoms of pneumonia can help patients suspect and present to the physician at an earlier point in the course of the disease.

(The author is Consultant of Respiratory Medicine at Jaslok Hospital and Research Centre)