When pneumonia turns deadly

Pneumonia typically affects the lungs and can be caused by bacteria, viruses or fungi.

There have been some high profile deaths that have been attributed to pneumonia recently. For example, American actor Val Kilmer’s recent death. I know that he had throat cancer for a long time, but he died of pneumonia. What is pneumonia?

Pneumonia is an inflammation of your lungs that is usually caused by a bacterial, viral or fungal infection.

Fluid accumulates in your lungs, and sometimes even pus.

This makes it difficult for you to breathe.

I heard the pope just recovered from double pneumonia. What does double pneumonia mean? Do you get pneumonia twice?

No.

Double pneumonia simply means that you get pneumonia in both of your lungs.

It is also called bilateral ­pneumonia.

Pneumonia can affect either one or both lungs.

Which is the most dangerous: bacterial, viral or fungal pneumonia?

Bacterial pneumonia is the most dangerous.

It also unfortunately tends to be the most common type of pneumonia.

It can become quite severe and usually requires you to be hospitalised.

Viral pneumonia tends to resolve on its own, and usually runs a milder course.

However, Covid-19, although it is a viral infection, can also result in severe pneumonia.

When there was no vaccine in 2020, it tended to run a more dangerous course.

Fungal pneumonia tends to affect immunocompromised people, such as those who have AIDS (acquired immunodeficiency syndrome).

It can be very severe because the immune system of the person is lowered and cannot fight off the fungus.

Kilmer, seen here as Admiral Tom “Iceman” Kazansky in Top Gun: Maverick, had been battling throat cancer for a decade before succumbing to pneumonia on April 1. — Handout

Would I most likely get pneumonia from someone who passes it to me?

There are several types of pneumonia:

> Community-acquired pneumonia

This is the commonest.

It means you got it from ­someone who infected you ­somewhere out there in your community.

Bacteria like Streptococcus pneumoniae, Haemophilus influenzae and Chlamydia pneumoniae are the commonest cause of this type of pneumonia.

Viruses like the common cold virus, the influenza virus, SARS-CoV-2 and respiratory syncytial virus (RSV) cause this as well.

Fungi, as mentioned, affect the immunocompromised.

The reason is that if you are healthy, your immune system can usually fend off fungal infections.

> Hospital-acquired pneumonia

This is the type you get when you are admitted to a hospital for another illness or a procedure.

You would have contracted this type of pneumonia from one of the other patients in the hospital.

The bacterial strains you get in a hospital are usually more serious and resistant to antibiotics, simply because they have mutated to survive the hostile hospital environment.

They may include Klebsiella pneumoniae and MRSA (methichillin-resistant Staphylococcus aureus).

Therefore, this type of pneumonia may be harder to treat.

> Healthcare-associated pneumonia

You can get this type of pneumonia if you are in a long-term healthcare facility, such as a nursing home.

The types of bacteria here are usually also antibiotic resistant.

> Ventilator-associated pneumonia

You can get this if you are on a ventilator in hospital.

> Aspiration pneumonia

This is when you eat or drink, or if you vomit, and part of the solid or fluid gets into your ­trachea (windpipe).

If you cannot cough it up again, you may get aspiration pneumonia.

When does pneumonia kill someone?

Pneumonia may not just stay inside your lungs; it can cause a lot of complications.

You are at higher risk of life-threatening pneumonia if you:

• Are aged 65 or older
• Are younger than two years
• Have hospital-acquired pneumonia or ventilator-acquired pneumonia
• Have a chronic disease, such as diabetes, asthma, chronic obstructive pulmonary disease, or as in Kilmer’s case, cancer.
• Have a chronic neurological condition that makes it difficult to swallow (thus increasing the risk of aspiration pneumonia)
• Have a weakened immune system
• Smoke or vape
• Are pregnant.

The issue when you are in one of these risky populations is that the symptoms of pneumonia may be milder, despite the pneumonia already being very serious and raging in your lungs.

If you are immunocompromised, for example, you may just have a simple cough that you mistake for a much milder disease.

You don’t seek treatment because you think you will recover.

You don’t even have a fever.

But the pneumonia spreads through your lungs and possibly into your bloodstream, and you don’t know until it is too late.

The good news is that most people do recover from pneumonia.

But 5% to 10% of hospitalised patients do die of it, as well as up to 30% of people who have been admitted to the ICU (intensive care unit).

The 88-year-old Pope Francis, seen here during a surprise appearance at the end of a mass for the sick and healthcare workers on April 4 in Vatican City, is still recovering after being hospitalised for double pneumonia. — AFP/Vatican Media

If I have a cough, how would I know it is pneumonia and not some throat infection?

If you are a healthy person, the symptoms of pneumonia tend to be more serious than a simple throat infection.

You may have difficulty in breathing, chest pain, a fever higher than 38.8°C, or you may cough phlegm that is yellow, green or bloody.

You should go to a doctor immediately and possibly be admitted to hospital.

However, if you are in one of the higher risk groups as mentioned above, you should take every little symptom seriously and get yourself checked out, just in case.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information ­provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any ­warranty on accuracy, completeness, functionality, usefulness or other ­assurances as to such information. The Star and the author disclaim all responsibility for any losses, ­damage to property or personal injury suffered directly or indirectly from reliance on such information.