lung infection

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Pneumonia occurs particularly often in the cold season, not infrequently as a result of prolonged flu-like infections. The most important symptoms are a general feeling of illness, cough, fever and shortness of breath. Pneumonia can be life-threatening in older, chronically ill or immunocompromised people. Read more about symptoms, risk of infection and treatment of pneumonia here!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. J15J14J16J18J12P23J13

Pneumonia: Quick Reference

Typical symptoms: strong feeling of illness, fever up to 40 °, chills, dry or productive cough
Causes: infection with bacteria, viruses, fungi or parasites, inhalation of toxic fumes, smoke, aspiration of stomach contents or blood
particularly at risk: infants and other children, the elderly, people with heart or lung diseases, immunodeficiency, diabetes or alcohol abuse
Danger of confusion: (chronic) bronchitis, tumors, foreign bodies in the bronchi, pleurisy / pleurisy
Examinations: Listening (auscultation) and tapping (percussion) of the lungs, voice fremitus, bronchophony, blood count, x-ray, antigen / antibody detection, computed tomography (CT), ultrasound
Treatment: Consistent rest, antibiotics (for bacteria) or fungal agents (for fungal infections), treatment of symptoms (e.g. painkillers and fever killers, cough suppressants, medication that liquefies the secretion)
Dangers: lack of oxygen (life-threatening), spread of the infection with chronic course, spread of the pathogens to other organs (meningitis, heart inflammation, etc.), blood poisoning (sepsis)
rare form: Pneumocystis carinii (fungal infection with severely weakened immune system)

Pneumonia: symptoms

A sudden onset of illness is typical for pneumonia. Signs such as a general feeling of illness and weakness are among the first symptoms.

Other symptoms of pneumonia follow:

fever
Cough with sputum (productive cough) or dry cough
chills
Shortness of breath (in severe pneumonia)

With pneumonia, the gas exchange in the lungs is disturbed. This leads to a lack of oxygen (hypoxemia) and an increase in carbon dioxide (hypercapnia). To compensate for this, with severe pneumonia, breathing often becomes very fast and shallow (tachypnea).

As a result of the exertion of breathing, the nostrils expand with every breath - a clear indication of shortness of breath and thus of pneumonia. If this does not compensate for the lack of oxygen, the lips and fingertips will turn bluish. Doctors speak of cyanosis.

The cough is initially dry in the early stages of pneumonia. This means that no sputum (mucus) can be coughed up. As a rule, however, a productive cough occurs after a short time, in which greenish-yellowish mucus is coughed up. Every cough can cause chest pain, which often radiates into the lower abdomen.

If there are other lung diseases such as asthma or bronchitis, these are often worsened by the pneumonia.

"Go to the doctor if the sputum is yellow"

Three questions for

Prof. Dr. med. Felix Herth,
Pulmonologist
1
How do I know if I have bronchitis or pneumonia?

Prof. Dr. med. Felix Herth
Not at all as a patient. This requires an X-ray to show that the lungs are inflamed. But it doesn't matter, because both bronchitis and pneumonia are treated with antibiotics by the doctor. The important thing is that you go to one if you develop a fever and yellow sputum - which can be the case with both pneumonia and bronchitis.
2
Do I have to go to the hospital with pneumonia?

Prof. Dr. med. Felix Herth
That depends: If you are older than 65 years, have difficulty breathing, blood pressure that keeps dropping or are simply confused, then it is recommended. The advantage in the hospital is that the antibiotics are given intravenously and work faster.
3
How long do I have to spare myself with pneumonia?

Prof. Dr. med. Felix Herth
It usually takes six weeks for the lungs to regenerate. During this time, however, you are allowed to exercise yourself physically, only for example to step down a little while doing sports. And: After pneumonia, your body is weakened and susceptible to further germs. Therefore, pay more attention to hand hygiene and do not attend mass events for the time being.
Prof. Dr. med. Felix Herth,
Pulmonologist
Medical director and chief physician of the Thoraxklinik Heidelberg, chief physician of the department of internal medicine - pulmonology.

Atypical pneumonia: symptoms less clear

Atypical pneumonia can be caused by certain bacteria, fungi, viruses or parasites. The cough stays dry all the time. Significantly milder symptoms, but which often drag on for weeks, are further characteristics of atypical pneumonia. Symptoms as they occur in typical pneumonia are absent, which is why atypical pneumonia is often overlooked and therefore not cured properly.

Pneumonia: symptoms with viruses or parasites

If viruses or parasites are responsible for pneumonia, symptoms may differ from those of the common bacterial pneumonia. Symptoms here are often initially fever and chills. A dry cough only appears after a few days.

Further signs: Pneumonia with a viral or parasitic cause is often accompanied by difficult coughing up of phlegm and a dry cough that lasts for a long time.

Pneumonia: symptoms in the elderly

Pneumonia is often much more serious in older people than in younger people - it can even quickly become life-threatening here!

Symptoms of pneumonia in older people include coughing (often with brownish / rust-colored sputum) and shortness of breath. The brownish color of the sputum is caused by blood admixtures, for example from tears in the smallest blood vessels in the throat. Blood in the sputum are also possible symptoms of Legionella pneumonia (Legionnaires' disease).

The shortness of breath that often accompanies pneumonia in older people is due to the reduced capacity of the lungs in old age. Sometimes those affected even have to be temporarily ventilated in the hospital.

If the disease is severe, older people in particular can fall into a kind of twilight state due to a lack of oxygen and an increase in carbon dioxide, in which they appear confused or completely apathetic to their environment. Then treatment in the hospital is also necessary.

Pneumonia: Symptoms in Children

Children and adults often develop different symptoms of pneumonia. Symptoms that practically only occur in children are abdominal pain, a bloated stomach, and headache and body aches. Chest retraction, nausea and ear pain also often occur. When it comes to these complaints, many parents do not immediately think of pneumonia! Pneumonia in children can often be recognized by changes in behavior, especially if the little ones cannot speak yet.

The first signs of pneumonia in children can therefore be:

high fever (at least in the case of bacterial pneumonia; in contrast, in pneumonia caused by viruses or fungi, the temperature hardly rises above 38.5 ° C)
Skin retraction between the ribs
bloated stomach
erect nostrils on inhalation
rapid breathing (tachypnea)
Unwillingness to drink
decreased appetite
particularly high heart rate

In children, too, a strong cough and general malaise are classic signs of pneumonia. And as in adults, the cough in children is often accompanied by greenish or yellowish sputum. When coughing up, chest pain may occur, which sometimes extends to the right lower abdomen.

Pneumonia: symptoms of immunodeficiency

People with compromised immune systems are particularly susceptible to pneumonia. The symptoms can be more pronounced here and last longer. They weaken the otherwise impaired body additionally. Therefore, pneumonia should always be treated in hospital in patients with weakened immune systems.

A weakened immune defense occurs, for example, as part of immunosuppressive therapy. This is a treatment that is intended to deliberately limit or suppress the function of the immune system (for example after an organ transplant). But diseases such as AIDS or diabetes mellitus can also significantly weaken the immune system.

Pneumocystis Pneumonia Symptoms

People with a weak immune system can also develop a rare form of pneumonia that practically does not occur at all in people with normal defenses: the so-called Pneumocystis pneumonia, caused by the fungus Pneumocystis jirovecii is caused.

Pneumocystis pneumonia usually begins insidiously with a cough and (not always present) mild fever. In the course of time, symptoms of this form of pneumonia are accompanied by increasing difficulty in breathing (dyspnea).

Pneumocystis pneumonia is a common first manifestation of AIDS!

"Cold" pneumonia

So-called cold pneumonia is characterized by the absence of a fever. Because fever is usually one of the typical symptoms of pneumonia, cold pneumonia is often not recognized as such.

Symptoms of cold pneumonia include:

Persistent, dry, irritating cough, no coughing up of phlegm
no fever or very low fever
jerky, heavy breathing
Shortness of breath
Sensation of tightness in the chest
headache
Weakness, tiredness

In addition, symptoms of cold pneumonia occur that do not occur in other forms of pneumonia: for example, back pain in cold pneumonia and cold hands in children can add to the already known symptoms. The symptoms appear insidious and not suddenly as with common pneumonia. For that they are more persistent.

Bronchitis or pneumonia?

Acute bronchitis is an acute inflammation of the inner wall of the bronchial tree through which the air enters the lungs. The bronchial walls thicken, the small blood vessels around the bronchi swell, and mucus is produced. Bronchitis is therefore associated with symptoms similar to pneumonia.

An X-ray of the chest area helps to differentiate between bronchitis and pneumonia: pneumonia shows up as shading in the chest area, whereas bronchitis cannot be seen in the X-ray image. Nevertheless, the doctor often cannot give a clear answer to the question: bronchitis or pneumonia? The symptoms of both diseases are far too similar for that.

Pneumonia: Treatment

How pneumonia is treated depends on its cause. The age of the patient and any accompanying or previous illnesses also play a role in the choice of therapy. You should also inform your doctor in advance of any drug allergies or intolerances (e.g. penicillin allergy) so that he can take this into account when planning therapy.

Tip: Sick people can support their own recovery with all forms of pneumonia by taking care of themselves and drinking a lot.

Antibiotics

In the case of bacterial pneumonia, antibiotics are almost always prescribed to kill the pathogens or prevent them from multiplying.

The earlier bacterial pneumonia is detected and treated, the higher the likelihood that it will go without complications. Therefore, if the diagnosis is confirmed, antibiotics are often prescribed when the exact pathogen has not yet been determined. The broad-spectrum antibiotics (broad-spectrum antibiotics) used for this work against many possible germs.

If the pathogen could be identified by a bacteriological examination of the blood or sputum, the doctor can also prescribe the patient a more targeted antibiotic (narrow-spectrum or narrow-band antibiotic).

The antibiotics are often given orally (e.g. as tablets). Under certain circumstances, however, antibiotic infusions may be more useful (for example in the case of severe pneumonia or babies).

The duration of therapy depends primarily on the severity of the disease: in the case of pneumonia with a mild to moderate course, the antibiotics should be given for five days, in the case of severe pneumonia for seven days. In individual cases, however, a shorter or longer antibiotic therapy can be useful.If the patient's condition has still not improved a few days after the start of antibiotic administration, the antibiotic may need to be changed or the diagnosis may need to be re-examined.

Antibiotics are also generally used when pneumonia is caused by inhaling saliva or stomach contents (aspiration pneumonia) or by inhaling irritating or toxic substances (chemical pneumonitis).

When antibiotics don't work

Antibiotic treatment is not effective for virus-induced or any other non-bacterial form of pneumonia. Even then, antibiotics are often prescribed in addition. The reason: You prevent an additional infection (superinfection) with bacteria.

Antibiotic therapy is also ineffective if individual strains of the pathogen have developed what is known as resistance, i.e. are insensitive to certain antibiotics. Resistant bacteria are particularly common in hospitals because antibiotics are used very often there.

As a patient, you can help prevent such resistance from developing by taking the prescribed antibiotics for exactly as long as your doctor has prescribed.

Other treatments

For pneumonia caused by viruses, fungi, or parasites, the treatment approach is different than for bacterial pneumonia. Depending on the pathogen, antifungal agents or special drugs against parasites may be necessary. In addition, drugs are used that are primarily intended to alleviate the symptoms and prevent secondary diseases:

Antitussives (e.g. codeine, dextromethorphan) reduce the urge to cough in dry, irritating coughs.
Secretolytics (expectorants, for example acetylcysteine, bromhexine) make it easier to expectorate with a productive cough.
Pain relievers and fever killers (e.g. ASA, paracetamol) reduce general symptoms such as aching limbs and fever.

Cough suppressants and cough removers must never be taken at the same time. Otherwise, the increasingly dissolved mucus cannot be coughed up - the shortness of breath worsens!

Pneumonia: Outpatient Treatment Or Hospital?

Young people without comorbidities can usually be treated at home. Pneumonia is usually over after two or three weeks at the latest. For some patients, however, hospital treatment is necessary or at least advisable, for example in the following cases:

The inflammation has spread to large parts of the lungs.
Severe symptoms occur.
The patient is of old age.
The patient has an immunodeficiency or a poor general condition.
Complications occur (such as blood poisoning, pneumonia, pleural effusion).
There are unstable comorbidities.
Social factors speak in favor of inpatient treatment (e.g. lack of home care for the patient).

What is pneumonia?

Pneumonia is one of the most common infectious diseases with an estimated 500,000 cases per year in this country. Almost a third of those affected have to be treated in hospital. Around three to five percent of those infected die. Pneumonia is thus the most common infectious disease leading to death in Western Europe.

In the case of pneumonia, either the alveoli (alveolar pneumonia) or the lung tissue (interstitial pneumonia) are predominantly damaged and can no longer work properly. This affects the gas exchange - the body can no longer get enough oxygen. At the same time, it cannot emit enough carbon dioxide.

Air sacs in pneumonia

The alveoli fill with watery or purulent fluid. An exchange of breathing gases is only possible to a limited extent in the inflamed area.

In some types of pneumonia, there are many small foci of inflammation in the lobes of the lungs (lobular pneumonia). In others, an entire lobe of the lung is affected (lobar pneumonia, lobar pneumonia).

But not only the spread is used to characterize pneumonia. There are many more criteria for differentiation:

Primary or Secondary Pneumonia?

If a healthy person falls ill with pneumonia without any significant health risk factors, doctors speak of primary pneumonia. If, on the other hand, there is another disease or a certain triggering event on the basis of which pneumonia could first develop (such as asthma, COPD, heart failure, smoke inhalation, aspiration, etc.), one speaks of secondary pneumonia.

Outpatient or nosocomial pneumonia?

An outpatient pneumonia (CAP, English for community acquired pneumonia) is caught outside of a hospital. This also includes pneumonia that someone in old people's or nursing homes is infected with.

Nosocomial pneumonia (HAP, English for hospital acquired pneumonia) means pneumonia that is contracted in hospital (more precisely: more than two days after admission or within 14 days after discharge).

The problem with nosocomial pneumonia: antibiotic-resistant germs are increasingly being found in hospitals and are particularly difficult to treat. Because most antibiotics no longer work on these bacteria. The risk of nosocomial infection is particularly high in patients in the intensive care unit, in whom the immune system is weakened. Artificial respiration, in particular, can promote pneumonia.

Typical or atypical pneumonia?

Pneumonia is also classified according to its course and symptoms:

Doctors speak of "typical pneumonia" when the classic symptoms of pneumonia such as productive cough (= with sputum), fever and typical examination findings in the X-ray and physical examination show. In the process, pus and water retention clog the alveoli, which are important for the exchange of breathing gases.

"Atypical pneumonia" (also "interstitial pneumonia") is when it is not the alveoli themselves but the tissue that embeds the alveoli and blood vessels (interstitium) that is inflamed. Atypical pneumonia is caused by other pathogens than the typical forms: by mycoplasma, chlamydia, rickettsiae or legionella (all bacteria), but also by fungi or parasites.

Mycoplasma pneumonia is common in community facilities such as schools, homes, or barracks. Pneumonia caused by chlamydia is caused by the bacterium Chlamydia pneumoniae which is transmitted exclusively from person to person. Legionella can mainly be found in standing, warm or hot water. These can be lakes, showers, air conditioning or ventilation systems, hot water boilers or heating systems. Legionella pneumonia (Legionnaires' disease) has a slow, protracted course. In addition to the known symptoms, confusion, lethargy and diarrhea often occur.

Special form of pneumonia: Pneumocystis pneumonia

Pneumocystis pneumonia is a special form of pneumonia. It is caused by a mushroom Pneumocystis jirovecii, triggered. Healthy people are not affected by the infection. Pneumocystis pneumonia mainly affects people with immunodeficiency and is in most cases the first sign of infection with HIV.

Pneumonia: causes and risk factors

Infectious agents of pneumonia are usually bacteria. A specific type of bacteria - pneumococci (Streptococcus pneumoniae) - causes half of all pneumonia cases. The cause of the infection is often droplet infection: a patient releases tiny droplets of saliva containing pathogens into the environment when they cough, sneeze or speak. These either land directly on other people's mucous membranes (e.g. by coughing up) or are distributed in the air and are then inhaled by healthy people. Then they can also get sick.

Many of the bacteria responsible for pneumonia are also found in the oral cavity of healthy people. However, if these germs get into the airways in large quantities, pneumonia can develop. Sometimes the pathogens are carried from other organs to the lungs via the blood.

Fungal pneumonia usually affects people with poor general health and a weakened immune system. Parasitic pneumonia is rather rare and is also more likely to occur in immunocompromised people or when traveling to / from tropical countries.

Other causes of pneumonia can be:

Secretion congestion in the bronchi
Lung tumors
Foreign bodies in the airways
corrosive irritants, gases, smoke or solvents
radiotherapy
Inhalation (aspiration) of food, liquid, blood, stomach contents / gastric juice
Heart failure (heart failure)
Pulmonary embolism after thrombosis
Covid-19
Spreading of germs via the bloodstream (haematogenous spread) from other sources of inflammation in the body (for example in the case of an inflammation of the bones)

Groups at risk for pneumonia

The following groups of people are particularly susceptible to pneumonia:

elderly and debilitated people
People with chronic diseases, especially heart disease, chronic bronchitis, COPD or diabetes (diabetes mellitus)
People whose body's defenses are significantly weakened (e.g. with HIV infection)
People who receive drugs that suppress the body's defenses (e.g. immunosuppressants or cytostatics)
alcoholic people
Toddlers

With these risk groups, it is particularly important to recognize as quickly as possible what type of pneumonia is present in order to be able to treat it accordingly. Because they are particularly at risk from infection.

Is Pneumonia Contagious?

Pneumonia can be contagious, depending on the form and cause. In pneumonia caused by viruses or bacteria, for example, pathogens are spread through the air through coughing or sneezing and can infect other people (droplet infection).

Pneumonia in Children

Pneumonia is the most common respiratory disease in childhood. It is sometimes difficult to recognize - the symptoms of pneumonia in (young) children can be very unspecific. In addition to a fever, cough and rapid pulse, signs include a bloated stomach, contraction of the skin between the ribs, erect nostrils when inhaling, apathetic behavior and no desire to eat or drink.

Since the immune system is not yet working as effectively in adolescents, children have little to counter a developing pneumonia. It is all the more important as a parent to be attentive and watch out for suspicious symptoms. This is particularly important with babies and toddlers, as they cannot yet speak and state their complaints.

You can find out more about this in the article Pneumonia in Children.

Pneumonia: examinations and diagnosis

To diagnose pneumonia, the attending physician will first record the medical history (anamnesis). To do this, he asks the patient (or the parents of a sick child) particularly about past and existing illnesses and complaints. Possible questions include:

Do you have a cough? If so, is it dry or with expectoration?
What is the nature of the sputum (quantity, consistency, color)?
Have you noticed any chills or fever in the past few days?
Are you breathless or tight in your chest?
How are you in general, do you feel weak and tired?

Also tell your doctor if you were abroad up to three months before the onset of the disease. Pathogens from other countries sometimes require different treatment than pneumonia caused by "domestic" pathogens.

The anamnesis is followed by a physical examination. The doctor tries to assess the ventilation by listening to the lungs with a stethoscope (auscultation) and to assess the density of the lung tissue by tapping. Decreased breathing sounds and compression suggest pneumonia.

Listening to the lungs

By listening to the lungs with a stethoscope, the doctor can detect insufficient ventilation of the lung tissue

Blood test, urine test

A blood test also provides evidence of inflammation. With bacterial pneumonia, the number of white blood cells (leukocytes) is greatly increased. Different leukocyte precursors can be detected in the blood. Doctors refer to this finding as a shift to the left. If there is a viral pneumonia, the number of leukocytes is hardly or not at all increased, but the proportion of lymphocytes (specialized white blood cells).

Legionella can be detected in the urine (urine test).

Imaging

If pneumonia is suspected, a chest x-ray (chest x-ray) is always required. The doctor can use it to confirm the diagnosis and determine the extent and location of the inflammation. If necessary, the X-ray image can also show that there is no pneumonia at all, but rather another disease that causes similar symptoms (e.g. tumor, lung abscess, tuberculosis).

If no X-ray machine is initially available, appropriately trained doctors can also perform an ultrasound scan to confirm the suspected diagnosis of pneumonia. Computed tomography may also be required if atypical pneumonia is suspected. This high-resolution imaging can also make small foci of inflammation visible.

Bronchoscopy

In the case of atypical pneumonia in particular, it can be important to track down the pathogen. Only then can an effective pneumonia treatment be initiated. For this purpose, the bronchi (bronchoscopy) are mirrored:

The doctor inserts a flexible tube into the bronchi that is connected to a camera and has several "working channels". These can be used to flush the bronchi and specifically suck out mucus to check for pathogens. Other pathological changes in the bronchi (constrictions, bulges or tumors) can often be detected via bronchoscopy.

Pneumonia: disease course and prognosis

The earlier the disease is noticed and treated, the better the therapy and recovery of pneumonia. The prognosis also depends on the pathogen, the age of the patient and their general health.

Around the world, three to four million people die each year from pneumonia, in Germany there are around 20,000. Nevertheless, with early, adequate therapy and without any existing comorbidities, the prognosis is good. In this case, those affected usually recover completely.

A worse prognosis is to be expected, however, if the pneumonia developed during a hospital stay. Since antibiotics are used a lot there, there is an increased risk that the bacterial strains will be resistant to many antibiotic agents, which makes therapy much more difficult.

Other factors that can negatively affect the course of pneumonia include:

old age
existing heart or lung disease
weakened immune system

Pneumonia complications

Pneumonia complications occur particularly under unfavorable conditions (e.g. immunodeficiency, old age, concomitant diseases). Although these are rare, they can increase the duration of treatment and worsen the prognosis. These include:

Inflammation of the pleura or pleura (pleurisy)
Fluid build-up between the lungs and pleura (pleural effusion)
Bronchiectasis (irreversible, sac-shaped widening of the bronchi)
Formation of pus-filled cavities in the lung tissue (lung abscess)
Inflammation of the heart sac (pericarditis) or the lining of the heart (endocarditis)
Accumulation of pus in the brain (brain abscess), inflammation of the meninges (meningitis)
Blood clot (thrombosis)
Inflammation of the bone marrow (osteomyelitis)
Inflammation of the joints (arthritis)

Other organs (such as the heart or brain) are threatened if the pathogens spread through the bloodstream in the body (haematogenic spread). This can also lead to general blood poisoning (sepsis).

Pneumonia: duration

In the case of bacterial pneumonia, antibiotic therapy is usually successful within a few days. With certain pathogens, however, longer treatment may be necessary in order to reduce the relapse rate (recurrence rate). After two to three weeks, the symptoms of pneumonia generally resolve.

However, some sufferers feel exhausted and weak for weeks after pneumonia, and the cough can also persist. In order not to relapse, you should only go back to work when your physical performance is back to normal and symptoms no longer exist.

Delayed pneumonia

It takes much longer if the disease is "dragged on" - for example, because the person concerned puts himself back under physical strain too early or because therapy was delayed.

Pneumonia dragged on for six to eight weeks is what doctors call chronic pneumonia.It can cause irreversible bulging of the bronchi (bronchiectasis), recurring inflammation in the lungs or bleeding.

As a result, the lung tissue scars and is less elastic later. This can severely restrict lung function (restrictive lung function disorder). People with a weakened immune system or serious pre-existing diseases of the lungs and heart are particularly at risk of delayed pneumonia.

Prevent pneumonia

The best way to prevent pneumonia is to live a healthy, active lifestyle. A balanced diet rich in vitamins and regular exercise improve overall health and help reduce the risk of pneumonia. Tobacco and alcohol, on the other hand, should be consumed as moderately as possible: Both weaken the immune system and make you an easier "victim" for pathogens - especially if you have already had pneumonia.

People who suffer from chronic respiratory diseases such as asthma, COPD or chronic bronchitis should under no circumstances change or pause their basic therapy in the event of an acute infection of the airways without consulting their doctor. The risk of a secondary infection, possibly also with pneumonia pathogens, is fundamentally higher for them.

Vaccination against pneumonia

There is no vaccine that is effective against all possible pneumonia pathogens. However, there are individual vaccinations that can often effectively prevent pneumonia. The Robert Koch Institute recommends three different vaccinations, each of which is important for different groups of people and can prevent pneumonia:

Pneumococcal vaccination

A large part of all pneumonia can be traced back to pneumococci as the pathogen. Therefore, experts recommend pneumococcal vaccination for the following groups of people:

all children up to 24 months
People over 65 years of age with frequent upper respiratory infections
Groups of people with a weakened immune system
People whose spleen has been removed
People with a chronic illness (such as bronchitis, coronary heart disease, heart failure or diabetes mellitus)

Haemophilus influenzae vaccination

The bacterium is found in around ten percent of all young patients Haemophilus influenzae responsible for pneumonia. Doctors therefore recommend vaccinating all children against this pathogen (Haemophilus influenzae type b vaccination, HiB vaccination).

Flu vaccination

The flu pathogen (influenza) can damage the mucous membrane and weaken the immune system. Affected people become more susceptible to pneumonia and are less able to resist it. The following people are therefore recommended to have a regular (annual) flu vaccination:

People over 60 years
People with cardiovascular diseases such as high blood pressure or angina pectoris
People with metabolic diseases such as diabetes mellitus
People with lung or kidney disease
HIV-infected people
Leukemia patient
People who are in daily contact with many different people

Additional information

S3 guideline "Treatment of adult patients with community-acquired pneumonia - Update 2021" of the German Society for Pneumology and Respiratory Medicine et al.
S3 guideline "Epidemiology, Diagnosis and Therapy of Adult Patients with Nosocomial Pneumonia - Update 2017" of the German Society for Pneumology and Respiratory Medicine et al.

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