How We Get Bacterial Pneumonia

How We Get Bacterial Pneumonia

By Richard P. Holm, MD
 
My good friend, a single man in his 60s, didn’t like going to the medical clinic for anything, let alone a cold. His illness started with a fever, aches all over and a sudden overabundance of mucus. After one or two days of those obvious viral symptoms, for which we have no good therapy, he got better, except he acquired a new dry hacky cough.
 
Initially he did what he should have and stopped going to work, put a box of tissues and a waste basket next to his comfort chair, drank plenty of hot lemonade and tea, got plenty of rest and took Tylenol. After a few days and while covering his dry cough and washing his hands a lot, he went back to work. So far, so good . . .
 
On day five or six, he developed a fever again with new and profound weakness. His dry cough became productive and the mucus occasionally was streaked with blood. After one more day of fever, he developed shaking chills, and his daughter called me to explain her dad seemed to be in trouble. We got him to the emergency room where they began powerful intravenous antibiotics. He had pneumonia, a life-threatening bacterial lung infection, which invaded because the viral infection first weakened his lung defenses. The bacterial infection had also spread into his blood stream and was disseminating throughout his body. This is called sepsis and it kills unless treated very early.
 
My friend was very sick for about four weeks but recovered to be strong enough to go back to work again thanks to excellent medical and nursing care with effective support, antibiotics and rehabilitation. In retrospect, antibiotics would not have helped if they were started too early during the viral process. The time to attack early with antibiotics should have been at the time of the second fever. Studies show if antibiotics are given during the viral infection, a bacterial pneumonia will still follow in about the same frequency, only now there will likely be resistance to that specific antibiotic.
 
Take home message:

1. Bacterial pneumonia can follow a viral respiratory infection, but, antibiotics won’t help until the bacterial infection begins;
2. We should all cover our coughs, wash our hands frequently and keep our fingers out of our own eyes and noses;
3. The flu shot saves lives by preventing the viral infection in the first place.

 
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