Signs, Symptoms, and Complications

The signs and symptoms of pneumonia vary from mild to severe. But some people are at risk for developing more severe pneumonia or potentially fatal complications.

Signs and Symptoms

See your doctor promptly if you have the following signs and symptoms:

• Have a high fever
• Have shaking chills
• Have a cough with phlegm (a slimy substance), which doesn't improve or worsens
• Develop shortness of breath with normal daily activities
• Have chest pain when you breathe or cough
• Feel suddenly worse after a cold or the flu

If you have pneumonia, you also may have other symptoms, including nausea (feeling sick to the stomach), vomiting, and diarrhea.

Symptoms may vary in certain populations. Newborns and infants may not show any signs of the infection. Or, they may vomit, have a fever and cough, or appear restless, sick, or tired and without energy.

Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. If they already have a lung disease, it may get worse. Older adults who have pneumonia sometimes have sudden changes in mental awareness.

Complications

Often, people who have pneumonia can be successfully treated and do not have complications. Possible complications of pneumonia may include:

• Bacteremia and septic shock. Bacteremia is a serious complication in which bacteria from the initial site of infection spread into the blood. It may lead to septic shock, a potentially fatal complication.
• Lung abscesses. Lung abscesses usually are treated with antibiotics. Sometimes surgery or drainage with a needle is needed to remove the pus.
• Pleural effusions, empyema, and pleurisy. These painful or even potentially fatal complications can occur if pneumonia is not treated. The pleura is a membrane that consists of two large, thin layers of tissue. One layer wraps around the outside of your lungs and the other layer lines the inside of your chest cavity. Pleurisy is when the two layers of the pleura become irritated and inflamed, causing sharp pain each time you breathe in. The pleural space is a very thin space between the two pleura. Pleural effusions are the build-up of fluid in the pleural space. If the fluid becomes infected, it is called empyema. If this happens, you may need to have the fluid drained through a chest tube or removed with surgery.
• Renal failure
• Respiratory failure