Caitlin Whyte (Host): Welcome to the Live Greater Podcast series, information for a healthier you from the University of Maryland medical system. I'm Caitlin Whyte. Today, we are discussing pneumonia, what it is, how it's treated, and how to prevent it with Dr. Jeffrey Marshall, a Critical Care physician and pulmonologist at UM Baltimore Washington Medical Group. Well, doctor, thank you so much for being with us today. To start out this important conversation, can you tell us first what is pneumonia and what are its symptoms?

Dr. Jeffrey Marshall: Well, thank you so much for having me. I really appreciate the opportunity to speak on the podcast today. Very simply, pneumonia is an infection of the lungs. So, our lungs are made up of many, many little air sacs that can fill up with inflammation or pus. And this can cause the usual symptoms that we think about with pneumonia, like coughing up phlegm, fevers, chills, and sometimes difficulty breathing.

When enough of these air sacs fill up, we can see it as what we call a consolidation or an abnormal area on chest imaging, like a chest x-ray or a CT scan. Pneumonia can range from mild to severe and life-threatening, especially in young kids, infants, older adults, and those who may have a weakened immune system.

Host: And what are the primary causes or triggers for developing pneumonia?

Dr. Jeffrey Marshall: Yeah. Pneumonia can be caused by any number of various pathogens, including bacteria and viruses most commonly, and sometimes also by fungus. The most common cause of pneumonia is bacterial pneumonia. This is often triggered by an organism called Streptococcus pneumonia, or other less serious bacteria which can cause what many of us refer to as "walking" pneumonia. Also, viral infections like the flu, RSV, or respiratory syncytial virus, or COVID, can also lead to pneumonia, especially if the immune system is compromised. A very serious contributor to pneumonia that many of us don't really recognize or think about are cigarettes and tobacco smoke. People who smoke are at a far higher risk of developing pneumonia and also at a higher risk of being hospitalized or even dying after getting pneumonia.

Host: Wow. Well, where should someone go to get treatment if they do develop pneumonia?

Dr. Jeffrey Marshall: So, anyone who is suspected of having pneumonia, so having those symptoms that I described earlier, coughing up phlegm, having fevers and chills, shortness of breath, they should go to see a healthcare provider for an evaluation and a proper diagnosis. Mild cases can often be managed by your primary care provider, but more severe cases might require hospital care for closer monitoring and treatment.

Host: Well, that brings me to my next question. What are some treatment options that are available?

Dr. Jeffrey Marshall: Treatment really varies based on the cause. So as I said, most pneumonia that we see are bacterial. This typically requires antibiotics while viral pneumonias like that caused by flu or COVID can be treated with antiviral medications. Most viral pneumonias, however, can't be treated with antibiotics or antivirals and antibiotics won't be appropriate or effective for these things. Supportive care is also very important, like getting plenty of rest, staying well hydrated, and sometimes the use of over the counter medications like Tylenol to help manage the symptoms. In very severe cases, oxygen therapy or even mechanical ventilation may be necessary.

Host: All right. And what is the outcome for people who get pneumonia?

Dr. Jeffrey Marshall: Outcomes can vary by age, overall health, and the type of pneumonia that the person has. With appropriate treatment, many, many people recover fully in just a few weeks. However, those with underlying health conditions or those who get treatment late can have much longer recovery periods or face significant complications.

Host: And I'd love to go back to when you mentioned hospitalization. If pneumonia can result in hospitalization, how often do we see that and when does that usually become the case?

Dr. Jeffrey Marshall: Yeah. So, pneumonia absolutely can result in someone becoming hospitalized, especially if it causes significant breathing difficulty, like someone having shortness of breath with minimal exertion or having really low oxygen levels. People can also develop complications like sepsis. People with immune systems that are compromised, the elderly, the really young, or those with chronic illnesses are at a far higher risk of developing pneumonia that can lead to hospitalization or the need for hospital care.

Host: And with that, can you tell us more about how pneumonia can evolve into those more serious diseases like you mentioned sepsis? And is it possible for pneumonia itself to ever be fatal?

Dr. Jeffrey Marshall: Yeah. So, pneumonia can be fatal, particularly in the vulnerable populations and patients that we already mentioned. If left untreated or if the body cannot control the infection, it can spread to the bloodstream and harm other organs, leading to what we call sepsis, which is a life-threatening response to infection. We all heard a brilliant review of sepsis on last month's podcast with Dr. Baghdadi, where he very nicely describes how infections like pneumonia can lead to sepsis. And pneumonia is a leading cause of sepsis in our hospitals.

Host: Wow. Then, what are some best ways to prevent or just minimize pneumonia cases?

Dr. Jeffrey Marshall: I'm so glad you asked. Vaccines, vaccines, vaccines. Vaccines are one of the most effective prevention strategies. We have vaccines against pneumonia, so that one type of bacterial pneumonia that I already discussed. We obviously have the annual flu vaccine, which is available to everybody. And in the last year or so. We also had a new vaccine come out for respiratory syncytial virus, or RSV, which is another virus that can lead to very severe pneumonia in those patients with underlying health conditions or other lung diseases.

Other ways that we can protect ourselves from pneumonia include basic things like practicing really good hand hygiene with regular hand washing and the use of hand sanitizer. And if you have a compromised immune system, trying to avoid others with respiratory illness, wearing a mask for those individuals can be a really helpful measure to avoid infections. And again, for those who smoke, working toward quitting or at least reducing exposure to tobacco smoke can really reduce the risk of developing pneumonia and reduce the risk of getting really sick or dying from them.

Host: Well, as we wrap up, what are some of your top tips for staying healthy in general?

Dr. Jeffrey Marshall: Stay up to date on vaccines, maintain a balanced diet, exercise regularly, get plenty of sleep, and avoid smoking, right? These are things that we all know about, and things that we sometimes don't practice well enough. These steps support the immune system and our overall health. And this helps reduce the likelihood of developing any infection really, but also particularly in reducing pneumonia.

Host: And my last question today, what are some key takeaways for our listeners when it comes to pneumonia, keeping it at bay or treating it if we do develop it?

Dr. Jeffrey Marshall: Yeah. So, thank you again. You know, pneumonia is a very serious illness, but often preventable with vaccines and healthy habits. Early diagnosis and treatment are critical for good outcomes. So, staying informed, practicing good hygiene, taking care of your health, and following up with your primary care providers if you do develop any of these symptoms so you can get assessed and treated early.

Host: Doctor, thank you so much for taking the time to join us today. Find more shows just like this one at umms.org/podcast and on YouTube. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical system. We look forward to you joining us again, and please share this on your social media.