How do you confirm diagnosis of pneumonia?

How is pneumonia diagnosed?

A doctor can often diagnose pneumonia based on the symptoms and by examining your chest. But you may need to have a chest X-ray to confirm that you have it.

Sometimes it can be difficult to tell whether you have pneumonia or another kind of chest infection. If it’s not clear, your GP may do a blood test or take a sputum sample to help decide if you need antibiotics.

How is pneumonia treated?

Pneumonia can be serious so it’s important to get treatment quickly. The main treatment for pneumonia is antibiotics, along with rest and drinking plenty of water. If you have chest pain, you can take pain killers such as paracetamol.

Treatment depends on how severe your pneumonia is. Treatment with antibiotics should be started as soon as possible after diagnosis. If you’re admitted to hospital, this should be within 4 hours of admission.

Mild pneumonia

If you have mild pneumonia, you may be able to manage it at home with treatment from your GP, especially if you have support from family and friends. Your GP will prescribe a 5-day course of antibiotics, which you’ll probably take as tablets. If you don’t start to feel better after 3 days, tell your GP – you may need a longer course of antibiotics.

More severe pneumonia

Some people are too ill to be treated at home and need to go to hospital.

If you’re too ill to drink and take tablets, you can have fluids and antibiotics through a drip in your arm. You’ll also be given oxygen if you need it, and the hospital staff can regularly check your temperature and breathing.

You’ll usually be given 2 different kinds of antibiotics at the same time, usually for 5 to 7 days but possibly up to 10 days. But you won’t necessarily have to stay in hospital that long.

People who are in hospital for other medical problems and then develop pneumonia have a high risk of becoming very ill. They may need different, more powerful antibiotics.

It’s very important to finish your full course of antibiotics – don’t stop taking your antibiotics before the end of the course, even if you start to feel better.

Complications caused by pneumonia

Pneumonia can sometimes have complications. They include:

• pleurisy – where the pleura, the thin linings between your lungs and ribcage, become inflamed, leading to chest pain. If you have pleurisy, you are more likely to develop fluid on the lungs.
• fluid on the lungs - about 1 in 10 people with pneumonia develop fluid around the lung, called a pleural effusion which can become infected. This may require a sample of the fluid to be taken by inserting a needle between the ribs under local anaesthetic, and if infected is likely to need a longer course of antibiotics. Occasionally, a tube is inserted into the lung to remove fluid as well.
• a lung abscess – a rare complication that’s mostly seen in people with a serious pre-existing illness or history of alcohol misuse.
• blood poisoning, also called septicaemia - this is where infection spreads from the lungs to the blood stream. This can cause low blood pressure and a severe illness that might need intensive care treatment.
• respiratory failure – this is where pneumonia causes low levels of oxygen in the blood even in people given oxygen. This might also require intensive care treatment.

The vast majority of people recover from pneumonia and return to good health. However, pneumonia can be very serious and some people with severe pneumonia don’t survive, despite the best available care. Those who are elderly or have other health problems are most at risk of severe or fatal pneumonia.

Next: recovering from pneumonia >

Last medically reviewed: October 2019. Due for review: October 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.

Pneumonia is an infection that causes inflammation in one or both of the lungs and may be caused by a virus, bacteria, fungi or other germs.

Your doctor may conduct a physical exam and use chest x-ray, chest CT, chest ultrasound, or needle biopsy of the lung to help diagnose your condition. Your doctor may further evaluate your condition and lung function using thoracentesis, chest tube placement or image-guided abscess drainage.

What is pneumonia?

Pneumonia is an infection that causes inflammation in one or both of the lungs. It can be caused by a virus, bacteria, fungi or other germs. The infection is usually acquired when a person breathes in air carrying germs.

Patients with pneumonia could have the following symptoms:

• cough that produces phlegm or sometimes blood
• fever
• shortness of breath or difficulty breathing
• chills or shaking
• fatigue
• sweating
• chest or muscle pain

Those most at risk for developing pneumonia are young children or people over the age of 65.

People with existing health problems are also at increased risk. Risk factors and circumstances that may increase a person's chances of developing pneumonia include:

• having illnesses such as emphysema, HIV/AIDS or other lung diseases or conditions that affect the immune system
• having the flu
• exposure to and inhalation of various chemicals
• smoking or excessive drinking
• a prolonged stay in the hospital or intensive care
• recent surgery
• recent injury

Pneumonia can sometimes lead to serious complications, such as respiratory system failure, spread of infections, fluid surrounding the lungs, abscesses or uncontrolled inflammation throughout the body (sepsis). The condition can also be fatal, so it is important to seek immediate medical attention if you are experiencing these symptoms.

top of page

How is pneumonia diagnosed and evaluated?

Your primary doctor will begin by asking you about your medical history and symptoms. You will also undergo a physical exam, so that your doctor can listen to your lungs. In checking for pneumonia, your doctor will listen for abnormal sounds like crackling, rumbling or wheezing. If your doctor thinks you may have pneumonia, an imaging test may be performed to confirm the diagnosis.

One or more of the following tests may be ordered to evaluate for pneumonia:

• Chest x-ray: An x-ray exam will allow your doctor to see your lungs, heart and blood vessels to help determine if you have pneumonia. When interpreting the x-ray, the radiologist will look for white spots in the lungs (called infiltrates) that identify an infection. This exam will also help determine if you have any complications related to pneumonia such as abscesses or pleural effusions (fluid surrounding the lungs).
• CT of the lungs: A CT scan of the chest may be done to see finer details within the lungs and detect pneumonia that may be more difficult to see on a plain x-ray. A CT scan also shows the airway (trachea and bronchi) in great detail and can help determine if pneumonia may be related to a problem within the airway. A CT scan can also show complications of pneumonia, abscesses or pleural effusions and enlarged lymph nodes.
• Ultrasound of the chest: Ultrasound may be used if fluid surrounding the lungs is suspected. An ultrasound exam will help determine how much fluid is present and can aid in determining the cause of the fluid.
• MRI of the chest: MRI is not generally used to evaluate for pneumonia but may be used to look at the heart, vessels of the chest and chest wall structures. If the lungs are abnormal because of excess fluid, infection or tumor, an MRI may provide additional information about the cause or extent of these abnormalities.
• Needle biopsy of the lung: Your doctor may request a biopsy of your lung(s) to determine the cause of pneumonia. This procedure involves removing several small samples from your lung(s) and examining them. Biopsies of the lung can be done using x-ray, CT, ultrasound and/or MRI.

top of page

How is pneumonia treated?

The following image-guided treatments may be used for pneumonia:

• Thoracentesis: Fluid may be taken from your chest cavity and studied to help your doctor determine which germ is causing your illness. X-ray, CT and/or ultrasound may be used during thoracentesis. The fluid removed during this procedure may also help provide symptom relief.
• Chest tube placement: During this procedure, also known as thoracostomy, a thin plastic tube is inserted into the pleural space (the area between the chest wall and lungs. The tube can help remove excess fluid or air. The procedure is performed under the guidance of CT or ultrasound.
• Image-guided abscess drainage: Image-guidance helps direct placement of a needle into the abscess cavity and can aid during insertion of a drainage tube. If an abscess has formed in the lungs, it may be drained by inserting a small drainage tube (catheter). Image guidance, including fluoroscopy, x-ray, ultrasound or CT, is used.

Each of these tests will help your doctor further evaluate your lungs and lung function or help determine the type of germ causing your pneumonia.

top of page

top of page

This page was reviewed on February, 08, 2021

Images

View full size with caption

Pediatric Content

Some imaging tests and treatments have special pediatric considerations. The hand denotes child-specific content.

• RadInfo 4 Kids

Sponsored By

Please note

RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

This website does not provide cost information. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur.

Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas.

Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, RSNA and ACR are not responsible for the content contained on the web pages found at these links.