This is the season when physicians and emergency rooms see an increased incidence of pneumonias. This is a specific diagnosis and reflects an infection that is affecting the lung tissue itself. Often we see patients that have been told they have pneumonia who never had an x-ray confirmation of the diagnosis. Patients are placed on multiple courses of antibiotics when their symptom of cough does not resolve quickly. This delay in symptom resolution often reflects the fact that the patient has some underlying lung disease or continues to smoke.
Patients with COPD who have pneumonias may not resolve their symptoms for 90 days or more. Their x-ray improvement lags behind their clinical symptoms and can take weeks, or more, to totally clear. The exact cause of pneumonia is often not discovered. Cultures of mucous are sometimes not adequate, or the patient has been started on antibiotics before the culture was taken. Data from a number of surveys suggest that more pneumonias are being caused by viral infections.
The reason for this may have something to do with the fact that more patients are getting vaccinated against the most common type of bacterial pneumonia. Viruses are not easily, or generally, cultured and are not responsive to antibiotic therapy. Symptoms associated with viral pneumonias often persist for weeks. The cough related to viral infections also seems to take longer to resolve and can lead to those multiple courses of antibiotics. In these cases symptomatic treatment and tincture of time is needed.