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Pneumonia

A lung infection that fills the air sacs with fluid or pus. It ranges from mild to life-threatening, depends on the germ, your age and your health, and needs the right treatment for the right cause.

Call 911 — or have someone call for you — if you or someone with a cough or fever has any of these emergency signs:

Get care the same day if you have a high temperature, a cough that brings up yellow or green mucus, chest pain that comes and goes or happens when breathing or coughing, or you are short of breath (NHS). A low blood-oxygen reading on a pulse oximeter is also a symptom of pneumonia (NHLBI); if your symptoms get worse, see a healthcare provider right away (NHLBI).

Do not drive yourself to the emergency room, and bring any medicines you take with you (NHS). The NHS is the UK’s health service, so in the U.S. call 911 where its page says 999.

What is pneumonia?

Pneumonia is an infection in one or both lungs that causes the tiny air sacs (alveoli) to fill with fluid or pus. It can range from mild to severe, depending on the cause, your age and your overall health (MedlinePlus, NHLBI). Because it can look like a cold or the flu at first, it is sometimes hard to diagnose; it may not be clear you have something more serious until symptoms last longer than a cold would (NHLBI). Pneumonia is a different illness from bronchitis, which is inflammation of the airways rather than the air sacs — see our Bronchitis guide — and a chest X-ray is often used to diagnose pneumonia (NHLBI).

CDC counted 41,627 U.S. deaths from pneumonia in 2024 and about 1.2 million emergency department visits in 2022 with pneumonia due to an infectious organism as the main diagnosis (CDC, FastStats). CDC says pneumonia can often be prevented and can usually be treated (CDC).

The types of pneumonia

Pneumonia is named by where you caught it, how you caught it or what caused it. The types overlap, so one illness can fit several names.

  • Community-acquired pneumonia develops in the community, outside a hospital. Most people get pneumonia by catching an infection from someone else in their community (CDC, NHLBI).
  • Hospital-acquired (healthcare-acquired) pneumonia develops during or after a stay in a healthcare setting; ventilator-associated pneumonia develops in someone who has been on a ventilator, a breathing-support machine (CDC). Critical illness, intensive care, not being able to move around much, or being sedated raise the risk (NHLBI).
  • Aspiration pneumonia happens when food, fluid, vomit or saliva is breathed into the lungs and cannot be coughed out (MedlinePlus, NHS). Stroke, head injury, dementia or Parkinson’s disease can weaken the cough or swallow, and sedation or an overdose can also lead to it (NHLBI). See our Head Trauma guide.
  • “Walking pneumonia” is a milder illness, often caused by the bacterium Mycoplasma pneumoniae. With mild symptoms people may not stay home or in bed, which is how the name arose; many mild infections clear without medicine, but doctors routinely treat the pneumonia it causes with antibiotics (CDC, NHLBI).
  • Bacterial pneumonia is the most common type in adults. Streptococcus pneumoniae (pneumococcus) is the most common cause in the United States. Legionella causes a severe type called Legionnaires’ disease. Bacterial pneumonia can develop on its own or after a cold or the flu (NHLBI, MedlinePlus).
  • Viral pneumonia: the flu and the common cold viruses are the most common causes in adults; RSV is the most common cause in young children; SARS-CoV-2, the virus that causes COVID-19, can also cause it (NHLBI). Viral pneumonia is often mild and goes away on its own within a few weeks, but it can be serious, and having it raises your risk of also getting bacterial pneumonia (MedlinePlus). See our Flu guide.
  • Fungal pneumonia is more common in people with chronic health problems or weakened immune systems. Types include Pneumocystis pneumonia, Valley fever and histoplasmosis (MedlinePlus). Some fungi live in the soil of the southwestern United States and the Ohio and Mississippi River valleys (NHLBI).

Doctors are not always able to find out which germ caused a particular case (CDC). We plan separate RSV and Smoking guides.

Who is at highest risk?

Symptoms

Symptoms can start suddenly or build over a few days (NHS). They can include a cough with or without mucus, fever, chills, shortness of breath, chest pain when you breathe or cough, low blood oxygen, headache, muscle pain, extreme tiredness, nausea, vomiting and diarrhea (NHLBI, MedlinePlus). CDC also lists confusion among the common symptoms (CDC). Babies may show no clear signs, or may vomit, have a fever and cough, or seem restless, tired and without energy (NHLBI). The emergency signs are at the top of this page.

Pneumonia can lead to serious complications, including bacteria in the bloodstream (bacteremia), lung abscesses, fluid or pus around the lungs, kidney failure and respiratory failure (MedlinePlus); complications are more likely if it is untreated and more common in children, older adults and people with other serious conditions (NHLBI).

How it’s diagnosed

  • History and exam: your provider asks about symptoms, exposures, vaccines, medicines, smoking and recent travel, checks your temperature and listens to your lungs with a stethoscope (NHLBI).
  • Chest X-ray looks for inflammation in the lungs and is often used to diagnose pneumonia (NHLBI).
  • Pulse oximetry uses a small sensor on a finger or ear to measure the oxygen in your blood (NHLBI).
  • Blood tests, such as a complete blood count, show whether your immune system is fighting an infection (NHLBI).
  • If you are in the hospital, very sick, older or have other health problems, you may also have a sputum test, a blood culture, a quick DNA (PCR) test, an arterial blood gas test, a chest CT scan, a pleural fluid culture or a bronchoscopy to look inside the airways (NHLBI, MedlinePlus).

Professional guidelines for doctors exist, including an American Thoracic Society and Infectious Diseases Society of America guideline for adults with community-acquired pneumonia (guideline abstract, 2019); CDC keeps a list of these (CDC). We read only the abstract of that guideline, which does not list its individual recommendations, so we do not summarize them here.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Treatment depends on the cause and severity: antibiotics for bacterial pneumonia (and some fungal types), antifungal medicine for others, sometimes antivirals for viral pneumonia, plus rest, fluids and fever relief. Severe cases need hospital care with IV medicines and oxygen. Vaccines prevent some pneumonia. Medicare Part B covers pneumococcal vaccines: you pay nothing if your provider accepts assignment. Treatment and hospital costs: cost estimate being researched. Many people recover at home. Some feel better within a week or two; for others it takes a month or longer, and most feel tired for about a month. Antibiotics only help bacterial pneumonia.
Chiropractic No established role in treating pneumonia. Spinal adjustment does not treat a lung infection. About $90–$200 for a first visit and $55–$100 for follow-ups (self-pay estimates). We found little research on chiropractic care for pneumonia. Related hands-on (osteopathic) treatment given in hospital showed very uncertain results. Never a substitute for antibiotics or medical care.
Acupuncture Needle treatments studied only as an add-on to standard care, mainly in hospitalized stroke patients with pneumonia in China. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. One 2025 review reported benefits as an add-on in stroke-associated pneumonia but called the evidence low quality. Not a treatment for pneumonia on its own.
Herbal medicine No herb or supplement treats pneumonia. Vitamin D and zinc have been tested as add-ons to antibiotics in children; some Chinese herbal formulas have been studied during recovery. Cost estimate being researched. Vitamin D probably makes little or no difference to how fast children recover; zinc did not clearly help treatment, though it may lower children’s risk of getting pneumonia. Herbal evidence is limited. Check with your pharmacist first.
Massage therapy Not a treatment for pneumonia. Airway-clearance (chest physiotherapy) is a separate therapy taught by respiratory or physical therapists. About $70–$90 a month at one national chain (Massage Envy) for one 60-minute session a month on a 12-month membership; rates vary by location. We found little research on massage for pneumonia. A Cochrane review of chest physiotherapy found the evidence very uncertain. Relaxation massage is comfort care at most.
MBHA Wellness Coach Rest, fluids, not smoking, light activity, sitting upright, finishing medicines, preventing spread, staying up to date on vaccines and knowing when to call your provider. Cost estimate being researched. Quitline coaching is free (1-877-44U-QUIT). Good recovery habits support, but never replace, medical treatment. A coach can help you follow your plan and spot warning signs early.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on the type of pneumonia, the germ causing it and how severe it is (MedlinePlus). Many people are prescribed medicine and recover at home; serious cases are treated in the hospital or intensive care unit (NHLBI). People at higher risk of becoming seriously ill — those over 65, with heart or lung disease, very young children, those very unwell, or those not improving on antibiotics — may need hospital treatment (NHS).

1. Matching the medicine to the germ

2. Antibiotic classes (no doses here)

Your doctor chooses the antibiotic and the length of treatment. Classes named on FDA drug labels for pneumonia or lower respiratory infections include:

FDA boxed warning for fluoroquinolones. The levofloxacin label carries a boxed warning that fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including tendinitis and tendon rupture, peripheral neuropathy and central nervous system effects. The label says to stop the medicine immediately and avoid fluoroquinolones if you have any of these reactions; that they may worsen muscle weakness in people with myasthenia gravis and should be avoided if you have a history of it; and that, because of the risks, levofloxacin should be reserved for patients with no alternative treatment options for uncomplicated urinary tract infection, acute bacterial exacerbation of chronic bronchitis and acute bacterial sinusitis (DailyMed, levofloxacin label). Tell your doctor about tendon or nerve problems and about myasthenia gravis, and call your doctor if you notice such symptoms. We read one manufacturer’s levofloxacin label.

Take the antibiotic exactly as prescribed. Most people begin to feel better after one to three days, but if you stop too soon the pneumonia may come back (NHLBI), and it may become resistant to the antibiotic (NHLBI). The NHS says to contact your doctor if you do not feel any better after 2 to 3 days of antibiotics (NHS).

3. Steroids — what the evidence shows

The NHS notes that hospital patients are sometimes given steroids as well as antibiotics (NHS). A Cochrane review of 17 trials of steroids added to antibiotics (all in hospitalized patients with community-acquired pneumonia) found they reduced deaths in adults with severe pneumonia (moderate-quality evidence) but not in adults with non-severe pneumonia; they reduced time to cure and hospital stays, and caused more high blood sugar (Cochrane review, 2017). A 2023 trial of adults in intensive care with severe community-acquired pneumonia found that 6.2% of those given hydrocortisone died within 28 days versus 11.9% given placebo (trial, New England Journal of Medicine). This is hospital care directed by a doctor; do not use leftover steroids on your own. People with diabetes should know that steroids can raise blood sugar — see our Diabetes guide.

4. Hospital care

If pneumonia is serious you may get antibiotics and fluids through an IV line and oxygen therapy, and if it is very serious you may need a ventilator (NHLBI). Rarely, a procedure or surgery is needed to remove seriously infected or damaged parts of the lung (NHLBI).

5. Recovery

Recovery varies. Some people feel better and return to normal routines in 1 to 2 weeks; for others it takes a month or longer, and most continue to feel tired for about a month (NHLBI). The NHS says most people get better in 2 to 4 weeks (NHS). Ask your provider about follow-up care: if your symptoms have not improved, a chest X-ray may be used to check for other conditions causing them, and pulmonary rehabilitation or physical therapy may help you regain breathing and strength (NHLBI). Pneumonia can have long-term effects such as depression and worsening heart and blood vessel disease; call your provider if you develop these, if symptoms suddenly get worse, or if you have trouble breathing or talking. If you keep getting pneumonia, tell your provider (NHLBI).

6. Prevention and vaccines

Vaccines cannot prevent all pneumonia, but people who are vaccinated and still get it tend to have fewer serious complications, milder infections and shorter illness (NHLBI). Recommendations change, so check CDC’s current adult immunization schedule (CDC) and ask your provider.

  • Pneumococcal: CDC recommends it for all children younger than 5, children 5 through 18 with certain risk conditions, all adults 50 and older, and adults 19 through 49 with certain risk conditions (CDC). It cannot prevent all cases. Medicare Part B covers pneumococcal vaccines at no cost to you if your provider accepts assignment (Medicare.gov).
  • Flu: everyone 6 months and older should get a flu vaccine every season, with rare exceptions (CDC). See Flu.
  • RSV: recommended for all adults 75 and older and for adults 50–74 at increased risk of severe RSV; a vaccine during pregnancy, or an antibody product for the baby after birth, can protect infants (CDC).
  • COVID-19: people who are up to date with their COVID-19 vaccine have a lower risk of severe illness (CDC); ask your provider what is currently recommended for you.
  • Hib: recommended for all U.S. children under 5 (NHLBI); CDC also lists pertussis, measles and chickenpox vaccines among those that help prevent infections that can cause pneumonia (CDC).

Other steps: wash your hands often with soap and water or an alcohol-based sanitizer; don’t smoke; stay active and eat a healthy diet to keep your immune system strong; if you have swallowing problems, eat smaller meals of thickened food and sleep with the head of the bed raised (NHLBI). CDC also advises avoiding sick people, cleaning frequently touched surfaces, coughing into a tissue or sleeve, limiting contact with cigarette smoke and managing chronic conditions such as asthma (CDC).

What it costs

  • Pneumococcal vaccines: $0 under Medicare Part B if your provider accepts assignment (Medicare.gov).
  • Doctor visit, tests, medicines and hospital care: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no established role in treating pneumonia. Pneumonia is an infection in the lungs; spinal adjustments do not treat the infection, and no adjustment replaces antibiotics, other prescribed medicines, oxygen or hospital care.

What the research says

  • We found little research on chiropractic adjustments for pneumonia. The closest research is on osteopathic manipulative treatment (OMT), a hands-on method used by osteopathic physicians, tested alongside standard care in hospital.
  • A 2010 trial of 406 hospitalized people aged 50 or older compared usual care alone, light touch and OMT. The main (intention-to-treat) analysis found no significant differences between groups; an analysis of those who followed the protocol found shorter hospital stays than usual care, but not versus light touch (trial, Osteopathic Medicine and Primary Care). The authors said OMT merited further study.
  • A 2022 Cochrane review of chest physiotherapy for pneumonia in adults, which included OMT, found the evidence very uncertain for deaths and cure rates; one trial reported transient muscle tenderness after OMT in two people and another reported three serious adverse events leading to early withdrawal after OMT (Cochrane review, 2022).

Safety

Mild side effects such as soreness, stiffness or headache are common after spinal manipulation; serious problems have been reported, and risk may be greater in people with underlying health problems (NCCIH). If you have pneumonia, ask your doctor before any hands-on treatment, and don’t use it to put off medical care.

What it costs

Self-pay estimates are about $90–$200 for a first appointment and about $55–$100 for follow-up visits (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is not a treatment for the lung infection itself. Research on pneumonia is limited to its use as an add-on to standard care.

What the research says

A 2025 review of 16 trials (1,125 patients) of acupuncture for stroke-associated pneumonia — a form of aspiration pneumonia in people recovering from stroke — reported better response rates, lower infection markers, a shorter cough and a shorter course of antibiotics, but the authors say the evidence was low quality and more rigorous studies are needed (meta-analysis, Frontiers in Medicine). These were trials of acupuncture added to standard care in a specific group of patients, so the results cannot be assumed to apply to everyone with pneumonia. We found little research in other types of pneumonia that we could review.

Safety

Relatively few complications have been reported, but nonsterile needles and improper delivery have caused serious problems, including infections, punctured organs and injury to the central nervous system; U.S. needles must be sterile and single-use (NCCIH). Choose a licensed practitioner and tell them about your lung infection. Don’t use acupuncture to postpone seeing a health care provider (NCCIH).

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement treats pneumonia or replaces antibiotics and other medical care. A few have been tested as add-ons. “Natural” does not mean risk-free, and NCCIH’s digest on herb–drug interactions describes possible interactions with prescription medicines for several popular herbs (NCCIH). Talk to your doctor or pharmacist first, especially if you take other medicines, are pregnant or are buying for a child. We don’t list doses here.

Vitamin D

A Cochrane review of seven trials (1,601 children aged one month to five years in hospital with pneumonia) found vitamin D, added to antibiotics, probably has little or no effect on time to resolution of the illness (moderate-certainty evidence); the authors do not know whether it affects hospital stay or deaths. No major adverse events were reported, and the authors conclude they are uncertain whether vitamin D has important effects (Cochrane review, 2023). We did not review adult trials.

Zinc

  • As treatment: a Cochrane review of four trials (3,267 children aged two to 35 months) found zinc added to antibiotics did not significantly improve recovery or shorten hospital stays, and judged the evidence insufficient to recommend it (Cochrane review, 2011).
  • As prevention in young children: a Cochrane review of six studies (5,193 children aged 2 to 59 months) found daily zinc supplements reduced the incidence of pneumonia by 13%, based on low-quality evidence (Cochrane review, 2016). Talk with your child’s doctor before giving any supplement.

Chinese herbal formulas

A 2022 review pooled 20 trials (2,241 children) of Chinese herbal medicine, given alone or with Western medicine, during recovery from pneumonia. The reviewers reported improved overall effectiveness, shorter time to cough relief and chest crackles clearing, and shorter hospital stay, with no significant difference in side effects (meta-analysis, Frontiers in Pharmacology). We read only the abstract and cannot judge the quality of the individual trials; the formulas varied, and the findings apply to children during convalescence, not to treating the infection itself.

Approach 5 of 6

Massage therapy

Massage is not a treatment for pneumonia. Some people find gentle massage relaxing while recovering, but it does not treat the infection. It helps to know the difference between massage and chest physiotherapy (airway clearance), which respiratory or physical therapists use in hospitals.

Chest physiotherapy is different

A 2022 Cochrane review of eight trials (974 adults) of chest physiotherapy — including conventional chest physiotherapy, breathing techniques, positive expiratory pressure and high-frequency chest wall oscillation — found the evidence about deaths and cure rate very uncertain. Some methods may slightly shorten hospital stay or fever, but all findings were of very low certainty. Positive expiratory pressure was reported with no adverse events in one trial (Cochrane review, 2022). Ask your care team rather than a massage therapist about these techniques.

Massage research

We found little research on massage for pneumonia — mostly small studies in children or in people on ventilators, which we did not review in depth — so we can’t say it helps.

Safety

The risk of harm from massage appears low, though rare serious problems such as blood clots, nerve injury or broken bones have been reported, some with vigorous massage or in people at higher risk, such as older adults. Don’t use massage to postpone seeing a health care provider (NCCIH).

What it costs

One national chain, Massage Envy, charges about $70–$90 a month for a membership that includes one 60-minute session a month, with a 12-month initial term; rates are set by each franchise location and vary (The Pricer).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach is not a medical provider and cannot diagnose or treat pneumonia. A coach can help you follow your doctor’s plan and build recovery habits.

Rest, fluids and a plan to get better

  • Take all your medicines as prescribed (NHLBI).
  • Rest until you feel better and stay home if you have a high temperature or don’t feel well enough for normal activities; drink plenty of fluids (NHS, NHLBI).
  • Choose nourishing foods, get plenty of sleep, and avoid alcohol and illegal drugs, which weaken the immune system and can raise the risk of complications (NHLBI).
  • Get light physical activity to regain strength — you may still feel short of breath, and activity that is too strenuous may make you dizzy. Sit upright to breathe more easily, and take a couple of deep breaths several times a day. Ask your provider how much activity is right (NHLBI).
  • Don’t smoke and avoid secondhand smoke, which can worsen pneumonia. For free help quitting, the National Cancer Institute’s Smoking Quitline is 1-877-44U-QUIT (1-877-448-7848) (NHLBI).

Home safety and protecting others

When to go back to your provider

Member stories

Living with Pneumonia? Share your experience

Real experiences help others choose. Tell us what you tried — conventional medicine, chiropractic, acupuncture, herbs, massage or coaching — what it cost and what changed.

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Which approaches have you tried?

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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