pneumonia that comes and goes

Overview

Pneumonia that comes and goes means you get pneumonia more than once. Pneumonia is an infection in the tiny air sacs in your lungs that makes it hard to breathe. Each time you get it, it is a new infection, not the same one coming back.

Recurrent pneumonia is not very common. Most people get pneumonia only once or never. But certain conditions can make some people more likely to have it again.

It mainly affects people with chronic lung diseases (like asthma or COPD), a weakened immune system, swallowing problems, or conditions like diabetes. Older adults, young children, and smokers are also at higher risk.

Symptoms

Common symptoms

• Cough that may bring up phlegm
• Fever and chills
• Shortness of breath
• Chest pain when breathing or coughing
• Tiredness and muscle aches

Symptoms in children

• Fast or noisy breathing
• Grunting sounds when breathing
• Flaring nostrils
• Irritability or crying more than usual
• Poor feeding or vomiting

Symptoms in older adults

• Confusion or changes in thinking
• Dizziness or feeling faint
• Lower body temperature than normal
• Loss of appetite
• Increased weakness

Causes

Main causes

• Bacteria, viruses, or fungi that infect the lungs
• Aspiration (breathing in food, liquid, or vomit) that leads to infection
• An underlying condition that makes your lungs or immune system weaker

Risk factors

• Smoking or vaping
• Chronic lung diseases like COPD, asthma, or bronchiectasis
• Weakened immune system from illness or treatment (e.g., chemotherapy)
• Diabetes, heart disease, or kidney disease
• Swallowing problems (dysphagia), which can cause aspiration
• Being in hospital, especially on a ventilator
• Age under 5 or over 65

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing or chest pain that is severe or getting worse
• If you are coughing up blood
• If you feel confused or have a very high fever

Book a routine appointment if:

• If you have repeated episodes of pneumonia and want to find out why
• If you have a cough, fever, or tiredness that lasts more than a few days
• If you are at higher risk and have any symptoms of pneumonia

Diagnosis

Your doctor will ask about your symptoms and health history, listen to your lungs with a stethoscope, and may order tests to confirm pneumonia and find the cause.

Tests that may be done

• Chest X-ray to look for infection in the lungs
• Blood tests to check for infection and see how your body is responding
• Sputum test (testing the phlegm you cough up) to identify the germ
• Pulse oximetry to measure oxygen levels in your blood
• Sometimes a CT scan or bronchoscopy if the pneumonia keeps coming back

What to expect at your appointment

At the appointment, the doctor will ask about your symptoms, any medicines you take, and your habits like smoking. They will listen to your breathing. Tests may take a day or two. If you have recurrent pneumonia, they may refer you to a lung specialist for further checks.

Treatment

Treatment for each episode of pneumonia focuses on killing the infection, supporting your breathing, and helping you recover. If you have an underlying condition, that will also be treated to prevent future episodes.

Self-care at home

• Get plenty of rest and drink enough fluids (water or clear soups)
• Use a cool-mist humidifier to ease cough and make breathing easier
• Propped yourself up with pillows to help with breathing
• Avoid smoking and second-hand smoke
• Take any prescribed medicines exactly as directed by your doctor

Medical treatments

Doctors may prescribe antibiotics if the cause is bacterial, or antiviral medicines if it is caused by a virus. They might also recommend oxygen therapy if your oxygen levels are low. In severe cases, you may need to stay in hospital for stronger treatment and monitoring. Never take antibiotics without a diagnosis, as they do not work for viral infections and can cause side effects.

When is surgery considered?

Surgery is rarely needed for pneumonia itself. It may be considered if there is a complication like a lung abscess (a pocket of pus) or if an underlying structural problem in the lungs needs correction.

Living with this condition

If you have recurrent pneumonia, focus on staying as healthy as possible and managing any underlying conditions. Work with your healthcare team to create a plan that includes regular check-ups and vaccines.

Lifestyle tips

• Quit smoking and avoid exposure to smoke or strong fumes
• Wash your hands often to prevent infections
• Stay up to date with recommended vaccines, including the flu shot and pneumococcal vaccine
• Keep chronic conditions like asthma or diabetes well controlled
• Eat a balanced diet to support your immune system

Diet and exercise

Eat a variety of fruits, vegetables, whole grains, and lean protein. Stay active as your energy allows—gentle walking or stretching can help maintain lung function. Ask your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Dealing with repeat illnesses can be stressful, frustrating, and sometimes worrying. It is normal to feel anxious or down. Talk to your doctor about how you are feeling. Support from family, friends, or a counselor can help.

Prevention

While you cannot always prevent pneumonia, you can lower your risk by staying healthy, getting vaccinated, and managing any health conditions. If you have recurrent episodes, your doctor may suggest extra steps like a swallow study or breathing exercises.

Vaccines

Vaccines are available for some types of pneumonia (pneumococcal vaccine) and for the flu and COVID-19, which can also lead to pneumonia. Ask your doctor which vaccines are right for you and when to get them.

Complications

If left untreated

• The infection can spread into the bloodstream, causing sepsis (a life-threatening reaction)
• Lung abscess (a pocket of pus inside the lung)
• Fluid around the lungs (pleural effusion) that may need draining
• Respiratory failure requiring a breathing machine
• Organ damage from severe infection

Long-term outlook

With prompt and proper treatment, most people recover fully from each pneumonia episode. If you have recurrent pneumonia, finding and managing the underlying cause can greatly reduce future attacks. Many people with recurrent pneumonia live full, active lives with careful management. It is important to work closely with your healthcare team and not lose hope.

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