50-year-old Mansi suffered from high fever with bouts of severe body ache. On the third day of fighting fever that refused to settle, she got tested for dengue, typhoid and the results came negative. Even COVID test was negative. A detailed examination at the physician revealed she had pneumonia. So let’s first understand what pneumonia is. Pneumonia is a medical term for infection of the lungs. Pneumonia is one of the most common and morbid conditions encountered in clinical practice. It is one of the leading causes of hospitalization, significant morbidity, and substantial mortality. India accounts for around 23% of the global burden of pneumonia cases. The case fatalities vary between 14 – 30 percent in pneumonia patients, explains Dr Rohit Kumar Garg, consultant, department of infectious diseases, Amrita Hospital, Faridabad. 

Symptoms of pneumonia

While it is believed that pneumonia will present classic lung symptoms like breathlessness, chest pain and cough, that’s not always the case. According to Dr Praveen Pandey, Director – Pulmonology, Max Hospital, Patparganj, “Symptoms of pneumonia vary from very mild to severe. Sometimes a person may have only cold or flu-like symptoms. In elderly patients, the presentation may be like confusion, altered mental status and low temperature. The patient may also have associated loose motion or local chest pain.” In extreme cases patients may require hospitalization or oxygen support or ventilatory support. 

Fever is the commonest presenting symptom for various infectious and non-infectious diseases. In the initial stages of illness, the character of fever is non-specific, and therefore, it may be difficult to differentiate the cause of illness based on fever alone. Other non-specific symptoms include myalgia, headache, body ache, fatigue, and sore throat. However, symptoms such as cough, shortness of breath, pleuritic chest pain, and anorexia point towards pneumonia and warrant medical evaluation, adds Dr Rohit. 

How to differentiate pneumonia from flu, COVID, dengue

Fever is the common symptom for all of them. “However, certain symptoms may provide important clues to the etiology. Fever, in Influenza as well as dengue, is often abrupt onset and high grade. In influenza, the common accompanying symptoms include dry cough, severe myalgia, nasal symptoms, sore throat, and headache. In dengue, commonly associated symptoms include myalgia, body ache, headache (particularly retro-orbital area), skin rash, etc. In COVID-19, fever is usually low grade and can be associated with symptoms such as dry cough, myalgia, headache, smell and taste abnormalities, diarrhea, skin rash, conjunctivitis, etc. Symptoms such as cough, shortness of breath, and pleuritic chest pain may point toward pneumonia,” explains Dr Rohit.

Dr. Shivanshu Raj Goyal, Consultant Respiratory, Pulmonology & Sleep Medicine, Artemis Hospital, Gurugram further adds, “Pneumonia is as such a lung infection with white patch in chest X-ray. COVID on the other hand is a viral infection, it may or may not develop pneumonia. Patients mainly get coughs with fever and drop in oxygen levels. Flu such as seasonal or swine flu is more related to sore throat and headache with bodyache. Dengue cardinally comes with fever, headache and body ache. Drop in platelet count usually is seen after fever settles but a normal platelet count does not exclude dengue.”

By – Kalpana Sharma