Fig. 3.-Bacterial bronchiectasis and bronchiolitis in 46-year-old...

What To Know About Double Pneumonia: Pope Francis' Recent Health Struggle

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Pope Francis Slept Peacefully, Ate Breakfast Following Diagnosis Of Pneumonia In Both Lungs

Pope Francis slept well and ate breakfast on Wednesday morning after he was diagnosed with pneumonia in both lungs, according to the Vatican.

Matteo Bruni, a spokesperson for the Vatican, said Francis had a peaceful fifth night in Rome's Gemelli hospital.

"He had a tranquil night, woke up and had breakfast," the spokesperson said.

The Vatican said Tuesday that Francis, who had the upper lobe of his right lung removed when he was young, had been diagnosed with pneumonia in both his lungs and that laboratory tests, chest X-ray and the pope's clinical condition "continue to present a complex picture."

POPE FRANCIS DIAGNOSED WITH BILATERAL PNEUMONIA, VATICAN SAYS

Pope Francis attends his weekly general audience in the Pope Paul VI hall at the Vatican on Aug. 23, 2023. (AP Photo/Andrew Medichini)

"The polymicrobial infection, which arose on a picture of bronchiectasis and asmatiform bronchitis, and which required the use of antibiotic cortisone therapy, makes the therapeutic treatment more complex," the Vatican said Tuesday.

"The chest CT scan that the Holy Father underwent this afternoon… demonstrated the onset of bilateral pneumonia that required further pharmacological therapy," it continued.

But the Vatican said Wednesday that the pope remains in good spirits and is grateful for the prayers for his recovery.

On Friday, Francis, 88, was admitted to the hospital in "fair" condition after a week of bronchitis worsened. On Monday, the hospital determined that he was suffering from a polymicrobial respiratory tract infection, which means that a mix of viruses, bacteria and possibly other organisms had colonized in his respiratory tract.

Pope Francis at his weekly audience in the Vatican on Feb. 28, 2024. (AP Photo/Andrew Medichini)

"The follow-up chest CT scan which the Holy Father underwent this afternoon ... Demonstrated the onset of bilateral pneumonia, which required additional drug therapy," Bruni said.

Bronchitis can lead to pneumonia, a deeper and far more serious infection of the lungs' air sacs. Pneumonia can develop in part of or the entirety of one lung or both lungs, and it is typically more serious when both lungs are affected, because there is insufficient healthy lung tissue to compensate.

Treatment may vary but can include providing oxygen through a nasal tube or mask, intravenous fluids and treatment of the underlying cause of the infection.

Francis is not believed to be using supplemental oxygen. He has eaten breakfast every day, read the newspapers and done some work from his hospital room.

POPE FRANCIS WILL REMAIN IN HOSPITAL, VATICAN SAYS

Pope Francis prays in front of the icon of the Madonna del Popolo, venerated by Belarusians and Ukrainians, during the general audience in the Paul VI Hall. Vatican City (Vatican), January 11th, 2023. (Grzegorz Galazka/Archivio Grzegorz Galazka/Mondadori Portfolio via Getty Images)

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The Vatican also said Francis was not running a fever, which Carmelo D'Asero, an infectious disease and geriatric disease expert in Rome, said was not necessarily a positive thing due to the seriousness of his infection.

"A high fever is a sign of an immune response to a pathogen," D'Asero said. "Having a low fever and having a serious bronchial infection ... Is a sign of a decreased immune response and that makes us worry a little bit more, let's say. Maybe if he had a fever, it would have been better."

The Vatican has not said how long the pope might remain in the hospital, saying only that the treatment of such a "complex clinical picture," would require an "adequate" stay.

The Associated Press contributed to this report.

Pope Francis Has Bilateral Pneumonia

Pope Francis, who remains hospitalized, has bilateral pneumonia, the Vatican said on Tuesday.

The term simply means pneumonia in both lungs, said Dr. James Musser, director of the center for infectious diseases at the Houston Methodist Research Institute. He added that, without examining a patient, he could not say anything specific about his condition.

In general, pneumonia is an infection of the small airways of the lungs. As the body mounts an inflammatory response, small pockets in the lungs fill with immune cells; symptoms can include fever, cough and shaking chills. To diagnose the illness, a doctor typically asks the patient to say a long "e," as if the person were singing. Through a stethoscope, the "e" of a pneumonia patient sounds like an "a," said Dr. Paul Pottinger, a professor of infectious diseases at the University of Washington.

Most people with pneumonia recover well at home and do not need to be hospitalized. But for older people, pneumonia can be "a deadly situation," infectious disease experts said.

Dr. Peter Chin-Hong, professor of medicine and infectious diseases at the University of California, San Francisco, added that "the mortality rate goes up after age 85." The pope is 88, and is missing part of one lung after pulmonary surgery in 1957.

The most likely cause of pneumonia is an infection caused by a bacterium, Streptococcus pneumoniae, according to Dr. Chin-Hong. "The No. 1, 2 and 3 cause of pneumonia is strep pneumonia," he said.

The illness can respond to antibiotics, but bacteria can sometimes spill out of the lungs and into the rest of the body, resulting in sepsis, a dangerous situation. A vaccine can help mitigate this sepsis risk but does not prevent the condition, Dr. Chin-Hong said.

Dr. Pottinger noted that, although strep pneumonia can involve both lungs, it usually is confined to one lobe of one lung. Most bilateral pneumonia, he said, is caused by viruses, including influenza, or other bacteria. Other causes include respiratory syncytial virus, or R.S.V., Legionella, mycoplasma and chlamydia, Dr. Pottinger said.

He agreed with Dr. Chin-Hong about the likely gravity of the pope's condition.

"It is a very scary situation," Dr. Pottinger said.

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