Pneumonia in Immunocompromised Patients: Overview, Causes of Pneumonia, HIV/AIDS

RSV And Other Lung Problems

Respiratory syncytial virus (RSV) is an infection that affects your lungs, nose, throat, and breathing passages. You get it when infected droplets enter your nose, eyes, or mouth. This might happen when someone with the virus coughs or sneezes near you. Or you may touch an infected surface or shake hands with someone who has it.

For people who are healthy, symptoms of RSV are typically similar to the common cold and include:

Congested or runny nose

Dry cough

Low-grade fever

Sore throat

Sneezing

Headache

But sometimes RSV can be severe. When this happens, the infection reaches down into your lungs and bronchial tubes (the tubes that let air in and out of your lungs). This causes more serious symptoms including:

Wheezing

High fever

Severe cough

Problems breathing, especially when lying down 

Bluish skin due to lack of oxygen in your blood

This more severe form of RSV also causes inflammation in the lungs and bronchial tubes, which causes infections such as pneumonia and bronchiolitis, as well as other complications. 

People at a higher risk of RSV complications include:

Infants under 6 months old, especially those born premature 

Children with congenital heart disease (heart disease they've had since birth) 

Children with chronic lung disease

People of any age with weakened immune systems 

Children with neuromuscular disorders such as muscular dystrophy

Adults with heart disease or lung disease

Adults age 65 and older

RSV pneumonia is pneumonia that happens because of an RSV infection. Pneumonia is an infection of the lungs. RSV is the most common cause of pneumonia. When you have pneumonia, the air sacs (alveoli) in your lungs fill with pus and fluid, making it hard to breathe.

Although viral pneumonia is often less serious and shorter in duration than bacteria pneumonia, RSV-caused pneumonia can still be life threatening. 

It can take several days for pneumonia symptoms to show up. Some of the symptoms may be hard to tell apart from those of RSV. Viral pneumonia can cause:

Fever

Dry cough

Headache

Muscle pain

Weakness

Typically the symptoms continue to get worse for a time. Your fever may go up, your cough may get worse, and you may have blue lips. Infants with pneumonia may vomit or just appear lethargic and have no energy. In older adults, pneumonia may affect their mental state, causing confusion.

To diagnose you with pneumonia, your doctor will listen to your lungs. They may also order tests such as:

Blood test to see what germ could be causing the infection

Chest X-ray to look for inflammation

Pulse oximetry to see how much oxygen is in your blood

Sputum test (test of the mucus you cough up) to see what could be causing the infection

People at higher risk (immunocompromised, very young, or older adult) may need additional tests such as:

CT scan to look more closely at the lungs

Arterial blood gas test to get a more accurate measure of the oxygen in your blood

Pleural fluid culture, which tests the fluid around your lungs

Bronchoscopy, a procedure that uses a thin, flexible tube with a small camera on the end to look at your airways 

Because RSV pneumonia is caused by a virus, antibiotics can't treat it. A doctor may prescribe an antiviral medication. Typically you treat the infection with rest, fluids, oxygen, and symptom management.

Bronchitis is an inflammation of the bronchi, or large airways to your lungs. Sometimes bronchitis is called a chest cold. When RSV infects your bronchi, it can cause bronchitis.

Acute bronchitis lasts about 10 days and causes symptoms similar to a cold, such as:

Cough

Coughing up mucus (sputum) that's clear, white, yellowish-gray, green, or rarely, bloody

Fatigue

Shortness of breath

Slight fever and chills

Chest discomfort

You may also have body aches or a headache. 

Sometimes it can be difficult for your doctor to tell the difference between the early days of bronchitis and the common cold. To diagnose you with bronchitis, your doctor will listen to your lungs with a stethoscope. They may also give you tests such as:

Chest X-ray to look at your lungs for pneumonia or another condition that causes cough

Sputum test to test the mucus you cough up. This shows if bacteria are causing your cough (which means your bronchitis is not RSV-caused). 

Pulmonary function test, where you blow into a device called a spirometer. It measures how much air you can hold in your lungs and how quickly you can blow it out. 

Older children and adults are more likely to get bronchitis. Younger children tend to get bronchiolitis instead.

Bronchiolitis is the inflammation of the smaller airways to your lungs called bronchioles. It's also caused by a viral infection, commonly RSV. When bronchioles swell with bronchiolitis, it's harder to breathe.

Bronchiolitis is the most common respiratory infection in children younger than 2. Infections are at their peak in winter and early spring months. 

Early symptoms are similar to those of the common cold. 

They include:

Runny nose

Mild fever 

Cough

Fatigue

Fussiness or irritability in infants

Once the infection settles into the bronchioles, you may have breathing problems such as:

Rapid or shallow breathing

Wheezing

Grunting noises when breathing

Flaring of the nostrils when breathing

Bronchiolitis can be life-threatening if it keeps you from breathing well. You can't treat it with antibiotics since it's caused by a virus. Typically, the infection clears on its own, but you can treat your symptoms with fluids, extra oxygen, saline for congestion, and pain reliever/fever reducer medications.

Asthma is a chronic lung disease that causes swelling and narrowing of your airways. When you have asthma, your airways are sensitive to viruses, allergens, irritants, or even emotions. 

Babies who get RSV are more likely to have asthma later in life. Babies who avoid RSV have a 26% lower risk of developing asthma by age 5. Based on these findings, doctors suspect RSV may trigger asthma for the first time in some people. Once you get asthma, you have it for life.

People who have asthma may have more severe asthma symptoms when they have RSV, too. 

Respiratory failure happens when your lungs aren't able to get enough oxygen into your blood. Respiratory failure can happen because of the inflammation caused by RSV. Your symptoms may develop slowly over time. 

Your body doesn't get enough oxygen when you're in respiratory failure. Symptoms of low oxygen include:

Being too tired to do daily activities such as getting dressed or taking a shower

Feeling short of breath or like you can't get a deep enough breath (called air hunger)

Drowsiness

Bluish fingers, toes, or lips

You may have a buildup of too much carbon dioxide, which can cause:

Blurred vision

Confusion

Headaches

Rapid breathing

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of your lungs. Like other related conditions of RSV, it narrows your airways and makes it hard to breathe. 

Because your lung function is already weak when you have COPD, RSV symptoms can hit harder and put you at higher risk of RSV complications. Studies show that when compared to the effect of bacterial infections on COPD, viral infections such as RSV are more severe, last longer, and cause more severe inflammation in your lungs. 

Advanced lung disease like COPD increases your risk of hospitalization when you have RSV. You may have to be on a ventilator to help you breathe, and some die from the infection. 

RSV has a connection to conditions outside your lungs, too. Congestive heart failure is a long-term condition that happens when your heart can't pump blood as well as it needs to so that your body has a normal supply. This makes blood and fluid collect in your lungs and legs. 

Like RSV, congestive heart failure makes breathing more difficult and may cause a dry cough. Symptoms also include:

Shortness of breath, especially at night

Chest pain

Heart palpitations (the feeling that your heart is "skipping a beat")

Fatigue when you're active

Swelling in your ankles, legs, and abdomen

Weight gain

Having to pee at night 

A full (bloated) or hard stomach

Loss of appetite 

Nausea

If you have congestive heart failure, your risk of being hospitalized for RSV goes up eightfold. This is because your lung inflammation, caused by RSV, puts an additional strain on your heart.

Your heart tissue gets more inflamed, which makes your heart symptoms worse. As your body fights the RSV, your blood pressure goes up, you're more likely to get blood clots, and your heart muscle can swell or scar. 

COVID-19 is also a type of respiratory virus with similar symptoms to RSV. 

Both RSV and COVID can cause:

But typically COVID-19 is more likely to also cause:

Aches

Loss of taste or smell

Fatigue

Sore throat

Although both viruses can cause trouble breathing, RSV is more likely to cause wheezing, which is rare in COVID-19.

If you get RSV, it can lower your immune defenses and increase your chances of getting COVID-19. You might get them at the same time, which can make COVID-19 worse. If your doctor thinks you have COVID-19, they can give you a simple nose swab to confirm your diagnosis. 

You can tell RSV has become more severe and/or caused a complication such as pneumonia or bronchiolitis if you have symptoms such as: 

Trouble breathing, such as pauses in between breaths or short, shallow, fast breathing

Flaring (spreading out) of the nostrils while breathing

Wheezing or noisy breathing

High fever (above 100.4 in babies)

Skin or lips turning blue or gray

Changes in your breathing or skin color, especially if you also have a fever, are signs it's time to see a medical professional when you have RSV. In babies, you may notice a lack of energy and more fussiness. They may have fewer wet diapers and lack tears when they cry, which are signs of dehydration.  

If you have these symptoms, contact a doctor right away or call 911. 

RSV is an infection of your lungs, nose, throat, and breathing passages. It can cause similar symptoms to the common cold. These symptoms get worse as RSV becomes more severe.

In healthy children and adults, RSV is usually mild. But in older adults, very young babies, immunocompromised people, or those with chronic lung or heart disease, symptoms can become severe and cause complications. 

Pneumonia, bronchitis, bronchiolitis, and respiratory failure are common complications of severe RSV. 

COVID-19, asthma, COPD, and congestive heart failure can worsen if you get RSV. You're at a higher risk of hospitalization if you get RSV when you have these conditions. 

How is RSV different from a cold? The virus that causes the common cold tends to stay in your upper respiratory system (head cold). RSV is more likely to move down into your lower respiratory system (chest cold). You're more likely to wheeze with RSV, and symptoms of RSV usually get worse before they clear. 

How common is RSV? Nearly every baby under the age of 2 will get RSV. In adults, RSV is the most common cause of lower respiratory infections. Each year, 60,000-120,000 older adults are hospitalized and 6,000-10,000 die from RSV infection.

How can I help prevent RSV? A single dose of the RSV vaccine is suggested if you're 75 or older. Experts also recommend the vaccine for adults 60 to 74 years old and up who are at high risk for severe RSV disease. You can also get the RSVpreF (Abrysvo) vaccine if you're pregnant. This is the only RSV vaccine approved for pregnant people. Babies under 8 months can get an RSV antibody immunization shot. Practice good hygiene by covering your coughs and sneezes and washing your hands often.

Lung Cancer Can Affect Anyone, Even Non-Smokers

It was the summer of 2020, and I was extremely worried about COVID-19 and how it would impact my health if I caught it. I had no idea that on top of that, I would have to worry about a stage 4 lung cancer diagnosis.

I was completely shocked and had no idea where this diagnosis came from. I thought that only smokers got this disease, and I was not a smoker nor was I around people who smoked. I went through a lot of different testing and throughout the testing process was even told that it was not cancer. I know a lot of people who went to therapy, and I had never considered anything like that until I got diagnosed. Not only had I been tested physically, but mentally as well. I needed help, and lots of it.

A strong support system is needed when going through situations like that, and I definitely had a strong village. A lot of my relationships have shifted during my diagnosis, but I couldn't let it affect me too much; I had to keep moving forward. When you get sick, a lot of things change in your life, and the things that seem important no longer are.

I started my initial treatment in August of 2020. Over the course of the years, I have had six different chemotherapy treatments, immunotherapy, radiation, and three clinical trials. One thing that really helped me a lot throughout this process was getting a dog. He was like an emotional support animal for me, and I became more active when I took him on walks and played with him. I was told that unfortunately, I would never be cured of the disease, but it could be treated. I was not happy with that, but I really had no choice but to accept it.

One day I was having a conversation with my pulmonologist, and she thought that I would be a good candidate for a double lung transplant. This program is considered a clinical trial that would remove the cancer from the lungs by having this transplant. I went through all of the testing required for the program and got approved for the transplant. I had the transplant, which was by far the most difficult procedure that I had ever done.

I was told that I was cancer-free and everything was going great. About two to three months later, things somehow changed. My lung cancer had returned with my new lungs, and this time it had spread to my spine, which was totally new for me. I was still glad that I got the surgery because there was a difference in how I felt before surgery versus after surgery. There are still a lot of unanswered questions regarding how and why the cancer returned.

I am currently undergoing treatment, which consists of chemo and sometimes radiation. I still seem to be doing pretty well, considering all things. I do deal with pain from time to time because of my spine. I am currently working on increasing my advocacy by sharing my story and working with different organizations to help educate others.

I feel that it is very important to let the world know that no matter how healthy you think you are, if you have lungs, you can potentially develop lung cancer.

This piece reflects the author's personal experience and perspective. For medical advice, please consult your health care provider.

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Pope Francis Has Pneumonia In Both Lungs, Vatican Says

Pope Francis has bilateral pneumonia, Vatican says

Pope Francis has been diagnosed with bilateral pneumonia in both lungs shared the Vatican Tuesday. "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," a Vatican statement said.

ROME - Pope Francis has developed pneumonia in both lungs, according to new tests, the Vatican said on Tuesday. The respiratory infection also involves asthmatic bronchitis which required the use of cortisone antibiotic treatment. 

Pontiff receiving treatment

What we know:

Francis was admitted to Rome's Gemelli hospital in "fair" condition last Friday after his bronchitis worsened.

A general view shows the statue of Pope John Paul II outside the Policlinico A. Gemelli Hospital, where Pope Francis is hospitalised for tests and treatment for bronchitis, on Feb. 18, 2025, in Rome, Italy. (Photo by Antonio Masiello/Getty Images)

Medical personnel found that the pope was suffering from a polymicrobial respiratory tract infection. 

Dig deeper:

A polymicrobial respiratory tract infection means a mix of viruses and bacteria and possibly other organisms have colonized in a patient's respiratory tract. 

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

What they're saying:

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

What we don't know:

The Vatican hasn't provided any information about how Francis is responding to any of the drugs he has been given other than to say he isn't running a fever.

"A high fever is a sign of an immune response to a pathogen," Dr. Carmelo D'Asero, an infectious disease and geriatric disease expert in Rome, 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."

What is pneumonia?

Bronchitis can lead to pneumonia, which is a deeper and far more serious infection of the lungs' air sacs. Pneumonia can develop in part of one lung or an entire lung or both lungs. It tends to be more serious when both lungs are affected because there isn't healthy lung tissue to compensate.

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

Lung removed

The backstory: Francis had part of one lung removed after a pulmonary infection as a young man and is prone to bouts of bronchitis in winter. He has admitted in the past that he is a non-compliant patient, and even his close Vatican aides have said he pushed himself too far even once his bronchitis was diagnosed. 

He refused to let up on his busy schedule and ignored medical advice to stay indoors during Rome's chilly winter, insisting on sitting through an outdoor Jubilee Mass for the armed forces on Feb. 9 even though he was having trouble breathing.

Francis' hospital admission this year has already sidelined him for longer than a 2023 hospitalization for pneumonia.

The Source: Information for this article was gathered from The Associated Press. This story was reported from Los Angeles.

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