What Are the Complications of Pneumonia?

Medically Reviewed by Poonam Sachdev on May 14, 2024
Written by Frances Gatta, Kate Rope, Amy Gopal
10 min read

When you get pneumonia -- whether it comes from bacteria, a virus, or a fungus -- there's a chance it could lead to other medical troubles. Learn the signs of complications of pneumonia and how to treat them.

Is pneumonia deadly?

Pneumonia can be deadly if it causes complications such as:

  • Respiratory failure
  • Sepsis
  • Bacteremia, where bacteria enter the blood
  • Lung abscesses, which are pus-filled spaces in the lung
  • Kidney failure
  • Lung failure
  • Heart rhythm problems

However, this isn't the case for most people, especially if they get treatment early enough. You’re more likely to have a deadly pneumonia if you:

  • Are under age 2 or over 65
  • Have other serious conditions such as heart or kidney disease
  • Have a weakened immune system
  • Need artificial respiration
  • Got pneumonia while in a hospital
  • Were taking antibiotics in the months leading up to your case of pneumonia

What is bacteremia?

Bacteremia is when bacteria are in your blood. It may happen in daily activities such as brushing and flossing your teeth, after dental and medical procedures, and with an infection such as a urinary tract infection. It usually doesn’t cause symptoms, and the immune system removes the bacteria in healthy people.

However, if your immune system doesn’t work as it should to remove the bacteria from the blood and if the bacteria increase, bacteremia can lead to an infection in the blood. Left untreated, it can progress to other more serious and life-threatening conditions such as sepsis, septic shock, and multiple organ dysfunction syndrome. 

Bacteremia and pneumonia

If bacteria caused your pneumonia, they could get into your blood, especially if you didn't see a doctor for treatment.

Bacteremia risk factors

Bacteremia can happen to anyone but often occurs in children with common bacterial infections such as strep throat.

Older people with more than one health condition at a time, especially those who stay in community centers or are being treated in a hospital, are also at risk. 

Bacteremia symptoms

People with bacteremia usually show no symptoms, or they have a mild fever. But if bacteremia progresses to a more serious condition such as sepsis or septic shock, your symptoms may include:

  • Chills
  • Nausea
  • Vomiting
  • Fast heart rate
  • Low blood pressure 
  • Stomach pain
  • Diarrhea
  • Rapid breathing
  • Fever

Get immediate medical help if you show these symptoms.

Bacteremia treatment

Bacteremia is treated with antibiotics when it causes an infection or sepsis. Doctors may also remove any sources of bacteria, such as a catheter put in the body during treatment. 

Septic shock and pneumonia

Bacteremia from pneumonia can lead to a serious situation known as septic shock. It's a reaction to the infection in your blood, which can cause your blood pressure to drop lower than normal.

When your blood pressure is too low, your heart may not be able to pump enough blood to your organs, and they can stop working. Get medical help right away if you notice symptoms such as:

Your doctor will test your blood for bacteria and treat you with antibiotics if you have bacteremia. You may get treated in the hospital for bacteremia or septic shock.

Pneumonia can lead to complications that involve the lungs, including lung abscesses, pleural effusion, and respiratory failure.

What are lung abscesses?

Lung abscesses are pockets of pus in your lungs. It's more likely to happen if you:

Men and older people are more likely to get lung abscesses. Tell your doctor if you have any of these symptoms:

Your doctor can test your mucus or the pus in your lungs to look for infection. They may also take an X-ray or a CT scan of your lungs.

Your doctor will likely treat your lung abscesses with antibiotics. They may do a procedure that uses a needle to remove the pus.

Pleural effusion and pneumonia

There are two layers of tissue surrounding your lungs called the pleura. One wraps around the outside of your lungs and the other lines the part of your chest where your lungs sit. They help your lungs move smoothly when you breathe.

If your pneumonia isn't treated, the pleura can get swollen, creating a sharp pain when you breathe in. If you don't treat the swelling, the area between the pleura may fill with fluid, which is called a pleural effusion.

You may not have any symptoms when you have pleural effusion. If you do, your symptoms may include:

  • Shortness of breath
  • Chest pain
  • Cough
  • Fever
  • Chills
  • Hiccups
  • Rapid breathing

You’re more likely to show symptoms as the fluid buildup increases.

Empyema and pneumonia

If the fluid from pleural effusion gets infected, it leads to a problem called empyema. Tell your doctor if you're having any of these symptoms:

Chest pain that gets worse when you breathe, cough, or sneeze

  • Pain that travels to your back or shoulder
  • Fever
  • Difficulty breathing
  • You don't want to breathe deeply because it hurts

Your doctor may look for swelling or fluid with an X-ray, ultrasound, or CT scan. They might also give you an EKG to ensure that a heart problem isn't the cause of your chest pain.

What is pleurisy?

Pleurisy is when the pleura or tissue around your lungs becomes inflamed. It can cause you to have sharp chest pains.

A doctor will likely treat pleural effusions, empyema, and pleurisy by treating the pneumonia. They may prescribe antibiotics.

If you have pleurisy, you may need medications that can stop the swelling.

For pleural effusions and empyema, your doctor may also suggest a procedure that removes fluid from your body with a needle.

Respiratory failure and pneumonia

When you have pneumonia, your lungs can fill up with fluid. If that happens, they won't be able to transfer enough oxygen to your blood or get rid of the carbon dioxide in your blood. It's a serious condition because your organs need oxygen to work.

If your pneumonia is severe or you're in the hospital to treat it, your care team will watch you for signs of this rare -- but life-threatening -- complication.

You're more likely to get respiratory failure if you're hospitalized, have a weak immune system, have a history of alcoholism, or if you're elderly.

Get medical help right away if you have any of these symptoms:

  • Fast breathing or not being able to breathe fully
  • Feel like you cannot get enough air
  • Racing or irregular heart rate
  • Confusion
  • A bluish tint to your skin, fingertips, or lips
  • Extreme restlessness
  • Anxiety
  • Fatigue
  • Sweating
  • Losing consciousness

To figure out if you're in respiratory failure, your doctor may use tools such as X-rays, CT scans, blood tests, and pulse oximeters. The best way to treat it is to get more oxygen, either through a tube in your nose or a mask that your doctor places over your mouth and nose. You may also get medications to treat any infection that is causing the problem.

Pneumonia can also lead to problems that affect how well your kidneys work, like acute kidney injury and, eventually, kidney failure.

Kidney failure and pneumonia

If you have bacteremia or septic shock, your heart may not be able to pump enough blood to your kidneys. It's not a common complication of pneumonia, but it's serious because your kidneys will stop working if they're not getting enough blood.

Your odds of getting kidney failure are higher if you're in the hospital or have other medical conditions on top of your pneumonia.

Kidney failure symptoms

As your kidneys stop working as well as they should, you may start having symptoms such as:

  • Itchiness
  • Swelling in the legs, feet, or ankles
  • Headaches
  • Tiredness
  • Sleep problems
  • Loss of sense of taste
  • Nausea and vomiting 
  • Not feeling hungry
  • Unintentionally losing weight
  • Not peeing enough or at all
  • Muscle cramps, weakness, or numbness
  • Joint pain or stiffness
  • Memory problems
  • Confusion
  • Difficulty focusing

Get medical help immediately if have these symptoms. 

Kidney failure treatment

Your doctor can see if your kidneys are working by looking at how much you're peeing and testing your urine or blood. Your doctor will treat the cause of your kidney failure, and in extreme cases, you may need to have your blood cleaned through a dialysis machine until your kidneys are working again.

Your doctor may also recommend a kidney transplant to restore kidney function.

Pneumonia can cause complications that involve the heart, especially in older adults, including heart attack, irregular heartbeat, and heart failure, all of which may lead to death.

Heart failure and pneumonia

Research shows that 30% of people admitted to a hospital for pneumonia later on develop heart-related complications such as heart failure within 10 years of being discharged.

Some possible reasons for heart problems include bacteria that enter the heart, the stress of the illness increasing the chance of having a heart problem, or your body not sending enough oxygen to your organs. The chances of having a heart problem related to your pneumonia are higher if you are elderly, are in the hospital, or already have a heart condition.

Heart failure symptoms

You may not have any symptoms as heart failure begins. When symptoms start, they can include:

See a doctor immediately if you have at least two symptoms, whether you have heart problems or pneumonia.

Heart failure treatment

Your doctor can look for heart failure by listening to your heart, testing your blood, or checking the results of an X-ray, EKG, echocardiogram, CT scan, or MRI. 

Although heart failure has no cure, many medications, procedures, and heart-healthy lifestyle changes can help manage it.

Depending on whether your heart failure is left-sided or right-sided, your doctor may prescribe medications such as:

  • Medicines that remove excess sodium and fluid from your body, such as diuretics
  • Medicines that relax blood vessels so that your heart can more easily pump blood, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)
  • Medicines that lower your heart rate so your heart can pump blood better and stop heart failure from worsening, such as beta-blockers
  • A medicine called digoxin that helps your heart pump more blood. A doctor will only prescribe it in cases of serious heart failure that other medicines can’t manage. 

In some serious cases, you may need surgery that implants a medical device such as a pacemaker or mechanical heart pump to help your heart work better.

A heart transplant may be best for you if you have life-threatening heart failure that other treatments can't manage.

Lifestyle changes that may help manage heart failure include:

  • Reduce how much salt you take to reduce fluid buildup, which can affect your heart health.
  • Stay physically active and ask your doctor how much activity you should include in your day.
  • Try to sleep regularly and well. See a doctor if you can’t sleep better despite practicing sleep hygiene, such as sleeping in a cool, dark, quiet room.
  • Quit smoking. You can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848) or visit the CDC’s recommended resource for quitting.
  • Avoid or limit how much alcohol you take.
  • Manage any heart conditions that may worsen heart failure, such as blood pressure and heart rhythm problems.
  • Manage your stress levels with relaxation exercises such as deep breathing and journaling. See a therapist or other mental health professional if you need help managing your stress levels.

Pneumonia may lead to serious complications that may be life-threatening or affect how well you can function. You may be more at risk for these complications if you’re an older adult, have a weakened immune system, or have underlying health problems such as heart or kidney disease. See a doctor as soon as you can if you have serious symptoms such as chest pain, shortness of breath, swelling of the legs and hands, and unintentional weight loss or gain.

What is the most common complication of pneumonia?

The most common pneumonia complications are respiratory failure, sepsis, organ failure, bleeding problems, and worsening of existing medical conditions.

When is pneumonia life-threatening?

Pneumonia is life-threatening if it causes complications such as sepsis, septic shock, and organ failure.

What are the danger signs of pneumonia?

Signs of pneumonia include:

  • Cough, which could produce mucus that may be green, yellow, or red/pink
  • Fever
  • Shaking chills
  • Sweating
  • Shortness of breath
  • Rapid, shallow breathing
  • Chest pain that feels sharp or stabbing and hurts more when you cough or breathe deeply
  • Loss of appetite
  • Tiredness
  • Nausea 
  • Vomiting
  • Confusion 

See your doctor to get help for your symptoms.