What is it?

Pneumonia is an infection of the lung tissue caused by a variety of bacteria or viruses primarily affecting the microscopic air sacs known as the alveoli. The more common types of pneumonia encountered by athletes are atypical pneumonia (also known as walking pneumonia) and community-acquired pneumonia (CAP). Pneumonia can occur in all age ranges, but most often affects young children or elderly adults at a rate of about 10-30 people per 1000 per year.

 

Symptoms

Symptoms of pneumonia may include:

• Cough

• Breathing faster

• Chest pain

• Wheezing

• Fevers or night sweats

Runny nose and sore throat are unlikely to be associated with pneumonia.

 

People at risk are the following:

• Alcoholics

• History of lung disease

• Smokers

• Travelers

• Street-drug users

 

Sports Medicine Evaluation & Treatment

A sports medicine physician will gather some information regarding symptoms and review them. He or she will examine the patient’s ears, throat and nose and then listen to the heart and lungs. The patient should have his or her oxygen level checked if pneumonia is a concern. A chest x-ray may be considered, and other tests could include checking urine, sputum and blood.

Based on the patient’s symptoms and results, the physician will decide if the patient can be treated at home or in the hospital. If the infection is caused by a bacteria, the treatment options usually include one or more antibiotics. In an athlete, a physician will most likely not use a fluoroquinolone antibiotic, as that type of antibiotic has the potential side effect of tendinitis and/or tendon rupture. Other potential treatments may include oral steroids or treating symptoms with over-the-counter medications like decongestants, cough suppressants, ibuprofen and acetaminophen among others.

 

Injury Prevention

There are 2 types of pneumococcal vaccines available in the United States, which are generally used in older adults, but for other specific patients as well. The Advisory Committee on Immunization Practices recommends that your pneumococcal vaccine is up to date. In those older than 65, it is recommended to receive both the PCV13 (Prevnar 13) first, followed in twelve months by the PPSV23 (Pneumovax). This protects against the most common bacterial agent, which is streptococcus pneumoniae. Receiving the flu shot is also important in preventing a viral pneumonia. The physician will assess whether vaccination is appropriate, and if so, which one is appropriate. General infection precautions are also recommended including frequent hand washing and not sharing food or drink with ill individuals.

 

Return to Play

Return to play should be gradual and allowed only after fever has subsided and the patient the patient’s conditioning has improved to meet the demands of the sport.

AMSSM Member Authors
Rathna Nuti, MD and Chris Chong, MD

References
Fields KB, Thekkekandam TJ, Neal S. Wheezing after respiratory tract infection in athletes. Current Sports Medicine Reports. 2012; 11(2):85-89. doi:10.1249/JSR.0b013e31824a78fc.
Kaysin A, Viera A. Community-Acquired Pneumonia in Adults: Diagnosis and Management. American Family Physician. 2016;94(9):698-706.
Metlay J, Kappor W, Fine M. Does this patient have community-acquired pneumonia. JAMA. 1997; 278(17): 1440-1445.