Statistics Korea recently released the “2024 Cause of Death Statistics,” naming cancer, heart disease, and pneumonia as the three leading causes of death in the country last year.

Pneumonia has a very high mortality rate among older adults. For those aged 65 and older hospitalized with pneumonia, about one in five patients die. If the disease worsens, its lethality increases.

Professor Ryu Ho-jun of the Department of Respiratory Medicine at Daejeon Eulji Medical Center explained thatsevere pneumonia requiring intensive care unit admission can kill 35 to 50 percent of patients.

Pneumonia differs significantly from the common cold or bronchitis.

Colds and bronchitis cause mild inflammation in the upper or lower respiratory tract. Symptoms are usually mild and often resolve with basic care or self-recovery.

Pneumonia involves severe inflammation of the lung tissue caused by pathogens such as bacteria, viruses, or fungi. Symptoms are more severe, often requiring antibiotics and sometimes hospitalization. In children and adolescents, viral pneumonia usually improves quickly with treatment.

With age, the risk of severe bacterial or drug-resistant pneumonia rises. Symptoms may start like a cold—cough, phlegm, fever—but with pneumonia, they typically worsen rather than improve and can include shortness of breath, chest pain, diarrhea, or headache.

In older adults, pneumonia symptoms are often subtle, with little fever or cough, and may appear mainly as a loss of appetite or energy. These can be mistaken for aging, so reduced appetite, fatigue, or mental dullness should raise suspicion of pneumonia even in the absence of cold symptoms.

This awareness is crucial for early diagnosis and prompt treatment of pneumonia. “Many patients with symptoms like low energy and poor appetite are monitored at home. They often receive a pneumonia diagnosis too late, when they finally visit the hospital. Caregivers often regret this, so it must be kept in mind,” Professor Ryu emphasized.

There is another important aspect regarding pneumonia treatment: bacterial and viral pneumonia require different management. Viral pneumonia treatment focuses on supportive care, such as fluids, antipyretics, and oxygen. Antiviral medications are sometimes used to treat viruses such as influenza or COVID-19.

Bacterial pneumonia is treated primarily with antibiotics. In practice, distinguishing bacterial from viral pneumonia at the start is difficult, and both can occur together, so antibiotics are usually started while further tests determine the exact cause.

The duration of antibiotic treatment for pneumonia varies depending on the patient's condition and the cause. Mild community-acquired pneumonia usually requires at least five days of antibiotics. In severe pneumonia, or with complications or poor responses to treatment, it can last more than two weeks, sometimes several months.

For this reason, patients should never stop antibiotics on their own. “Even if symptoms improve, the bacteria may not be completely eliminated, and stopping medication midway significantly increases the risk of developing resistant bacteria,” Ryu said. “Patients must consistently take antibiotics for the full prescribed duration as directed by their doctor.”

Even after people recover from pneumonia, lung tissue takes time to return to normal. During this process, patients may continue to experience a dry cough or fatigue for up to two months, reflecting natural post-inflammatory recovery.

Professor Ryu advised patients to check for secondary infections or sequelae if their cough worsens again, persists for over two months, or if fever returns.