The Life-Threatening Complications Of Severe Pneumonia

Pneumonia is a mild, common illness in the US, with cold or flu-like symptoms that can be treated at home. However, it can also be more severe, especially in younger children and older adults. 

Life-threatening complications can develop in severe pneumonia, especially if left untreated. These complications include respiratory failure, organ failure, septic shock, and death. 

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Respiratory failure 

Your lungs can start to fail as a result of pneumonia. The primary function of your lungs is to take oxygen into your body through the air you breathe. Pneumonia can cause the build-up of fluid or pus in your lungs and, in severe cases, damage them. This affects your ability to breathe in air and leads to low oxygen levels in your blood.

Having enough oxygen in your blood is essential to keep your organs working properly. If you don’t have enough oxygen due to respiratory failure, it can be life-threatening because it causes damage to your organs. 

Here are the symptoms to watch out for:

  • Shortness of breath

  • Fatigue 

  • Sleepiness 

  • Not being able to exercise to the level you are typically able to

Respiratory failure is common in more severe cases of pneumonia, where you’ll often already be in a hospital. 

If you’re under the care of a doctor or nurse, they will monitor these signs for you. If you are at home and start to experience these symptoms, seek medical attention. 

Acute respiratory distress syndrome

Acute respiratory distress syndrome¹ (ARDS) is a fast-developing form of respiratory failure. This means the lungs fail to breathe properly, leading to low oxygen levels in your blood, but over a much shorter period. 

ARDS can develop over a few days or less. Because it develops so quickly, it can be life-threatening if not treated early. It leads to fluid in the lungs, which prevents them from expanding when you breathe. 

The water in your lungs causes the same symptoms as a respiratory failure but will have a rapid onset. Also, bubbling or clicking with every breath is a sign of ARDS. 

Because of the fast-acting nature of ARDS, if you are experiencing these symptoms, seek medical attention immediately.

Treatment of ARDS

Severe cases of respiratory failure and ARDS are both treated by supplying oxygen. This would look like an oxygen tube hooked up to your nose. 

In more severe situations, you may also need to be hooked to a ventilator to help you breathe.

Necrotizing pneumonia

If a bacterial infection in the lungs caused by pneumonia gets out of hand, it can lead to necrotizing pneumonia.² This is where the condition starts to damage your lung tissue and leads to pus-filled abscesses forming in your lungs. It affects your ability to take in oxygen and can cause respiratory failure, organ damage, infection, and inflammation. 

The drop in oxygen levels in your blood when you have this condition makes it hard to treat. This is because antibiotics usually travel around in your blood. Surgery to remove damaged tissue and abscesses is an option if antibiotics are not working to treat the infection.

Pleural or lung disorders

The outer lining of your lung is two layers called pleura, with a fluid-filled space called the pleural space between them. The pleural space helps the layers to glide smoothly with every breath. 

A pleural disorder is an infection, which can be caused by pneumonia, that causes blood or air to fill the pleural space. The symptoms of a pleural disorder are similar to pneumonia symptoms:

  • Chest pain

  • Shortness of breath

  • Fatigue 

  • Cough 

  • Fever 

  • Blue skin from lack of oxygen 

  • Rapid heartbeat 

Treatment for a pleural disorder depends on its cause. Sometimes it can be treated with antibiotics and other medications. Sometimes it requires a medical procedure such as draining the fluid from the pleural space, injecting medicine, or surgery. 

If left untreated, a pleural disorder could cause your lung to collapse, sepsis, a trapped lung, or cause your blood pressure to drop to a life-threatening level. If you are experiencing any of the symptoms above, especially if you have a diagnosis of pneumonia, seek medical advice. 

Sepsis/septic shock

When an infection from pneumonia is severe or left untreated, it can travel into the bloodstream. This causes sepsis, or widespread inflammation in the body, potentially leading to organ failure. 

The primary outcome of sepsis is septic shock,³ where the inflammation causes your body to go into shock, and your blood pressure drops rapidly. This low blood pressure can be dangerous because it can affect your heart’s ability to pump blood around your body. This can cause heart failure as well as widespread organ failure and death. 

Signs of sepsis include:

  • Rapid heart rate 

  • Fever or chills

  • Rapid breathing 

If you are experiencing any of the above symptoms, seek medical attention immediately. 

Kidney or heart damage

The kidney and heart are vital organs in your body. The low oxygen levels in your blood as a result of pneumonia and many of its other complications can damage these essential organs. 

Experiencing sepsis and septic shock caused by pneumonia also exposes these organs to high levels of inflammation or low blood pressure. These exposures could damage the kidney or heart. 

The kidney plays a vital role in your body, where it clears the body of toxins and produces urine. Kidney failure can have serious health risks, so if you are experiencing any of the following symptoms and have had pneumonia, you should seek medical attention. 

Symptoms of kidney failure include: 

  • Swelling in the lower legs and feet 

  • Headaches 

  • Itchiness 

  • Little or no urine 

  • Fatigue or trouble sleeping 

  • Joint pain 

  • Confusion 

  • Lack of appetite 

The heart is responsible for pumping blood around your body to all your organs and tissues. There is a measured risk of heart failure following a case of pneumonia, most likely due to the strain on the heart during the illness and any complications from it. 

Rapid heartbeat, low oxygen levels in the blood, low blood pressure, and inflammation from pneumonia and septic shock could all contribute to heart failure.

Symptoms of heart failure include:

  • Shortness of breath

  • Coughing or wheezing 

  • Fatigue 

  • Swelling in your lower legs and feet

  • Increased heart rate 

  • Confusion 

  • Nausea or lack of appetite 

The lowdown 

Pneumonia can lead to life-threatening complications if it is severe or left untreated. These complications can affect the lungs, heart, kidneys, and other organs. 

Mainly caused by the infection spreading and the inability to breathe properly, many of these complications can cause serious harm or even death. Please seek medical attention if you have been experiencing any of the symptoms described throughout this article.


Can pneumonia cause back pain?

Back pain may be a symptom of pneumonia caused by COVID-19⁴ or a pleural disorder caused by pneumonia, such as Empyema necessitans.⁵ Chest pain or a painful cough can lead to pain in the back and shoulders.

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