Pope Francis has been hospitalised for more than a week with what many media outlets are now referring to as “double pneumonia”.
The 88-year-old Pontiff has a long-standing history of respiratory issues, including the removal of part of his lung in his youth.
But what exactly is double pneumonia, and why is it considered more serious than other forms of pneumonia? More importantly, how is it treated, especially in older adults with underlying health concerns?
Double Pneumonia: What It Is and What It’s Not
Double pneumonia, medically termed bilateral pneumonia, is a severe infection that affects both lungs. It causes inflammation and reduced oxygen absorption. Knowing what it is—and isn’t—in addition to its location in the lungs helps recognise symptoms and the need for prompt treatment.
Double Pneumonia Is:
- An infection that affects both lungs simultaneously.
- Causes inflammation of the alveoli (tiny air sacs responsible for gas exchange).
- This leads to fluid or pus buildup in the alveoli, reducing oxygen absorption.
- It presents symptoms such as persistent cough, chest pain, shortness of breath (dyspnoea), fever, chills, fatigue, and sometimes bluish skin (cyanosis).
- It can be caused by bacteria, viruses (like influenza or COVID-19), or fungi.
- Often more severe than regular pneumonia due to the extensive impact on lung function.
- It may require oxygen therapy or hospitalisation if breathing is significantly affected.
- It needs urgent treatment with antibiotics, antifungals or antivirals to avoid complications.
Double Pneumonia Isn’t:
- Unilateral pneumonia, which only affects one lung.
- A mild respiratory infection.
- Limited to a single cause, it can result from bacterial, viral, or fungal infections.
- A condition that always resolves independently or with non-invasive medical treatment.
- Bronchitis or other upper respiratory infections that affect the airways, not the alveoli in the lungs.
- A common cold or flu.
Causes of Double Pneumonia
Different germs, such as bacteria, viruses, or fungi, can cause double pneumonia. In Pope Francis’s case, reports say multiple types of germs are responsible for the infection, which is known as a polymicrobial infection. This makes treatment more challenging because each germ may require a different medicine for effective treatment.
Common causes include:
Various microbes—bacteria, viruses, or even fungi—that invade the lungs and cause infection can trigger double pneumonia.
Bacteria are usually the main culprits. A common one is Streptococcus pneumoniae, but it’s not the only offender. Other bacteria, like Haemophilus influenzae and Staphylococcus aureus, can cause severe lung infections.
Viruses can be just as problematic. The flu, RSV (a common cold-like virus), and even COVID-19 can lead to pneumonia. Sometimes, these viral infections spread to both lungs, making breathing even harder.
Fungi are a less common cause, but they can still be dangerous — especially for people with weakened immune systems. Fungi like Histoplasma or Cryptococcus can cause lung infections that are tough to shake off.
Risk factors that increase susceptibility include:
While double pneumonia can affect anyone, some people are at a higher risk of serious illness.
Older adults are at higher risk because, as we age, our immune systems naturally slow down. This makes it harder for the body to fight off infections, meaning illnesses like pneumonia can hit harder and take longer to recover from.
Chronic health conditions can also make people more vulnerable. Conditions like chronic obstructive pulmonary disease (COPD), diabetes, or heart failure can weaken the body’s defences and make it easier for pneumonia to take hold.
Weakened immune systems are another significant risk factor. People going through cancer treatments, those living with HIV/AIDS, or anyone taking immunosuppressive medications have a more challenging time fighting off infections, making pneumonia more dangerous.
Past respiratory issues can add to the risk, too. In Pope Francis’s case, he had part of his lung removed in his youth due to pleurisy, which means his lungs might not function at full capacity, making him more susceptible to serious lung infections like double pneumonia.
Symptoms and Diagnosis
Double pneumonia is serious because it affects both lungs, making it harder for the body to get enough oxygen. The symptoms can be intense and often feel worse than those of a common respiratory infection.
One of the first signs is a persistent cough, which often produces thick or discoloured mucus as the lungs try to clear the infection. High fever and chills usually follow—your body’s way of fighting the disease—and can leave you feeling shaky, sweaty, and exhausted.
Another common symptom is shortness of breath. With both lungs inflamed, even simple tasks like walking across the room can leave you gasping for air. Sharp chest pain is common, often worsening with deep breaths or coughing.
The infection also causes extreme fatigue and weakness, leaving you completely drained.
In older adults, symptoms can be less noticeable. Instead of fever or a strong cough, they may show signs of confusion, drowsiness, or delirium, making the infection harder to spot early.
Diagnostic approaches:
When double pneumonia is suspected, several tests are used to understand what’s happening inside the lungs.
It begins with a physical examination. Using a stethoscope, the doctor listens for crackling sounds (rales) or quiet areas, indicating fluid build-up or inflammation.
Next, come the imaging tests. A chest X-ray often reveals cloudy patches (infiltrates) in both lungs. If more detail is needed, a CT scan provides a clearer view and can help detect complications.
Laboratory tests are used to identify the cause. A full blood count (FBC) checks for signs of infection, while analysis of blood or mucus (sputum) samples can show whether bacteria, viruses, or fungi are responsible.
Finally, your lungs are assessed for functioning. A pulse oximeter, clipped onto your finger, measures oxygen levels. At the same time, an arterial blood gas (ABG) test gives a more detailed look at how efficiently your lungs absorb oxygen and expel carbon dioxide.
Treatment Options
Treating double pneumonia requires a combination of approaches to help the lungs recover and fight the infection.
If bacteria are suspected, antibiotics are typically the first step. Broad-spectrum antibiotics are used initially, and the dosage is adjusted once test results identify the specific cause. Antiviral or antifungal medications are also prescribed if a virus or fungus is responsible.
Supportive care is also crucial. Oxygen therapy helps with breathing, IV fluids maintain hydration, and fever reducers like paracetamol manage high temperatures. In severe cases, mechanical ventilation may be needed to assist breathing until the lungs heal.
Prognosis and Recovery
The prognosis of double pneumonia varies based on several factors:
- Age and existing health conditions play a significant role. Older adults and people with issues like heart disease, diabetes, or chronic lung problems often face a stricter recovery and a higher risk of complications.
- Timing is everything. Catching double pneumonia early and starting treatment quickly can make a huge difference. The sooner the infection is treated, the better the chances of a smoother recovery.
- The severity of the infection also matters. If both lungs are heavily affected or complications like sepsis or acute respiratory distress syndrome (ARDS) develop, recovery can take longer.
In Pope Francis’s situation, his advanced age and history of partial lung resection present additional challenges. However, with comprehensive medical care, including antimicrobial therapy and supportive measures, recovery is achievable, though it may be protracted.
Breathe Easier with Manse Medical
Manse Medical specialises in diagnosing, treating, and managing complex respiratory conditions like double pneumonia. We offer advanced services such as lung function tests and imaging. Our expert respiratory physicians provide tailored care for acute and chronic lung issues, ensuring optimal recovery and long-term support.
Contact us today for expert care and comprehensive treatment if you or a loved one are experiencing respiratory concerns.
