The pope is seriously ill with double pneumonia. What does that mean?
“Double pneumonia,” also called bilateral pneumonia, means both lungs are infected. When things are worse, you might hear “multi-lobar,” meaning multiple parts of your lungs are infected.
In pneumonia, the lung sacs where air is exchanged, called alveoli, become inflamed and filled with pus and fluid. This can cause your blood oxygen to go down and might cause you to need breathing support of oxygen or, in severe cases, mechanical support on a ventilator.
Symptoms most often include cough, sputum production, shortness of breath, and fever. Pleurisy, or pain when you breathe, is common. Older people might be too weak to have much of a cough or fever, or just have a new and unexplained confusion or become less alert.
The pope has underlying lung diseases that increase his risk of pneumonia. He had part of a lung removed for infection in 1957 and a previous hospitalization for pneumonia in 2023. Pope Francis has asthmatic bronchitis—recurrent bronchitis triggered by allergies.
The pope also has bronchiectasis, which is the widening of the bronchi, or tubes that carry air to your lungs. This leads to pooling of mucous and increased infections from the bacteria and secretions not being cleared normally. Many things, including chronic obstructive pulmonary disease, autoimmune illnesses, immunodeficiency, and cystic fibrosis, can cause bronchiectasis.
Treatment For Pneumonia
We know no specifics about the pope’s antibiotic therapy. Typically, the choice of antibiotics is guided by culturing a sputum sample and testing it against a variety of antibiotics to see which will kill the bugs that have grown in the culture. Some hospitals have newer technologies like the BioFire FilmArray pneumonia panel, a bacterial polymerase chain reaction assay, which can detect some viruses and atypical organisms like Mycoplasma. Ideally, you want to use the most specific antibiotic possible to limit toxicities and the emergence of more resistant bacteria.
A report about the pope’s progress said, “the drug therapy [that] was strengthened after the multiple infections were diagnosed.” He’s also been receiving oxygen through a simple nasal cannula. Unfortunately, he needed steroids to reduce the lung inflammation or help with asthma. Steroids raise blood sugar and can necessitate insulin for diabetes. It also contributes to the growth of more difficult-to-treat organisms like fungi.
What To Expect For The Pope’s Recovery
The pope was admitted to Rome’s Gemelli hospital on February 14. He was said to have a “complex respiratory infection, involving bacteria, virus and other organisms.” The good news is that he did not have a bloodstream infection or sepsis, which has a mortality rate as high as 50%.
The pope’s physicians indicated that he was not “a not-terribly-compliant patient in the past” and was a workaholic. There are concerns, too, because the pope is overweight and sedentary, which can cause weakness and complications. His difficulty raising secretions and clearing his lungs is a particular concern
If all goes well, Pope Francis is expected to stay in the hospital for another week.
Prognosis Of Pneumonia
Pneumonia is serious at any age, but particularly for young children or the elderly, who have weaker immune systems. Other than childbirth, it’s the most common cause of hospital admissions in the U.S., with a million hospitalizations and 50,000 deaths.
Pneumonia is the eighth leading cause of death and is the leading infectious cause of death in the United States. Hospital-acquired pneumonia has a higher death rate than that acquired in the community. Compared to CAP, HAP’s mortality rate was 11.1% vs. 5.1% in one study.
While the pope is improving, he has a long way to go. Broad-spectrum antibiotics have numerous side effects, including liver inflammation, bone marrow suppression, and debilitating (and sometimes deadly) diarrhea from Clostridium difficile.
Ways To Reduce Your Risk Of Pneumonia
There are a few things you can readily do to stay healthier. First, stay current on immunizations, including COVID-19, influenza, and pneumococcal pneumonia vaccines. The flu shot reduces the risk of subsequent pneumonia by 25-53%. Pneumococcal or Staph pneumonia commonly follow influenza. Effective vaccines against pneumococcal pneumonia are available. Please get them!
Influenza and COVID-19 are both airborne viruses, so masking can markedly reduce your risk of infection, particularly if you wear an N95, KF94s (S. Korean), or KN95s (Chinese). Look for a reputable dealer and learn how to spot fake masks that are not protective.
If you do become ill, particularly if you are elderly, or if you notice a family member with worsening shortness of breath, fever or low body temperature, or confusion, please seek medical care immediately.
