Symptoms of dry pneumonia

The course of an atypical or dry pneumonia is highly dependent on the causative pathogen and the immune system of the patient. In the end, the mortality rate in this disease is also dependent on this. In most cases, the course of the disease is a gradual one without a real acute phase.

In retrospect, the patient is not able to determine the exact beginning of the disease. The symptoms of dry pneumonia are in most cases not as impressive as in classical pneumonia. The fever does not rise as high, the coughing irritation is much less pronounced and the blood tests do not usually show excessively high inflammation values.

On the other hand, headaches are the predominant physical symptom in atypical pneumonia. The affected person therefore coughs less than in typical pneumonia, with no or only little sputum.One speaks also of Reizhusten, which occurs at night more frequently. Headaches and aching limbs often occur.

A general exhaustion with reduced drive is typical for adults, for children an increased whining and increased attachment. Usually there is no increase in body temperature (fever), or only a slight one (<39°C). A chill due to fever occurs in only a few patients.

It is precisely this circumstance that often leads to a visit to a doctor only a few weeks after the onset of the disease. The risk of infection is largely dependent on the “aggressiveness” of the pathogen and the patient’s immune system. Since the pathogens for pneumonia must reach the lungs via the respiratory tract in most cases in order to trigger pneumonia, coughing is one way of transmitting the pathogens.

However, since the coughing irritation is generally less pronounced in dry pneumonia than in typical pneumonia, the risk of infection is lower. In the X-ray image, atypical or dry pneumonia differs from typical pneumonia in the diffuse distribution of the inflammatory infiltrate. The water and mucus infiltrations cannot be clearly limited to one lung lobe, but are present across borders.

This is referred to as interstitial pneumonia, whereas in typical pneumonia the most likely signs are lobar pneumonia. The whole lung appears whitish in the X-ray image and there are hardly any black areas within the lung that would indicate normal, non-inflamed lung tissue. The CT usually confirms what can already be seen in the x-ray.

However, computed tomography is only indicated if the x-ray does not provide clear findings, as otherwise the CT will result in unnecessarily high radiation exposure for the patient. However, with its three-dimensional viewing capability, CT also offers the option of detecting structures or changes that would be hidden by the inflammatory infiltrate in the X-ray image. As a standard procedure, however, no CT should be performed, but rather the X-ray image should always be preferred in order to keep radiation exposure as low as possible.

However, if abscesses or empyema are detected, this could indicate other pathogens, which would then have to be treated differently therapeutically. If you would like to know more about computed tomography of the lungs, it is particularly interesting to note that the change in the blood count is only slightly indicative of an inflammation. While in a typical pneumonia there is a strong increase in leukocytes and the inflammation markers C-reactive protein and calcitonin, these values are by far not as high in atypical pneumonia.

The values may still be in the upper range of the normal value, but in most cases they exceed it. Nevertheless, the laboratory values do not suggest that it is a pneumonia affecting the entire lung. Even if it is not a direct laboratory parameter, it is an indication that is much less elevated in atypical pneumonia than in typical pneumonia.