Fluid accumulation in your chest is a known complication of pneumonia. If you or someone you love was diagnosed with pneumonia associated with fluid in the lungs, you can read all about it here. I have personally treated several patients over the last 15 years with fluid in the lungs from pneumonia.
Based on my personal experience as well as a review of the current medical literature, I will explain what it means when you have fluid in the lungs from pneumonia, who is at risk, and what options you have to get rid of that fluid.
What does it mean to have fluid in the lungs from pneumonia?
Pneumonia is an infection of the lungs. It can have many complications. One of the complications of pneumonia is presence of fluids in the chest. Medically, it is called para-pneumonic effusion, which is a type of pleural effusion.
Don’t worry, I will explain in details what that means. I will also tell you where and how the fluid buildup occurs.
Your lungs are covered by a double layered lining. There is a small amount of fluid in-between the two linings. This layer of fluid acts as a lubricant and helps make lung movement smooth.

With pneumonia, sometimes the infection and inflammation may spread out from the lungs to reach the inner lining. The infection may then involve the layer of lubricating fluid. To fight the infection, your body tries to send more white blood cells in the area where the lubricating fluid lives. To do that, they widen the gap in the small arteries that supply blood to the area. More white blood cells rush to the area and take extra fluids with them. Eventually, fluid buildup begins in the lungs.
As you can see, fluids in the lungs from pneumonia builds up in-between the two layers. This area is medically called pleural space, and that’s why this type of fluid buildup is called pleural effusion. When pleural effusion is caused by pneumonia, it is called para-pneumonic effusion.
Symptoms of fluids in the lungs from pneumonia
If you would like to review different types of pneumonia and their symptoms, please read this article. Symptoms of fluids in the lungs from pneumonia come together with the symptoms of pneumonia. If you already have pneumonia and are having these additional symptoms, you need to be concerned about possible fluids in your lungs from pneumonia.
Here are those symptoms:
- You have a new pain in your chest: This is usually a sharp pain that gets worse when you take a deep breath.
- You fevers start to go up again after initially coming down.
- It starts to hurt every time you cough.
- Your heart rate starts to go up.
- You start breathing faster.
- Worsening shortness of breath since initial diagnosis
Who is at risk for getting fluids in the lungs from pneumonia?
Medical research has identified different groups of people that are at a higher risk of getting fluid buildup in the lungs from pneumonia.
Here are those gruops:
- People who had a delay in starting antibiotics for their pneumonia: Those who were diagnosed late and received antibiotics more than six days from the start of pneumonia had higher risks of getting fluids in the lungs from pneumonia.
- People with a history of alcoholism: Alcoholics are more likely to develop fluids in the lungs from pneumonia than non-alcoholics
- Malnourished people: People who are malnourished are also more likely to get fluids in the lungs from pneumonia
- Low sodium: If your sodium is lower than 130 mg/dl, you are at a high risk of getting fluids in the lungs
- History of drug abuse: If you have a history of drug abuse, especially injections, you are at a higher risk of getting fluids in the lungs from pneumonia.
- Very high inflammatory markers: There are certain blood tests that indicate the level of inflammation in the body. When you have very high levels of these inflammatory markers, you are more likely to get fluids in the lungs.
How to get rid of fluids in the lungs from pneumonia?
Except in cases of small amounts of fluids in the lungs, it is important to get that fluid drained. To be more specific, if the layer of fluids in the lungs is higher than 10mm with the patient lying down, it needs to be drained. The longer the fluids stay in your chest, the higher the chances of complications.
If there are only a moderate amount of fluids, and the fluids are flowing freely, they can be simply drained with a small needle. These days, it is customary to use an ultrasound or CT scan to visualize the path of the needle to make sure it is going to the right spot. With continued antibiotics, a one-time drainage may be enough for a small, uncomplicated fluid buildup from pneumonia.
After getting the fluids drained, they are sent to the lab for a chemical analysis and a culture. The results will help guide further treatment.
For more thicker fluids with pockets of pus, more invasive surgical options may need to be considered. A procedure called thoracoscopy is usually performed first. They use a flexible scope with a camera to look into the pleural space. This is space where the fluid in the lungs builds up. They insert the tube through a small cut in-between the ribs. Once it is in place, they can suck the fluid out. They can also cut and break down fibers to open up pockets of trapped fluids and drain those as well.
In conclusion, fluid in the lungs from pneumonia can make you very sick. The longer you wait to get treated for pneumonia, the higher your chances of having complications such as fluids in the lungs. The fluid is usually trapped in-between the two layers of the lining of your lungs. It is important to get that fluid drained out if there is a significant amount.
References:
https://www.ncbi.nlm.nih.gov/books/NBK534297/