Pneumonia after a stroke

Pneumonia after a stroke is the most common complication. Its treatment is difficult if it is not diagnosed in a timely manner. Relatives should take preventive measures to prevent the onset of the disease. If infection does occur, a doctor should give recommendations for further therapy.

The causes of the onset of the disease


Pneumonia is diagnosed in half of stroke patients. The likelihood of such a complication increases if the patient is over 65 years of age and has previously suffered from pneumonia or diseases of the cardiovascular system. Overweight contributes to the development of pathology.    

Respiratory disorders are almost always diagnosed with severe brain damage, since this is accompanied by a decrease in immunity and promotes the penetration of microorganisms into the lower respiratory tract.

Pneumonia after a stroke is recorded in people who have fallen into a coma, as well as those who have been on mechanical ventilation for a long time . In addition, the work of the organ is disrupted due to prolonged hospitalization in the supine position. 

In 20% of people, pneumonia develops immediately after hospitalization, in 50% of the disease occurs after 3 days.  

In most cases, the causative agent is bacteria, but if the patient receives antibiotics and glucocorticosteroids , fungal infection is possible. 

The following factors contribute to the appearance of infection in patients:

  • violation of the act of swallowing;
  • tracheal intubation;
  • hypoglycemia;
  • uremia;
  • chronic heart disease;
  • smoking.


The risk of respiratory disorders is increased in patients whose consciousness is less than 9 points on the Glasgow scale, as well as in patients who are ventilated for more than 10 days. 

Development mechanism

Pneumonia is associated with impaired blood flow, which leads to stagnation of fluid in the lungs. This becomes the cause of the growth of pathogenic microflora.

With a stroke in humans , two types of infection are possible: aspiration and stagnant. The first type is associated with a violation of the act of swallowing. As a result, liquid or pieces of food enter the bronchi, which disrupts air circulation.  

The stagnant form occurs due to the supine position of the patient. The reason for its appearance is a violation of blood circulation in the respiratory organs and compression of the chest. These factors impair lung function, which contributes to the accumulation of phlegm in them. 

Symptoms of pneumonia

Increased body temperature

The main symptom of infection is respiratory failure. The patient’s temperature rises to 38 degrees. Chest pain and coughing are also noted. During expectoration, purulent sputum is released. The last symptom is typical for other pathologies of the respiratory system, therefore it is very important that the doctor correctly determines the cause of the appearance of such a symptom.  

Diagnostic features

Timely diagnosis becomes more difficult because early manifestations of pneumonia are often confused with neurological disorders. For this reason, the disease is often detected at an advanced stage.

Pathological processes in the lungs are shown by X-ray and ultrasound of the pleural cavity. If a congestive form is suspected, the patient is given an ECG and an echocardiogram .

For the diagnosis of pneumonia in bedridden patients after a stroke , a blood test is important. When infected, the patient has an increase in the number of leukocytes, neutrophils. However, these figures are overestimated in any critical condition and do not always indicate problems with the respiratory system. More informative is the study of the gas composition of the blood.  

Blood test

Therapy is possible only after installing the pathogen and determining its sensitivity to antibiotics.

Methods for treating pneumonia after stroke

Pneumonia is treated comprehensively. Medicines are selected taking into account the patient’s condition, the causative agent of infection and related diseases.
Therapy includes:

  • antibiotics or antiviral drugs;
  • antipyretic, anti-inflammatory drugs; 
  • expectorant, diuretic drugs; 
  • pain medications;
  • medicines to restore blood circulation.

Mechanical ventilation

In addition to these drugs, the patient needs drugs that support the work of the heart and blood vessels. In the absence of fever, immunotherapy is required .

If the respiratory function is impaired, a patient with a stroke is provided with mechanical ventilation. With a severe form of the disease, detoxification drugs are prescribed . If necessary, undergo a course of infusion of native plasma.  

After starting therapy, the patient should breathe easier after 36 hours. The doctor, constantly checking his condition, can correct the treatment by changing the drugs or increasing their dosage. Recovery is evidenced by:    

  • decrease in the number of leukocytes;
  • decrease in temperature;
  • reduction of expectorated sputum.

Breathing exercises and chest massage are of great importance in the treatment of stroke patients.


If pneumonia is bilateral, the prognosis is negative for patients with cerebrovascular accidents . They rarely survive with this form of the disease. Patients with minor brain damage are more likely to recover if they undergo rehabilitation and remain physically active.  

People older age as a result of suffering a stroke more likely to get complications, compared with the young. Their sputum accumulates more intensively, so respiratory failure occurs faster.  

Prevention of pneumonia after stroke

To prevent the development of respiratory disorders after a stroke, it is necessary to pay sufficient attention to the hygiene of the patient and his belongings. People around you should also use antiseptics.  

Bedridden patients should periodically change their position. They are recommended breathing exercises and any active movements in bed. The patient’s upper torso should be elevated at a 45 degree angle. It is necessary to regularly sanitize the nasopharynx.


If a stroke patient is connected to mechanical ventilation, it is important to use quality tracheostomy tubes.

Possible complications

If pneumonia is left untreated in stroke patients, lung function deteriorates, leading to respiratory failure. Death is more likely in patients with congestive disease.

With untimely treatment of respiratory disorders, the state of a lying patient is complicated by pericarditis, myocarditis and shortness of breath. Mortality is increased if the infection has spread to the heart valves and leads to heart defects.  

The consequence of pneumonia can be sepsis with multiple hemorrhages. This complication occurs with severe intoxication with the microorganisms that caused the disease. One of the most dangerous conditions that are detected in this case is infectious-toxic shock, accompanied by a decrease in blood pressure.   


The likelihood of pneumonia after stroke is quite high, especially among bedridden patients. In order to detect the disease in a timely manner, a hospital stay is required for several days after the attack. This will increase the chances of survival.

event_note June 30, 2021

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