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how do you know if pneumonia is viral or bacterial?

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Well, for a certain type of pneumonia caused by Klebsiella pneumoniae, the sputum (the stuff you hack up) will have a distinct reddish color. This means that a bacteria, K. pneumoniae, contributes to the pneumonia.

For less obvious examples, doctors will sometimes (getting to that later) order a sputum sample to a) look under the microscope for things that don't belong and b) try to grow whatever is causing the pneumonia on a petri dish. Bacteria and fungi can be seen under the microscope after staining. Viruses cannot be seen on the scopes most hospitals use to look at slides. Bacteria and fungi grow on petri dishes. Viruses do not. However, some bacteria are extremely picky and do not grow well on petri dishes, so a 'clean culture' does not necessarily equal no bacteria.

Thus, if there is some bacterial cells/ fungal filaments under the microscope of the sputum sample, then you know it's bacteria/fungus.

However, you may ask, if there isn't, then what?
An expert on iVillage says, "it would be impossible for a physician to be certain that you had viral pneumonia" and that a bout of viral pneumonia predisposes the lungs to a bacterial infection. As a result, many doctors prescribe antibiotics, just in case the culprit is bacterial and to prevent bacterial pneumonia after the body fights off the viral one.

Best of health!
Tetraoxygen
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