Beloved Oscar-winning actress Diane Keaton died from pneumonia, according to a statement her family shared with People magazine.
It was not clear if she had any underlying health conditions that contributed to her death on Saturday at 79.
Here’s everything you need to know about the lung infection, what causes it and how it led to Keaton’s death.
What is pneumonia?
Pneumonia is an infection that inflames the sacs in one or both lungs, according to the Mayo Clinic.
Those sacs of air fill with fluid or pus, causing a cough with phlegm or pus, fever, chills and trouble breathing, according to the clinic. The illness can range in seriousness from mild to life-threatening, and can cause death in severe cases.
It is more serious for infants and those over the age of 65. People who have underlying health conditions or weakened immune systems are also at higher risk of severe pneumonia, the Mayo Clinic said.
What causes pneumonia?
Pneumonia can be caused by a variety of pathogens, such as bacteria or viruses.
The immune system typically prevents these germs from causing infection in the lungs, but some can still evade the body’s defenses, even if a person is in good health, according to the Mayo Clinic.
Dr. Ben Singer, a pulmonologist with Northwestern Medicine, said some kinds of pneumonia are caused by bacteria, but most commonly it’s caused by a respiratory virus, such as cold, flu or Covid.
“Walking pneumonia” is caused by a bacterium and is a milder form of the illness, according to the Mayo Clinic.
Patients can develop pneumonia while in the hospital for other reasons, according to the Mayo Clinic. Hospital-acquired pneumonia can be more serious because the bacteria may be antibiotic-resistant and because patients may already have weakened immune systems.
People who are on breathing machines are more vulnerable to catching pneumonia in the hospital, which is why a lot of people who had early variants of Covid died from pneumonia, Singer said.
It is also possible to contract aspiration pneumonia, which happens when someone inhales food, drink, vomit or saliva and is more likely in people whose gag reflexes are functioning abnormally, like if they have a brain injury or swallowing problem or if they are using drugs or alcohol, according to the Mayo Clinic.
What are the symptoms of pneumonia?
Symptoms can range from mild to severe.
In some cases, symptoms can be similar to those of cold and flu but last longer and include:
- Chest pain while breathing or coughing.
- Confusion or changes in mental awareness (in older patients).
- Cough, which may produce phlegm.
- Fatigue.
- Fever, sweating, chills.
- Lower than normal body temperature (in older patients and those with weak immune systems).
- Nausea, vomiting, diarrhea.
- Shortness of breath.
Patients with pneumonia might face complications, including sepsis or bacteria in the bloodstream, difficulty breathing, fluid around the lungs and abscesses in the lungs.
Dr. Humberto Choi, a pulmonologist with the Cleveland Clinic, also noted that other complications can arise, such as pulmonary embolism, arrhythmias or even encephalopathy, which can affect the brain.
Those who have trouble breathing, chest pain, a fever of 102 degree Fahrenheit or a persistent cough should seek medical care, according to the Mayo Clinic.
How does pneumonia cause death?
“It is true that pneumonia tends to be more severe in people who are very, very young — so in infants — or in older adults, and that seems to be the age demographics that tend to experience severe disease, but it certainly can affect anyone,” Singer said.
In Keaton’s case, even if she did not have an underlying condition, “that doesn’t mean that perfectly healthy people can’t become severely ill, rapidly with pneumonia,” Singer said.
Pneumonia is also a very common cause of sepsis, which is when “severe infection creates an overwhelming reaction in the body to try to treat the infection,” Singer said. “The body is trying to kill the infection, but as a consequence, harms the body itself.”
Both can occur quickly, too. When the lungs fail, it causes a syndrome called acute respiratory distress syndrome, or ARDS, which affects the body very fast, as does sepsis, which can progress in a matter of hours to become life-threatening.
Choi noted that low oxygen levels can progress from minutes to hours, and other complications, like a cardiac arrhythmia associated with pneumonia, can occur “very suddenly and out of nowhere.”
How is pneumonia prevented and treated?
Doing things like keeping good hygiene and maintaining a healthy immune system can help protect against pneumonia.
Vaccines to prevent certain types of pneumonia exist and are recommended for children ages 2 to 5, the Mayo Clinic says. In 2024, an independent group of advisers to the CDC voted 14 to 1 to lower the age for routine pneumococcal vaccines to 50.
Doctors caution the vaccines only protect patients from certain types of pneumonia and not all of them.
On the one hand, there are vaccines that prevent against viruses that cause pneumonia, like influenza, Covid and respiratory syncytial virus or RSV, Singer said.
There is also a vaccine that targets a specific bacteria that causes most bacterial pneumonia cases, Singer said, but it is generally recommended for older adults and people with underlying conditions. This vaccine is not administered yearly, but a doctor can advise whether an individual needs a booster after getting the initial shot, he added.
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