Q&A about bacterial pneumonia, illness that caused death of beloved actress

A newly released death certificate shows that Oscar-winning actress Diane Keaton died from bacterial pneumonia at the age of 79. As fans remember her films, including “Annie Hall,” “Reds” and “The First Wives Club,” some are wondering how a relatively common ailment took such a toll on the beloved star.

Amanda Overstreet, D.O., is a geriatrician at MUSC Health in Charleston, South Carolina. In this Q&A, she discusses bacterial pneumonia and its impacts.

Q: What is bacterial pneumonia?

A: It's an infection of the lung tissue from bacteria. The common bacteria that cause pneumonia in older adults are streptococcus pneumonia, haemophilus, influenza and staphylococcus aureus.

Q: How do people get infected?

A: There are several ways. One is that older adults are just at higher risk of developing pneumonia, often because of chronic conditions that they might have. Things like underlying lung disease or heart disease or if they're smokers can make them more susceptible. The same way that any of us can get sick is the way an older adult can get sick. It's just that those patients are more at risk because of their age and medical problems.

Q: What is pneumonia doing in the body as it progresses?

A: Oftentimes, the pneumonia is impacting the body's ability to take in oxygen. It can lead to respiratory failure – lung failure. Also, whenever your body has any infection, you're at risk for a syndrome called sepsis. That’s the body's response to an overwhelming infection. And sepsis can impact all of your organs, not just the organ where the primary infection is.

Q: How do you treat it?

A: For someone like Diane Keaton, who had a bacterial pneumonia, she likely received IV antibiotics. Antibiotics are tailored to the most common causes of bacterial pneumonia. For someone that's really sick, that will be IV antibiotics in the hospital. For someone who is more stable and doing OK, that might be antibiotics by mouth out of the hospital.

Q: How do you know if you have pneumonia?

A: The big things would be signs of any respiratory illness. So things like cough, shortness of breath, a fever, would prompt someone to be examined and to make sure that it's not something serious like a pneumonia. 

In Diane Keaton's case, we don’t know if she had any underlying medical conditions that made her more at risk for pneumonia but also for things like sepsis.

Q: Can a vaccine prevent bacterial pneumonia?

A: Definitely, yes. There are a few pneumonia vaccines against several of the most common strains of bacterial pneumonia. The vaccine provides protection for people who get the vaccine, but there’s also some protection in terms of herd immunity. So the more people that get the pneumonia vaccine, the less likely it is to be transmitted within the community. 

Our rates of community-acquired pneumonia for older adults are lower in the United States than in Europe because we actually have better vaccination rates for pneumonia in the United States.

Q: What message do you want to leave people with?

A: Vaccines reduce your risk of getting pneumonia and also reduce your chances of having a bad outcome from a pneumonia or from getting seriously ill from pneumonia.

Pneumonia is responsible for 1.5 million hospitalizations each year. So it's not unusual for adults with pneumonia to be hospitalized.