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Hillary Clinton's pneumonia raises questions about diagnosis, treatment

Hillary Clinton is taking a pause in her campaign schedule after her physician announced that the presidential candidate has pneumonia—a diagnosis that raises many questions about how the illness is spread and diagnosed, how it’s treated, and what her recuperation timeframe might look like.

Captured on camera yesterday unsteady on her feet as she made an early departure from a Sept. 11 memorial ceremony in New York, Clinton’s doctor later revealed she’d been diagnosed with pneumonia on Friday after suffering a lingering cough from allergies.

Pneumonia, an infection in the lungs, can be either viral or bacterial. 

Clinton’s personal physician, Dr. Lisa Bardack, said Sunday that the candidate is being treated with antibiotics. She was advised to rest and modify her schedule, but Clinton continued to make campaign stops until Sunday when it was reported she was overheated and dehydrated at the 9/11 event.

Symptoms and diagnosis 

Dr. Marie Budev, a pulmonologist at the Cleveland Clinic, told CBS News that patients with pneumonia first usually develop “non-specific symptoms” – a fever and a cough that’s producing a mix of saliva and mucus that may be colored green or yellow. Sometimes there’s also a little shortness of breath or a feeling of heaviness in the chest.

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“You listen to the lungs and you can hear abnormalities in the lungs. Coarse breath sounds, abnormal breath sounds that don’t sound clear,” explained Budev, who is not involved with Clinton’s treatment. 

The sputum coughed up can  be cultured to help identify the bug, but the diagnosis of the lung infection is classically confirmed by a chest X-ray.

“In a normal chest X-ray, you wouldn’t see anything in the lung field. In pneumonia, you see a whitish area called infiltrate. It shows there’s either fluid, puss or secretions within the bronchial sacs – the lung sacs,” said Budev, who is medical director of the Cleveland Clinic lung transplant program. 

CBS News medical contributor Dr. Tara Narula, a cardiologist at Lenox Hill Hospital in New York, told “CBS This Morning” that pneumonia can range from mild to severe.

“That difference in severity depends on the age of the patient, their underlying health conditions and what type of pneumonia they have,” she explained. 

“What we know is based on a letter that her doctor released last July, in July 2015, that says she has a history of hypothyroidism, seasonal allergies​, prior deep vein thrombosis or blood clots, as well as a concussion that led to a clot​ in the brain [in 2012],” Narula said. Clinton’s doctor said she is up-to-date on her cancerscreenings​ and had a clean bill of health on her most recent cardiac evaluation.

Fainting or losing balance isn’t typically a symptom of pneumonia, said Cleveland Clinic’s Budev. It’s “probably dehydration and exhaustion from having this infection,” she said.

Antibiotics, increased respiration, and fever can also lead to dehydration, said Narula.

Treatment and recovery

When treated with antibiotics, sleep, lots of liquids and stress reduction, most people usually recover from pneumonia within days, but more severe cases may need hospitalization, where intravenous antibiotics can be given.

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“Typically the treatment time is a week to 10 days in a non-complicated case,” Budev said.

Clinton, 68, comes in contact with so many people along the campaign trail that it’s easy to pick up bugs, and hand-washing is pivotal to help avoid infections​​, Budev added. She said she’d also recommend flu​ and pneumonia vaccines after the candidate recovers, to protect her from future illnesses.

This year, she said, “I’m seeing influenza a little bit earlier than what I usually see” – in September, as opposed to October or later.

Overall, she said, “Long term prognosis for someone with a classic case of pneumonia is good – she should do fine. Her first days back she’ll probably be tired but she’ll gain all her strength and energy back,” Budev said.

And for those who are still concerned, Budev noted that the candidates are well cared for. “I think she has been traveling with her physicians with her, or she has one in every city. Their health is unbelievably watched.”

The Clinton campaign said Monday that they will release additional health information​ this week.

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