pneumonia classification

Submitted to Faculty of computer and information Menoufia University.

In Partial Fulfillment of the Requirements for the Degree of BSc.

Prepared By:

1. Mahmoud Mostafa Hawash

2. Aya Osama Haswa
3. Mahmoud Hany
4. Moshira Nasser

Students in the Department of Information System Faculty of computer and

information, Menoufia University.
Supervisor:
Dr. Mohamed Adel
Dr. Mina Ibrahim
 The lecturer in faculty of computers and information system, Menoufia
university.

Abstract:
Pneumonia is a common acute respiratory infection that affects the alveoli
and distal airways; it is a major health problem and associated with high
morbidity and short-term and long-term mortality in all age groups
worldwide. Pneumonia is broadly divided into community-acquired
pneumonia or hospital-acquired pneumonia. A large variety of
microorganisms can cause pneumonia, including bacteria, respiratory
viruses and fungi, and there are great geographical variations in their
prevalence. Pneumonia occurs more commonly in susceptible individuals,
including children of <5 years of age and older adults with prior chronic
conditions. Development of the disease largely depends on the host
immune response, with pathogen characteristics having a less prominent
role. Individuals with pneumonia often present with respiratory and
systemic symptoms, and diagnosis is based on both clinical presentation
and radiological findings. It is crucial to identify the causative pathogens,
as delayed and inadequate antimicrobial therapy can lead to poor
outcomes. New antibiotic and non-antibiotic therapies, in addition to rapid
and accurate diagnostic tests that can detect pathogens and antibiotic
resistance will improve the management of pneumonia.
chapter1: Introduction…………………………………………………….. 4
1.1 Introduction: …………………………………………………….. 4
1.2 Problem Introduction: …………………………………………… 5
1.3 Objectives: ….……………………………………………………. 8
1.4 Stakeholders: ……………………………………………………... 10
1.5 Significance of the Study: ………………………………………… 10
1.6 Aims and Scop: ………………………………………………….... 11
Chapter2: Planning & Requirements……………………………………….. 13
2.1 Development Requirement: ……………………………………….. 13
2.2 Launching Requirement: ………………………………………….. 14
2.3 Feasibility Analysis: ………………………………………………. 15
2.3.1 Technical Feasibility: ……………………………………….. 15
2.3.2 Economical Feasibility: ……………………………………. 15
2.3.3 Organizational Feasibility: ………………………………….. 15
2.4 Cost, Budget: ……………………………………………………… 16
2.5 Risk List: ………………………………………………………….. 17
Chapter3: Design Specification……………………………………………… 19
Chapter4: Implementation…………………………………………………… 40
Chapter5: Conclusion………………………………………………………… 59
future improvements………………………………………………………….. 61
 chapter1: Introduction

1.1 Introduction:
Pneumonia is an inflammation of the air sacs in the lungs
(alveoli) and the surrounding tissue. It often leads to a
sudden high fever, the feeling that you are very unwell, a
cough and shortness of breath.
Because pneumonia is usually caused by bacteria, it can
generally be treated effectively with antibiotics.
Vaccinations that can prevent infection by certain germs
are also available.
People who are otherwise in good health generally
recover within a few weeks. But pneumonia shouldn't be
taken too lightly: it can last one or sometimes even
several months until you are back to full strength.
Pneumonia may sometimes have life-threatening
complications, especially if you have already been
weakened by another illness. Pneumonia can also be
dangerous for babies and older people.

Pneumonia is a form of acute respiratory infection that

affects the lungs. The lungs are made up of small sacs
called alveoli, which fill with air when a healthy person
breathes. When an individual has pneumonia, the alveoli
are filled with pus and fluid, which makes breathing
painful and limits oxygen intake.
Fast facts on pneumonia:
 Pneumonia is an infection of the lungs that can
cause mild to severe illness in people of all ages.
 It is the leading cause of death due to infection in
children younger than 5 years of age worldwide.
 Pneumonia and influenza together are ranked as
the eighth leading cause of death in the United
States.
 Those at high risk of pneumonia include older
adults, the very young, and people with underlying
health problems.

1.2 Problem Introduction:

Symptoms
The signs and symptoms of pneumonia vary from mild to
severe, depending on factors such as the type of germ
causing the infection, and your age and overall health.
Mild signs and symptoms often are similar to those of a
cold or flu, but they last longer.
Signs and symptoms of pneumonia may include:
 High fever and chills
 Physical weakness and a strong feeling that you are
unwell.
 Cough with phlegm (sputum)
 Shortness of breath and rapid breathing.
 Racing pulse.
  Chest pain when you breathe or cough.
 Confusion or changes in mental awareness (in
adults age 65 and older).
 Cough, which may produce phlegm.
 Fatigue.
 Fever, sweating and shaking chills.
 Lower than normal body temperature (in adults
older than age 65 and people with weak immune
systems).
 Nausea, vomiting or diarrhoea.
 Shortness of breath.
The symptoms don't always all occur at the same time.
Particularly children and older people may not show
some symptoms, or other, less typical symptoms such as
diarrhoea, stomach pains or drowsiness and confusion
might be more noticeable.

Pneumonia is an infection that inflames the air sacs in

one or both lungs. The air sacs may fill with fluid or pus
(purulent material), causing cough with phlegm or pus,
fever, chills, and difficulty breathing. A variety of
organisms, including bacteria, viruses and fungi, can
cause pneumonia.
Pneumonia can lead to inflammation of the lining that
covers the lungs (pulmonary pleura). That causes severe
pain when you cough or breathe. Fluid can also collect
between the lungs and the chest wall, which makes
breathing even more difficult. Another possible
complication is a lung abscess, the formation of a pus-
filled space in the lung.
Life-threatening complications such as heart rhythm
problems, circulatory collapse, respiratory or heart
failure, or septicaemia are also possible. The risk of
complications is greater if you:
 are under 2 years old or over 65,
 have other diseases such as heart or kidney disease,
 have a weakened immune system,
 need artificial respiration,
 contracted the disease in a hospital, or
 were already treated with antibiotics in the months
before you developed pneumonia.

1.3 Objectives:
The goal of treatment for community-acquired
pneumonia (CAP) is to get rid of the infection and
prevent complications. Initial treatment of CAP with
antibiotics is based on which type of organism is likely to
be causing pneumonia (called "empiric" treatment). Most
people improve with empiric treatment.
Hospital versus home care — Most people with CAP
are treated at home with oral antibiotics. People who are
seriously ill or are at increased risk for complications
may be hospitalized. Hospital monitoring usually
includes measurement of your heart rate and breathing
rate, temperature, and oxygen levels. People who are
hospitalized usually get intravenous (IV) antibiotics
initially. When they start improving, they can usually be
switched to antibiotic pills.
Some people need extra oxygen (given through small
nasal tubes or a face mask) to help them breathe more
easily. People who are still having a hard time breathing
may need a breathing tube connected to a machine called
a "ventilator." Some people who need to stay in the
hospital are also given steroid medications to help reduce
inflammation in the lungs. (This medicine is not the same
as the steroids athletes take to build up muscle.)
The number of days a person needs to stay in the hospital
varies and depends on the person's responds to treatment
and underlying medical problems. Some people,
including people with previous lung damage or disease, a
weakened immune system, or infection in more than one
lobe of the lungs (called multi lobar pneumonia), may
take longer to recover and require a longer
hospitalization.
Antibiotic choice - A number of antibiotic treatment
regimens exist for treatment of CAP. The choice of
which antibiotic to use is based upon several factors,
including your underlying medical problems and the
likelihood of being infected with a type of bacteria that is
resistant to specific drugs.
People with certain medical problems and those who
have used antibiotics in the past three months have a
higher risk of infection with drug-resistant bacteria. For
all antibiotic regimens, it is important to finish the entire
course of medication and take it exactly as directed.
1.4 stakeholders:
Anyone who suspects that they have pneumonia should
seek medical care as soon as possible. Pneumonia is a
serious illness that can be life-threatening if not treated,
especially for people who are older than 65 years, abuse
alcohol, have underlying medical problems, or have a
weakened immune system.
If you develop any of the following symptoms, you
should see your health care provider promptly:
●Fever and cough with phlegm that does not
improve or worsens
●New shortness of breath with normal daily
activities
●Chest pain with breathing
●Feeling suddenly worse after a cold or the flu
●Confusion along with respiratory symptoms (as
listed above).

1.5 Significance of the Study:

The lungs are made up of small sacs called alveoli,
which fill with air when a healthy person breathes.
When an individual has pneumonia, the alveoli are
filled with pus and fluid, which makes breathing
painful and limits oxygen intake. Pneumonia is the
single largest infectious cause of death in
children worldwide.

Little consideration is given to the ethical issues

involved in the prolongation of the life of a person
whose quality of life may be exceedingly
 poor. Studies of pneumonia should more clearly
identify patients who should be treated and, if
possible, cured, and those to whom the infection
comes as a friend indeed.

1.6 Aims and Scope:

Pneumonia is the only journal to focus exclusively on

pneumonia. Publishing original research, case reports,
reviews, commentaries and
correspondence, Pneumonia provides an international
forum for the exchange of knowledge by scientists and
clinicians involved in studying the etiology and
pathogenesis of pneumonia, as well as its diagnosis,
epidemiology, treatment and prevention. The journal's
scope extends to research on lung infections and
diagnosis, inflammation and immunity, microbial
pathogenesis and viral-bacterial interactions.

Cutting-edge research, insightful reviews and dedication

to the community make Pneumonia an essential resource
for clinicians, researchers, respirologists and allied
professionals involved with infectious diseases.
Studies of pneumonia should more clearly identify
patients who should be treated and, if possible, cured,
and those to whom the infection comes as a friend
indeed.

Types:

Pneumonia types differ depending on their cause. The

different types and their associated causes include:
  Bacterial pneumonia: Many bacterial strains can
cause pneumonia, but the most
common is Streptococcus pneumoniae (S.
pneumoniae). A doctor may refer to pneumonia
resulting from this strain as pneumococcal
pneumonia.
 Viral pneumonia: Viral causes of
pneumonia include Trusted Source the respiratory
syncytial virus and influenza types A and B.
 Fungal pneumonia: This can result from Trusted
Source
Trusted Source .
Centers for Disease Control and Prevention (CDC)

 Governmental authority

a condition such as valley fever, caused by

the Coccidioides fungus.
 Aspiration pneumonia: This type occurs as a result
of inhaling food, liquids, or stomach contents into
the lungs. Aspiration pneumonia is not contagious.
 Hospital-acquired pneumonia: This can occur in
people receiving hospital treatment for other
conditions that involve use of a respirator or
breathing machine.
Regardless of the cause of pneumonia, the signs and
symptoms will be similar.
Pneumonia is typically due to infectious pathogens, such
as bacteria and viruses. These pathogens can spread via
coughing and sneezing or by contaminating surfaces that
people touch.
In most cases, a person contracts pneumonia-causing
pathogens by breathing them into the small air sacs, or
alveoli, within their lungs. The immune system responds
by sending white blood cells to attack the infection,
which triggers inflammation of the alveoli. The alveoli
fill with fluid and pus, causing pneumonia.

Chapter2: Planning and

Requirement

2.1 Development Requirement

Your doctor will start by asking about your medical

history and doing a physical exam, including listening to
your lungs with a stethoscope to check for abnormal
bubbling or crackling sounds that suggest pneumonia.
If pneumonia is suspected, your doctor may recommend
the following tests:
 Blood tests. Blood tests are used to confirm an
infection and to try to identify the type of organism
causing the infection. However, precise identification
isn't always possible.
 Chest X-ray. This helps your doctor diagnose
pneumonia and determine the extent and location of
 the infection. However, it can't tell your doctor what
kind of germ is causing the pneumonia.
 Pulse oximetry. This measures the oxygen level in
your blood. Pneumonia can prevent your lungs from
moving enough oxygen into your bloodstream.
 Sputum test. A sample of fluid from your lungs
(sputum) is taken after a deep cough and analyzed to
help pinpoint the cause of the infection.

2.2 Launching Requirement:

To launch any system, have some specific

functionality. The following Launching
requirements are identified for the better
performance of the system, you need to upload
project files on web server, you need to promote
your project to get customers, domain name and
payment getaway:
Figure2Launching Requirement

Figure1 SoftwareDevelopmentLifeCycle
2.3 Feasibility Analysis:

2.3.1Technical Feasibility
 It will use flutter, firebase, deep learning using
vgg16 and resent50 and UI / UX
 The project will be simple.
2.1.2 Economic Feasibility
 The project will cost 500$
 It will save time and profit for doctors and
patients.
2.3.3Organizational Feasibility
 Doctors and patients can operate with the
system.
 It will be easy to use.

2.4 Cost, Budget:

The cost of treating community-acquired pneumonia

Community-acquired pneumonia (CAP) is responsible
for an average of 4.5 million visits annually to
physicians' offices, emergency departments, and
outpatient clinics. However, there have been few studies
using national data on the costs of treating CAP. Without
such data, it is difficult to assess whether new therapies
and treatment strategies are needed to improve patient
outcomes. We conducted a retrospective analysis based
on national incidence data and paid claims data for
patients treated for CAP to assess the frequency of
services rendered and costs to the health-care system.
Records were selected for the study based on a primary
diagnosis of CAP according to the International
Classification of Diseases, 9th Revision. Incidence data
were derived from the National Health and Nutrition
Examination Survey III. Medicare was the primary
source of data for patients aged > or =65 years. Data
from the National Healthcare Cost and Utilization
Project, the National Ambulatory Medical Care Survey,
and the National Hospital Ambulatory Medical Care
Survey were used to determine the cost of treating
patients aged <65 years. We arrived at a total cost of $4.8
billion for treating patients aged > or =65 years and $3.6
billion for treating patients aged <65 years. These
calculations were based on the following: 1.1 million
hospital discharges resulting in inpatient costs of $4.4
billion (52.4% of the $8.4 billion) for the 0.6 million
patients aged > or =65 years and $3.1 billion (36.9% of
the $8.4 billion) for the 0.5 million patients aged <65
years. The average hospital length of stay was 7.8 days
with an average cost of $7166 for patients aged > or =65
years and 5.8 days with an average cost of $6042 for
younger patients. Room and board represented the largest
percentage of the average hospital bill for patients with
CAP. Inpatient physician service costs were $305 million
and $192 million for the > or =65 and <65 groups,
respectively. Based on 1.1 million outpatient office visits
for those aged > or =65 years and 3.3 million visits for
those aged <65, total outpatient costs were $119 million
and $266 million, respectively. Given the overwhelming
cost burden for CAP in the hospital setting, any new
therapy that allows patients to be treated in the outpatient
setting could result in significant savings, especially for
patients aged > or =65 years.

2.5 Risk list:

A risk factor is something that enhances your odds of
getting sickness or condition. It can develop symptoms
of pneumonia with or without the risk factors noted
below.
However, the higher risk factors a person has, the greater
are the chances of developing pneumonia. If you tend to
have numerous risk factors, consult your doctor about
what you can do to degrade your risk. It is essential to
know that anyone can get pneumonia, but certain groups
have a higher risk. These groups include:
 Infants from birth to 2 years old.
 Individuals of age 65 years and older.
 Individuals with weakened immune systems
because of illness or use of medications, such as
steroids or even certain cancer drugs.
 Individuals with particular chronic medical
conditions, such as cystic fibrosis, asthma, diabetes,
or heart failure.
 Individuals who have latterly had a respiratory
infection, such as a cold or the flu.
 Individuals who have been lately or are currently
hospitalised, essentially if they were or are on a
ventilator.
  Individuals who have had a stroke, have problems
swallowing or have a condition that causes
immobility.
 Individuals who smoke, utilise particular types of
drugs or drink extreme masses of alcohol.
 Individuals who have been exhibited to lung
irritants, like pollution, fumes, and certain
chemicals.
CERTAIN FACTORS CAN ALSO INCREASE
YOUR RISK OF PNEUMONIA, SUCH AS:
 Having a weakened immune system. This is usually
a problem for people with HIV/AIDS, who are
alcoholic, have had an organ transplant, or have
undergone chemotherapy or long-term treatment
with steroids or other immunosuppressant drugs.
 Being hospitalised or being on a ventilator
 Having a chronic condition including asthma,
chronic obstructive pulmonary disease, structural
lung disease and heart disease
 Smoking

SMOKING AND DRUGS

People who smoke have a much bigger risk of developing
pneumonia. If a person stops smoking, the risk will gradually
reverse to standard. Nevertheless, this might take as long as ten
years.
People are also at risk for pneumonia if they are constantly
exposed to second-hand/passive smoking. For instance, kids in a
household where the adults usually tend to smoke also have
higher rates of pneumonia than children who live in smoke-free
homes.
Alcohol and drug use can put an individual at a much higher risk
of pneumonia. Similar to alcohol, drug use can boost your
chance of getting pneumonia and other infectious diseases. The
uncertainty of pneumonia progresses among people living in
congested situations, such as students in dormitories, people
residing in establishments, military personnel in barracks, and
even people inhabiting nursing homes.

Chapter3: Design Specification

user Interface:
 Splash screen
In a splash screen there is a graphical control
element consisting of a window containing a logo of
app.
 Login screen

In Login screen there is a form to user use it to login

 Sign up screen

In sign up screen there is a form to user use it to

sign up
 Home screen

In home screen there is a summary and what is

pneumonia and some note and bottom navigation
bar.
 Scan screen

In scan screen there is a button to pick x-ray for

gallery and display the result in screen and bottom
navigation bar.
 Info screen

In info screen there is a symptoms and precautions

of pneumonia and bottom navigation bar.
 About us screen

In about us screen there is an information about us

and bottom navigation bar.
 Profile screen

In profile screen there is information about user and

bottom navigation bar.
 Chapter4: Implementation

In this project we used flutter and many package,

firebase, deep learning using vgg16 and resent50 and
linking deep learning with flutter using tflite.
Dataset: Download the dataset from this url. The dataset
contains Test, Train, Validation folders. We will use test
and train datasets for training our model. Then we will
verify our model using the validation dataset.

Transfer learning (TL): It is a technique in deep

learning that focuses on taking a pre-trained neural
network and storing knowledge gained while solving one
problem and applying it to new different datasets. In this
article, knowledge gained while learning to recognize
1000 different classes in ImageNet could apply when
trying to recognize the disease.
VGG16: It is an easy and broadly used Convolutional
Neural Network (CNN) Architecture used for ImageNet
which is a huge visible database mission utilized in
visual object recognition software research. that was
proposed by the Visual Geometry Group at the
University of Oxford in 2014. The name "VGG" stands
for "Visual Geometry Group."

The VGG16 architecture is made up of 13 convolutional

layers and 3 fully connected layers. The input to the
network is a 224x224 RGB image.
The first 2 layers are convolutional layers with 64 filters
of size 3x3 and a stride of 1. The third layer is a max
pooling layer with a pool size of 2x2 and a stride of 2.
The next 2 sets of layers are similar to the first, with two
convolutional layers with 128 and 256 filters
respectively, followed by a max pooling layer.
The fourth set has 3 convolutional layers with 512 filters
followed by a max pooling layer. The final set has 3
convolutional layers with 512 filters followed by a max
pooling layer.
The output of the convolutional layers is then flattened
and fed into the fully connected layers.
The first fully connected layer has 4096 neurons,
followed by a dropout layer with a dropout rate of 0.5,
and then another fully connected layer with 4096
neurons, followed by another dropout layer with a
dropout rate of 0.5, and finally a fully connected output
layer with 1000 neurons, corresponding to the number of
categories in the ImageNet dataset.
The VGG16 architecture has been shown to achieve
state-of-the-art results on a variety of image
classification tasks.
It is widely used as a base model for transfer learning in
computer vision applications. The VGG16 model has
approximately 138 million parameters.
ResNet stands for Residual Network and is a specific
type of convolutional neural network (CNN) introduced
in the 2015 paper “Deep Residual Learning for Image
Recognition” by He Kaiming, Zhang Xiangyu, Ren
Shaoqing, and Sun Jian. CNNs are commonly used to
power computer vision applications.

ResNet-50 is a 50-layer convolutional neural network

(48 convolutional layers, one MaxPool layer, and one
average pool layer). Residual neural networks are a type
of artificial neural network (ANN) that forms networks
by stacking residual blocks.
ResNet-50 Architecture
The original ResNet architecture was ResNet-34, which
comprised 34 weighted layers. It provided a novel way to
add more convolutional layers to a CNN, without
running into the vanishing gradient problem, using the
concept of shortcut connections. A shortcut connection
“skips over” some layers, converting a regular network
to a residual network.
The regular network was based on the VGG neural
networks (VGG-16 and VGG-19)—each convolutional
network had a 3×3 filter. However, a ResNet has fewer
filters and is less complex than a VGGNet. A 34-layer
ResNet can achieve a performance of 3.6 billion FLOPs,
and a smaller 18-layer ResNet can achieve 1.8 billion
FLOPs, which is significantly faster than a VGG-19
Network with 19.6 billion FLOPs.
The ResNet architecture follows two basic design rules.
First, the number of filters in each layer is the same
depending on the size of the output feature map. Second,
if the feature map’s size is halved, it has double the
number of filters to maintain the time complexity of each
layer.
Special characteristics of ResNet-50
ResNet-50 has an architecture based on the model
depicted above, but with one important difference. The
50-layer ResNet uses a bottleneck design for the building
block. A bottleneck residual block uses 1×1
convolutions, known as a “bottleneck”, which reduces
the number of parameters and matrix multiplications.
This enables much faster training of each layer. It uses a
stack of three layers rather than two layers.
The 50-layer ResNet architecture includes the following
elements, as shown in the table below:
 A 7×7 kernel convolution alongside 64 other
kernels with a 2-sized stride.
 A max pooling layer with a 2-sized stride.
 9 more layers—3×3,64 kernel convolution, another
with 1×1,64 kernels, and a third with 1×1,256
kernels. These 3 layers are repeated 3 times.
 12 more layers with 1×1,128 kernels, 3×3,128
kernels, and 1×1,512 kernels, iterated 4 times.
 18 more layers with 1×1,256 cores, and 2 cores
3×3,256 and 1×1,1024, iterated 6 times.
 9 more layers with 1×1,512 cores, 3×3,512 cores,
and 1×1,2048 cores iterated 3 times.
(up to this point the network has 50 layers)
 Average pooling, followed by a fully connected
layer with 1000 nodes, using the softmax activation
function.
deep learning implementation:
 Model architecture
 Some code of implementation
flutter implementation:
 Chapter5 Conclusion:

Pneumonia is usually due to an infection (bacterial, viral,

or fungal). People can also develop pneumonia after
inhaling contaminated food, water, or saliva into their
lungs.
This lung condition is more common among young
children, older adults, and people with pre-existing
medical conditions that affect their organs or weaken
their immune systems. These groups also have an
increased risk of serious complications of pneumonia. As
such, they should take extra measures to help prevent
pneumonia, which may include receiving a
pneumococcal vaccine.
Whatever the cause of pneumonia, treatment includes
getting lots of rest and drinking plenty of fluids.
A doctor may recommend additional treatments
depending on a person’s pneumonia type, symptoms, and
overall health. People should contact their doctor if their
symptoms persist or worsen.
pneumonia , Inflammation and solidification of lung
tissue caused by infection, foreign particle inhalation, or
irradiation but usually by bacteria. Mycoplasma
pneumoniae is the most common cause in healthy
individuals. The bronchi and alveoli may be inflamed.
Coughing becomes severe and may bring up flecks of
blood. It can be serious but is rarely fatal. Streptococcus
pneumoniae is more common and generally more severe
but usually affects only those with low resistance,
especially in hospitals. A highly lethal form caused
by Klebsiella pneumoniae is almost always confined to
hospitalized patients with low immunity. Other bacterial
pneumonias include Pneumocystis carinii pneumonia
(rare except in AIDS) and Legionnaire disease. Most
respond to antibiotic treatment. Viruses set the stage for
bacterial pneumonia by weakening the individual’s
immune system more often than they cause pneumonia
directly. Fungal pneumonia usually occurs in
hospitalized persons with low resistance, but
contaminated dusts can cause it in healthy individuals. It
can develop rapidly and may be fatal. X-ray treatment
(see radiation therapy) of structures in the chest may
cause temporary lung inflammation.

Future improvements

Lifestyle and home remedies:

 Get plenty of rest. Don't go back to school or work
until after your temperature returns to normal and
you stop coughing up mucus. ...
 Stay hydrated. Drink plenty of fluids, especially
water, to help loosen mucus in your lungs.
 Take your medicine as prescribed.
Bacterial pneumonia:
Treatment is usually with antibiotics. Viral
pneumonia: Treatment is not usually necessary, though a
doctor may prescribe antiviral medications if influenza is
the cause. Fungal pneumonia: Treatment usually
involves antifungal medications.
The goal of treatment for community-acquired
pneumonia (CAP) is to get rid of the infection and
prevent complications. Initial treatment of CAP with
antibiotics is based on which type of organism is likely to
be causing pneumonia (called "empiric" treatment). Most
people improve with empiric treatment.