Coughs are a common symptom of respiratory infections like a cold or the flu — your body’s way of naturally clearing irritants out of your air passages to help prevent infection. (1) But a cough that won’t go away even after your sore throat, fever, and other symptoms have gotten better, and that’s accompanied by wheezing or shortness of breath, may indicate that you’re dealing with something more serious, like bronchitis or pneumonia. (1,2) Given how many symptoms the two respiratory conditions share, it’s not surprising that bronchitis is often mistaken for pneumonia and vice versa. Bronchitis that’s thought to have turned into pneumonia may actually have been pneumonia all along. It’s also common for people to think that bronchitis can often turn into pneumonia, but in reality, this is not the case for most people, explains Ralph Gonzales, MD, the associate dean for clinical innovation and chief innovation officer for the University of San Francisco Health and an internal medicine specialist. “What we call bronchitis may sometimes be pneumonia,” he says. Pneumonia is an infection in one or both of the lungs that can be caused by bacteria, viruses, or fungi. When you have pneumonia, the air sacs of the lungs (alveoli) fill up with fluid or pus. While anyone can get pneumonia, some people — such as children, the elderly, people with asthma, and individuals with chronic disease — are at an increased risk of developing this lung condition. (1,5,6) RELATED: Everything You Need to Know About Pneumonia in Kids Both bronchitis and pneumonia involve inflammation in the chest (though that inflammation occurs in different parts of the chest for each one). And both conditions share some common symptoms: (1,2,5,7,8)
Cough (often accompanied by the production of mucus)FatigueShortness of breath that can get worse when you’re activeFever and chills
Bronchitis can also, however, bring on chest discomfort and wheezing. And pneumonia can bring on these symptoms not usually linked to bronchitis: (7,8,9)
Excessive sweating and clammy skinSuddenly feeling worse after cold or flu symptoms go awaySharp pain in the chest, especially when breathing deeply or coughingHeadacheLoss of appetiteLack of energyConfusionNausea, diarrhea, and vomiting
While symptoms for either bronchitis or pneumonia can range from mild to serious enough to require hospitalization, symptoms such as fever, breathing problems, and chest pain tend to be more severe with pneumonia. In people with pneumonia, the alveoli fill with pus and other fluids and prevent oxygen from reaching the bloodstream; when there’s too little oxygen in the blood, the body cannot function properly, increasing the risk of death. (1,10) That said, in some cases bronchitis does turn into (thereby causing) pneumonia. This occurs when either the infection spreads from the bronchial tubes to the lungs or a secondary infection occurs. While either scenario is rare, it tends to happen more often in people who have a weakened immune system or another condition that makes them more susceptible to infection. Some people are at risk of bronchitis turning into pneumonia: (11,12)
Those with a weakened immune systemSmokersIndividuals who have a chronic health condition, such as heart, kidney, or liver diseasePeople with an underlying lung diseaseOlder adultsYoung childrenPregnant women
While doctors aren’t sure exactly how having a viral infection may make someone more prone to developing pneumonia or another secondary infection, studies have pointed to some theories. “Animal models have shown that when you have an infection, it weakens your body’s ability to protect against bacterial infection,” Dr. Gonzales explains. (13) Doctors also think that the epithelial tissue of the airway, which serves as a barrier against viruses and bacteria, can become compromised following a viral infection, making it easier for bacteria to invade, Gonzales adds. (14)
High fever (higher than 100.4 degrees Fahrenheit) that lasts at least a couple of daysChest pain (especially if it develops suddenly and is on one side — a common sign of pneumonia)Cough that lasts more than three weeksBlood in mucusShortness of breath, even with only mild or moderate activitiesShaking chillsRapid breathing (breathing faster to try to get air)Drowsiness or confusion
Besides reviewing your symptoms, your doctor may use a simple chest X-ray to diagnose pneumonia. The best way to prevent a secondary infection is to reduce your risk of getting a viral or bacterial infection in the first place. Wash your hands regularly, avoid touching your face, and if a family member is sick, don’t share utensils and clean common areas regularly (the flu virus can live on a surface for up to 48 hours, according to the Centers for Disease Control and Prevention). (14,15) Doctors also stress the importance of getting a flu vaccine and pneumococcal vaccine to prevent a viral infection that can lead to pneumonia. (10) You can also try to prevent getting a secondary infection by taking care of yourself and treating your bronchitis symptoms, which includes these actions: (2,16)
Getting sleep and staying restedNot smoking and minimizing your exposure to secondhand smokeAvoiding using housecleaning products until you recoverAvoiding strenuous exercise for a few daysAvoiding cold air, which, like certain chemicals, can be irritating to your airway passagesUsing a humidifier
If you’re not experiencing breathing difficulties or other serious symptoms and your pneumonia is determined to be bacterial, you may be prescribed an oral antibiotic. (17) Your doctor may also test you for other infections, such as the flu, and depending on your symptoms and test results, recommend an antiviral medication, says Holguin. (17,18,19) If your doctor determines that your pneumonia can be treated at home, they may suggest the following: (17)
Drinking plenty of fluids, which can help loosen phlegm and clear it out of your bodyGetting lots of rest (not going to work and enlisting someone to help with household chores)Taking ibuprofen (Advil) or acetaminophen (Tylenol) for fever or chest pain
If hospitalized for pneumonia, you may be given these treatments: (17,18,19)
Oxygen therapy and other breathing treatmentsFluids (possibly intravenously as well as by mouth)Antimicrobial agents (either antibiotics or antiviral medications)