Is It Bronchitis or Pneumonia?

Bronchitis affects the bronchial tubes, while pneumonia affects the lung air sacs. Without treatment, bronchitis can become pneumonia.

You’re coughing, you’ve got a fever, and your chest feels clogged with mucus. Do you have bronchitis or pneumonia? Both are lung infections with similar symptoms, so it can be hard to tell the difference.

The big difference between these two conditions — and you might not be able to feel it — is which part of the respiratory system is affected.

Bronchitis affects the bronchial tubes that carry air to your lungs.
Pneumonia affects the air sacs, called alveoli, where oxygen passes into your blood. Pneumonia causes these air sacs in the lungs to fill with fluid or pus.

In addition, bronchitis comes in two forms:

Acute bronchitis.Acute bronchitis is an infection caused by viruses and sometimes bacteria.
Chronic bronchitis.Chronic bronchitis is a long-term inflammation in your lungs.

Sometimes, bronchitis can turn into pneumonia.

Keep reading to learn more about the symptoms, causes, and treatment for these two conditions.

It can be difficult to tell bronchitis and pneumonia apart based on congestion and cough alone. However, these two conditions have very different causes, symptoms, and treatments.

The big difference in symptoms involves severity. Pneumonia symptoms are usually more severe than bronchitis, and pneumonia usually looks more like a body-wide infection with a fever or chills.

Both pneumonia and bronchitis can develop from bacteria or viruses that cause respiratory infections.

Bronchitis is limited to the bronchial tubes that bring air to your lungs, while pneumonia develops and worsens deeper in your lung tissues.

Additionally, pneumonia can also be caused by fungal infections and aspiration (inhaling something, like food or saliva, into your lungs).

At-a-glance identification

How to identify what you have and what to do at-a-glance:

Bronchitis	Pneumonia
Symptoms	cough shortness of breath wheezing a squeaking sound when you breathe tightness in your chest	cough shortness of breath chest pain fever chills nausea vomiting diarrhea
Causes	viruses bacteria environmental irritants	viruses bacteria fungus aspiration
Treatment	anti-inflammatory medications breathing treatments supportive care like rest and fluids antibiotics in rare cases	antibiotics antivirals antifungals supportive care like rest and fluids

Bronchitis is a condition that mostly affects the upper airway. Caused by infection or irritation, acute bronchitis can usually resolve on its own over the course of a few weeks.

Both bronchitis and pneumonia cause a cough that sometimes produces phlegm, a thick type of mucus that’s made in your chest. You can tell the difference between bronchitis and pneumonia by checking for other symptoms.

Symptoms of bronchitis

The symptoms of bronchitis depend on whether it’s acute or chronic. Simply stated, acute bronchitis will go away over several weeks and is usually caused by an infection. Chronic bronchitis, on the other hand, is a long-term condition caused by repeated exposure to chemicals or irritants like cigarette smoke.

Acute bronchitis

Symptoms of acute bronchitis are very similar to those of an upper respiratory infection, such as:

fatigue
sore throat
runny nose
stuffed nose
fever
chills
body aches
mild headache

When you cough, you might also notice that your phlegm looks green or yellow.

Acute bronchitis symptoms usually get better within a few days, but the cough can stick around for a few weeks.

Chronic bronchitis

Chronic bronchitis, on the other hand, causes a persistent cough that often lasts for at least 3 months. You might also feel that your cough goes through cycles of getting better and worse. When it gets worse, it’s known as a flare-up.

Chronic bronchitis is part of a group of conditions called chronic obstructive pulmonary disease (COPD). COPD also includes chronic emphysema and asthma.

Additional symptoms of COPD, including chronic bronchitis, are:

shortness of breath
wheezing
fatigue
chest discomfort

What causes bronchitis?

Acute bronchitis is usually caused by a virus. In less than 10 percent of cases, it’s caused by bacteria.

In both viral and bacterial bronchitis, germs enter the bronchial tubes of your lungs and cause irritation. Sometimes, a cold or other respiratory infection turns into bronchitis.

Chronic bronchitis is caused by frequent exposure to things that irritate your lungs, such as:

cigarette smoke
polluted air
dust

As with many types of respiratory infections, some people are at a higher risk of developing bronchitis than others. High-risk groups for bronchitis include:

smokers
people who work with harmful fumes or chemicals
people with lung or respiratory diseases
older adults

How is bronchitis treated?

How bronchitis is treated depends on whether it’s acute bronchitis or chronic bronchitis.

Acute bronchitis may be treated with:

antibiotics
antiviral medications
nonsteroidal anti-inflammatory drugs (NSAIDs)
steroids
supportive care like rest and fluids

Even with no prescription treatment, acute bronchitis should resolve in a few weeks.

Chronic bronchitis treatment can require lifestyle changes like quitting smoking and possibly making changes to your workplace or home environments. As chronic bronchitis progresses over time, treatments may include things like:

bronchodilators
mucolytics
oxygen therapy
pulmonary rehabilitation

Taking care of yourself is the best medicine

Regardless of whether you have acute bronchitis, chronic bronchitis, or some form of pneumonia, supportive care can help you recover.

Follow these tips to speed up your healing time:

Get plenty of rest.
Drink plenty of fluids to loosen up the mucus in your lungs. Water, clear juices, or broths are the best choices. Avoid caffeine and alcohol, which can be dehydrating.
Take an over-the-counter anti-inflammatory medication to reduce a fever and soothe body aches.
Turn on a humidifier to loosen up the mucus in your lungs.
Ask your doctor about using an over-the-counter cough remedy if your cough is keeping you up at night or making it hard to sleep.

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Think of pneumonia as a clog in your lungs’ plumbing. There are tiny air sacs in your lungs called alveoli. These thin, delicate sacs transfer oxygen from the air you breathe into your blood.

When they are weighed down with fluid or mucus, these sacs can’t expand and contract well. This can reduce how well they move oxygen into your blood and other waste materials out of it.

Symptoms of pneumonia

Pneumonia also usually comes with a cough that sometimes produces yellow or green phlegm.

Other symptoms of pneumonia include:

fatigue
fever, which may be as high as 105°F (40.5°C)
shaking chills
chest pain, especially when you breathe deeply or cough
sweating
nausea, vomiting, or diarrhea
shortness of breath
confusion, especially in older adults
blue lips from lack of oxygen

Pneumonia symptoms can range from mild to severe.

What causes pneumonia?

Pneumonia usually results from a virus, bacteria, or fungi. Inhaling irritants can also cause it. When these germs or irritants enter the alveoli in your lungs, you can develop pneumonia.

There are several types of pneumonia, depending on the underlying cause:

Bacterial pneumonia. This is caused by bacteria. The most common type of bacterial pneumonia is called pneumococcal pneumonia, which is caused by the Streptococcus pneumoniae bacteria.
Viral pneumonia.Viral pneumonia is caused by a virus, such as the influenza virus.
Mycoplasma pneumonia.Mycoplasma pneumonia is caused by tiny organisms called Mycoplasma that have characteristics of both viruses and bacteria.
Fungal pneumonia. Fungal pneumonia is caused by fungi, such as Pneumocystis jiroveci.

Anyone can develop pneumonia, but there are some people who are at a higher risk. These include:

smokers
people over age 65
people with certain medical conditions that can weaken the lungs or immune system
people who have difficulty swallowing

How pneumonia is treated

Pneumonia is treated by addressing the source of the infection. Antibiotics may be used to treat a bacterial cause, while antivirals may be used for viral infections like influenza. If the cause of your pneumonia is fungal, a combination of antifungals and antibiotics may be used.

In severe cases, you may require hospitalization, supplemental oxygen, or more invasive treatments like mechanical ventilation to help your alveoli function while your pneumonia resolves.

Your doctor can use the same techniques to diagnose both bronchitis and pneumonia.

To start, they’ll ask about your symptoms, including when they started and how severe they are.

Next, they’ll likely use a stethoscope to listen to your lungs as you breathe. Crackling, bubbling, whistling, or rattling sounds could be signs that you have either bronchitis or pneumonia.

Depending on your symptoms, they may do some additional testing, such as:

Sputum culture. A sputum culture involves taking a sample of the phlegm you cough up and analyzing it for specific germs.
Chest X-rays.Chest X-rays can help your doctor see where the infection is in your lungs, which can help them distinguish between bronchitis and pneumonia.
Pulse oximetry. For a pulse oximetry test, your doctor attaches a clip to your finger to measure the amount of oxygen in your blood.
Pulmonary function tests. In a pulmonary function test, your doctor has you blow into a device called a spirometer, which measures how much air your lungs can hold and how forcefully you can blow that air out.

If you feel like you have either bronchitis or pneumonia, it’s always a good idea to check in with your doctor. If the underlying cause is bacterial, you should start feeling much better within a day or two of starting antibiotics.

Otherwise, call your doctor if your coughing or wheezing doesn’t improve after 2 weeks.

You should also seek immediate medical care if you notice:

blood in your phlegm
a fever over 100.4°F (38°C) that lasts for more than a week
shortness of breath
chest pain
extreme weakness

Last medically reviewed on March 27, 2023