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While they have similar symptoms, bronchitis and pneumonia are very different illnesses.

Do you have a lingering cough deep in your chest that just won’t go away? It could be bronchitis, or possibly pneumonia. The two conditions have very similar symptoms, so it’s not always easy to tell the difference.

Bronchitis and pneumonia can be caused by the same infections — such as the common cold or flu — and can cause breathing problems, pain and severe coughing that often brings up mucus.

“Bronchitis and pneumonia are two distinct illnesses,” says Jason Stankiewicz, MD, a Geisinger pulmonologist. “Having your provider review your history, examine your lungs and if needed, obtain imaging of your chest can help diagnose your condition. Then they can develop a treatment plan to help you feel better.”

Here’s how to tell the difference between bronchitis vs. pneumonia.

What is bronchitis?

Bronchitis is the swelling and inflammation of the bronchial tubes, which carry air from the main windpipe into the lungs. Most bronchitis cases are viral, but they also can be bacterial or fungal. 

“Environmental substances that irritate the airways, such as smoke, dust, fumes and air pollution, also can contribute to bronchitis,” says Dr. Stankiewicz.

Common symptoms of bronchitis include:

  • Fever, chills and body aches
  • Severe coughing, often producing clear, green or yellow mucus
  • Wheezing, difficulty breathing
  • Tightness in chest or chest congestion
  • Runny nose
  • Sore throat

There are two types. The most common is acute bronchitis, which is typically caused by a virus. It can last one to two weeks and usually goes away on its own without any specific treatment. Some specific causes of acute bronchitis have their own specific treatments (i.e., the flu, COVID-19). If your bronchitis is caused by bacteria, which is less common, you may benefit from treatment with antibiotics.

However, chronic bronchitis is a more long-term, potentially serious condition that can cause ongoing inflammation of the airways and slowly damage lung function. It can also put you at higher risk for pneumonia. “People with chronic bronchitis may benefit from further evaluation with their primary provider and/or a pulmonologist. This condition may indicate a more long-term pulmonary condition, including diagnoses such as chronic obstructive pulmonary disease (COPD) or asthma,” explains Dr. Stankiewicz. 

What is pneumonia?

Pneumonia causes inflammation in the lungs, too. But unlike bronchitis, the inflammation and infection occur in the lungs’ tiny air sacs, where oxygen passes into the bloodstream. 

Bacteria is the most common cause for pneumonia, although viruses or fungi can also be the culprit. Cases can range from mild to severe, with pneumonia being more serious in babies, older adults and those with compromised immune systems. 

Common symptoms of pneumonia include:

  • Fever, chills and body aches
  • Fatigue and low energy
  • Severe coughing, producing yellow, green or bloody mucus
  • Rapid breathing and shortness of breath
  • Sharp chest pain
  • Sore throat
  • Nausea or vomiting

In contrast to bronchitis, worrisome signs of pneumonia may include confusion, especially in older adults; shallow breathing as opposed to wheezing; nausea and vomiting; and loss of appetite. Someone with pneumonia typically feels much worse than a person with bronchitis.

Bacterial pneumonia can be treated with antibiotics, and sometimes specific viral infections may have treatments (i.e., from the flu or COVID-19), but generally there are no specific treatments for viral pneumonia other than managing symptoms. In severe cases, some people may require hospitalization for additional support. 

But prevention is always preferable to treatment. “People age 65 and older (as well as others at high risk for serious infections) can benefit from the pneumococcal vaccine,” says Dr. Stankiewicz. “It can help protect against pneumococcal pneumonia, which is the most common type of bacterial pneumonia and can be very serious in older adults.”

Can bronchitis turn into pneumonia?

In rare cases, yes, bronchitis can turn into pneumonia. The infection can spread in the lungs, but this most often happens in people with weakened immune systems.

Most of the time, bronchitis and pneumonia are separate illnesses that happen independent of each other, and one doesn’t necessarily cause the other.  

When should I see a doctor?

Since it’s difficult to tell the difference between bronchitis and pneumonia, it’s best to see a doctor as soon as symptoms appear. Bacterial pneumonia is a fast-moving illness that needs medical attention.

Contact your provider right away if you have:

  • Difficulty breathing
  • Severe coughing that brings up mucus and lasts more than three weeks
  • A very high fever
  • Symptoms that don’t get better, or they get better and then return
  • A chronic condition

“Watch for worsening symptoms,” says Dr. Stankiewicz. “Bronchitis and pneumonia can become severe and require medical attention. Be sure to take all breathing problems seriously because they can worsen quickly.”

Next steps: 

Learn about lung and respiratory care at Geisinger
How to bounce back after a bug
Feeling under the weather? Here’s how to tell if it’s a cold, flu, allergies or COVID-19

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