Bronchitis vs Pneumonia: Symptoms, Treatment and Diagnosis

By Edo Paz, MD
Medically reviewed checkmarkMedically reviewed
September 25, 2020

You know this is worse than your run-of-the-mill common cold. Between the chest filled with mucus, body aches, and fatigue, you can barely get out of bed. You may have bronchitis or pneumonia. But how can you tell which it is? My patients often come to me confused about which condition they have, as the symptoms can present themselves in a similar fashion but treatment is very different. 

In this article, I’ll describe the symptoms of both bronchitis and pneumonia. I will also talk about the causes of each, how they’re diagnosed, and what your treatment options are. 

What Is Bronchitis?

Bronchitis is the inflammation of your bronchial tubes. Your bronchial tubes are part of your lower respiratory tract, and move air back and forth from the lungs. There are two types of bronchitis: 

Acute bronchitis

Acute bronchitis usually develops from a cold or other respiratory infection and is fairly common. It is usually caused by a virus but can also be bacterial. Symptoms generally appear 3-4 days after the infection and will usually improve in 10 to 14 days. 

Chronic bronchitis

Chronic bronchitis is a recurring disease that is not curable, with symptoms varying from person to person. It lasts at least three months out of the year for a minimum of two years, and is often associated with smoking.

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Symptoms of Bronchitis

 Symptoms of bronchitis include:

If you have acute bronchitis, your symptoms may resemble those of a common cold. Most of the symptoms will resolve themselves fairly quickly, though a cough may persist for weeks. Chronic bronchitis symptoms will improve and worsen at various points. This can occur any time of year, but symptoms generally flare up in the winter, as the cough worsens in damp, cold weather. 

What Is Pneumonia? 

Pneumonia is a lung infection that occurs when the air sacs of the lungs, alveoli, become filled with pus or fluid. It can occur in one or both lungs. Although anyone can get pneumonia, infants younger than 2 and adults over 65 are at the highest risk. 

Surprisingly, it’s possible to have pneumonia and not be aware of it. This is known as walking pneumonia. Walking pneumonia is a milder form of pneumonia, with symptoms that are either nonexistent, or seem very much like a common cold

Symptoms of Pneumonia 

The most common pneumonia symptoms include:

  • Fatigue
  • Coughing green, yellow, or bloody mucus
  • Increased heart rate and breathing rate
  • High fever, even up to 105° F (40.5°C) 
  • Chills
  • Decreased appetite
  • Sharp chest pains
  • Sweating 

Wondering If It’s Bronchitis or Pneumonia?

I explain to patients that pneumonia typically exhibits symptoms more severe than those of bronchitis. A high fever is usually indicative of pneumonia, as are chills and sharp chest pains. Other symptoms of severe pneumonia that do not occur with bronchitis include coughing up blood, and blue lips or fingernails. Your doctor may also be able to tell the two apart by listening to your lungs or doing a test, such as a chest x-ray.

Not sure if you have bronchitis or pneumonia? Download K Health and chat with a doctor about your symptoms.

How to Tell If You Have More Than a Cold 

You might also be wondering how to tell the difference between having a cold, and having bronchitis or pneumonia. A cold presents as a cough, runny nose, and a mild fever or none at all. You may feel fatigued, but you should generally be able to carry on with your activities of daily living. The initial symptoms of a cold will lessen in intensity after a few days, though congestion may continue to linger. The symptoms of bronchitis and pneumonia are both more intense, and will last longer than a cold. 

Did you know?

Most acute respiratory infections don’t require a visit to the doctor’s office. Most can be successfully treated with over the counter medications.  

  •     28 minutes are usually spent in a doctor’s office waiting room
  •     15 minutes are spent actually seeing a physician
  •     63% of primary care visits for ARI’s are unnecessary

Causes of Bronchitis vs Pneumonia

Causes of Bronchitis

Acute bronchitis can be caused by bacteria or viruses that irritate the bronchial tubes. However, in the vast majority of cases, bronchitis is caused by a virus. 

Chronic bronchitis is mainly caused by smoking. Other causes include air pollution and exposure to dust and other pollutants in the air. People with chronic bronchitis can also develop acute bronchitis on top of their pre-existing chronic bronchitis.

Acute bronchitis can be contagious, while chronic bronchitis is not. 

Causes of Pneumonia

Pneumonia and walking pneumonia are both caused by infections in the respiratory tract, albeit from different germs. Pneumonia is caused by bacteria, viruses, or exposure to fungi, while walking pneumonia is usually the result of a bacterial infection.  

Bacterial pneumonia and viral pneumonia share symptoms, but bacterial pneumonia is the most common form, and usually more severe in how the symptoms express themselves. In rare cases, people can get fungal pneumonia by inhaling fungi from bird droppings or soil. 

Both bacterial and viral pneumonia can be contagious. 

How Are Bronchitis and Pneumonia Diagnosed?

When diagnosing bronchitis or pneumonia, I first ask my patients about their symptoms and perform a physical exam, including listening to their lungs with a stethoscope. The more information I have, the sooner I can give an accurate diagnosis. Additional tests are usually not needed to diagnose acute bronchitis, however some testing that may be used to diagnose chronic bronchitis include:

  • Chest x-ray: A chest x-ray can help rule out other diagnoses, like pneumonia.
  • Sputum culture: You’ll give a sample of phlegm, which will then be analyzed to look for specific germs.
  • Pulmonary function testing (PFT): This test measures the volume and airflow of air in your lungs. You’ll blow into a device called a spirometer which can determine how your lungs are functioning.
  • Pulse oximetry: A clip attached to your finger is used to assess the level of  oxygen in your blood.
  • High resolution computed tomography (HRCT): An HRCT is a type of CT scan that takes high-resolution images of your lungs.

To diagnose pneumonia, your doctor will ask you questions to try and determine whether you may have been exposed to viruses, bacteria, or fungi. These will include questions about your work environment, recent travel, or exposure to others who might be ill. 

Your doctor will also perform a physical exam, including listening to your lungs. Some additional tests might be used to confirm your diagnosis, including chest x-ray, sputum culture, pulse oximetry, and a CT scan. Your doctor may also use:

  • Blood tests: Blood tests can help confirm the diagnosis of pneumonia and can sometimes identify the specific germ causing it.
  • Bronchoscopy: Bronchoscopy is a procedure used to check the lung’s airways. It is usually used if you are hospitalized and your treatment isn’t working.
  • Pleural fluid culture: Pleural fluid culture involves the removal of a small amount of the fluid that surrounds the lungs.
  • Arterial blood gas test: More accurate than pulse oximetry, this test measures the amount of oxygen in a blood sample from an artery.  

Bronchitis and Pneumonia Treatment Options

Bronchitis and pneumonia treatment options vary according to the cause of the illness. Acute bronchitis symptoms usually go away on their own, although sometimes doctors will prescribe antibiotics or other drugs to help with breathing. Bacterial pneumonia is usually treated with antibiotics

For chronic bronchitis, your doctor may prescribe pulmonary rehabilitation, oxygen therapy, steroid treatments, or bronchodilator medications (inhaled medications that help to open the airways). Quitting smoking will be strongly advised to avoid making the condition worse. 

For most patients with bronchitis or pneumonia, evaluation by a physician is needed.  However, if you’re looking for some at-home remedies, I recommend drinking plenty of fluids, getting lots of rest, and taking over-the-counter cough suppressants and pain relievers, as needed. You may also find relief from using a humidifier or taking a bath—both of these can help open your airway.

How to Prevent Bronchitis and Pneumonia

With both bronchitis and pneumonia, the best method of prevention is to notice the symptoms and act early. Early symptoms of bronchitis are similar to a cold or flu. A mucus-producing cough may follow. Untreated, bronchitis can lead to pneumonia, especially if the bronchitis is due to a bacteria.

The Centers for Disease Control and Prevention recommends that adults 65 and older get the pneumococcal vaccination. In addition, good hand hygiene, including frequent hand washing, can play a big part in limiting the spread of germs.  

Related Conditions and Risk Factors 

Related conditions include upper respiratory infections and chronic obstructive pulmonary disease (COPD). 

  • Upper respiratory infections: Upper respiratory infections (URI), like the common cold, are usually caused by viruses. Symptoms are less severe than bronchitis or pneumonia.
  • COPD: COPD is an umbrella term used to describe a group of lung diseases, including chronic bronchitis and emphysema.
  • Asthma: Caused by inflammation and narrowing of the airways, asthma can cause cough, wheezing, and shortness of breath. 

Bronchitis risk factors: 

  • Genetics: Genetics can play a part in developing chronic bronchitis.
  • Cigarette smoke: Smoking or being exposed to smoke can put you at a higher risk of both types of bronchitis.
  • Other irritants: Exposure to lung irritants can increase your chance of developing bronchitis. 

Pneumonia Risk Factors 

  • Smoking cigarettes: Smoking has been linked to increased susceptibility of contracting pneumonia.
  • Chronic disease: Having a chronic disease, such as COPD or asthma, makes it more likely to get pneumonia.
  • Hospitalization: Being hospitalized will increase your chances of contracting pneumonia. 

When to See a Doctor

Visit your doctor if you notice that your breast is red, painful, hot or swollen. Prompt treatment will give you relief as well as stop the infection from worsening.

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How K Health Can Help

At K Health, we hear from many users who wonder when is the appropriate time to speak to a medical professional. If you think you have symptoms of bronchitis or pneumonia, don’t wait to talk to a doctor. Bronchitis can turn into pneumonia if left untreated. And the sooner pneumonia is detected, the more successful the treatment. This is especially important for high-risk groups, including infants, older adults, or individuals with underlying health conditions/compromised immune systems.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Edo Paz, MD

Edo Paz is the VP of Medical at K Health. Dr. Paz has two degrees in chemistry from Harvard and earned his medical degree from Columbia University. He did his medical training in internal medicine and cardiology at New York-Presbyterian. In addition to his work at K Health, Dr. Paz is a cardiologist at White Plains Hospital, part of the Montefiore Health System.