AARP Eye Center
Bronchitis and pneumonia both affect the lungs and share some common symptoms, but they are different diseases that require different treatment. Here's how you can tell the difference.
Bronchitis
The less severe of the two, acute bronchitis is caused by inflammation of the bronchi, the branching tubes that deliver air into the lungs. (Chronic bronchitis is a different subject altogether.)
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The most common symptoms of bronchitis include:
- Coughing with clear, yellow or green sputum (the gunk you cough up)
- Fatigue
- Wheezing
- Runny, stuffy nose occurring before chest congestion begins
- Shortness of breath, usually following a coughing jag
- Discomfort in the center of the chest due to cough
- Mild fever
Although yellow or green sputum is often thought to indicate bacterial infection, don't be fooled.
"Over 80 to 90 percent of bronchitis in otherwise healthy people is viral, not bacterial, in origin, especially if the symptoms of bronchitis follow a cold," says Homer Boushey, M.D., a lung specialist and professor emeritus of medicine at the University of California, San Francisco.
Viral infections cannot be treated with antibiotics. In fact, says Boushey, antibiotics will kill many of the healthy, protective bacteria in your body. "That leaves you more susceptible to disease-causing bacteria."
Acute bronchitis will most often go away on its own within a week to 10 days, though your mucus-y cough will likely persist for several more weeks.
"It's just a matter of the body cleaning up the mess," says pulmonologist Len Horovitz, M.D., of Lenox Hill Hospital in New York. "Most people recover just fine from bronchitis."
Pneumonia
An inflammation of the lungs, pneumonia has many of the same symptoms as bronchitis, including:
- Persistent fever (often high)
- Cough, often with yellow or green mucus
- Chills, which sometimes cause shaking
- Shortness of breath
- Sharp chest pain
- Confusion (which occurs primarily in older people)
Though many of the signs may be similar, pneumonia is much more serious than acute bronchitis. It's more often caused by bacteria than by a virus, which means that antibiotics can be used to treat it. However, bacterial pneumonia can be a fast-moving disease that needs attention right away, says Boushey.
"Don't wait too long to get treated," he warns. "If you come in with very advanced pneumonia, it may be too late. For people who come in right away, we have good treatments."
When to see a doctor
Older people do worse with respiratory infections (whether viral or bacterial), especially if they have other health problems such as chronic obstructive pulmonary disease, heart disease, diabetes, kidney disease or cancer. If you have symptoms, play it safe and see your doctor.
"Any time you have a fever or a cough, you should go in," says Horovitz. "Any time you feel bad, you should go in, because you never know what you are dealing with. Don't wait until you are in extremis."
Your doctor will listen to your lungs and, if necessary, take an X-ray of your chest, which will identify pneumonia infection.
