Bronchitis vs. Pneumonia: How to Tell Symptoms Apart

Just know that with bronchitis, recovery can take time, especially when it comes to getting rid of the cough. “It’s not going to be a day-by-day improvement; it’s going to be a week-by-week improvement,” Kalsi says.

What is pneumonia?

While bronchitis affects the upper airways, pneumonia develops lower down in the lungs. Like bronchitis, it also causes inflammation and fluid buildup. 

Viruses, bacteria and fungi can all cause pneumonia. In the U.S., some of the more common causes of viral pneumonia include influenza, RSV, COVID-19 and rhinovirus (the predominant cause of the common cold), according to the CDC. When it comes to bacteria, pneumococcus, which causes pneumococcal disease, is often to blame.

Like bronchitis, pneumonia can trigger a bad cough that may come with mucus. But other symptoms of pneumonia tend to be more serious and can include:

• Fever, shaking and chills
• Shortness of breath
• Rapid, shallow breathing
• Chest pain
• Loss of appetite
• Fatigue
• Confusion, especially in older adults

With pneumonia, “you can feel much more run-down, fatigued, short of breath,” says Kalsi, who says that a chest X-ray is typically used to diagnose pneumonia. “It can be much more intense.” According to the American Lung Association, pneumonia causes more than 1 million hospitalizations and more than 50,000 deaths each year in the U.S.

How is it treated?

That depends on what’s causing the infection. If it’s bacterial pneumonia — a blood test or sputum test can help identify the cause — your doctor may prescribe an antibiotic. And antifungals can help treat pneumonia caused by a fungal infection.

Viral pneumonia usually isn’t treated with prescription medication. However, your doctor may recommend over-the-counter cold medicines or fever reducers to help with symptoms.

Don’t ignore severe signs

A fever that’s higher than 101 degrees F. is concerning and is a sign you need to see a doctor, says Anthony Szema, M.D., a physician who specializes in pulmonary diseases at Northwell Health in Long Island, New York. The same goes if you are short of breath, or if your breathing worsens, or if you are extremely fatigued or feel dehydrated.

“If you are wheezing and waking up at night with chest tightness, those are all reasons to seek medical care,” Kalsi says.  

It may be the case that your illness is severe enough to require extra care in the hospital.

Preventing bronchitis and pneumonia

The good news: You can do a few things to reduce your risk of coming down with bronchitis or pneumonia. The pneumococcal vaccine, which is recommended for adults 65 and older, can help reduce the risk of pneumonia caused by pneumococcus bacteria.

Similarly, the vaccines for COVID-19, RSV and influenza can lower the likelihood of those infections and the complications they can cause. And don’t forget about frequent handwashing and face masks, which can help block the spread of many germs, including those that can cause bronchitis and pneumonia. “The pandemic taught us how effective just wearing a mask can be,” says Kalsi, who adds that people with lung issues like asthma and emphysema will want to take extra precautions.

Szema also recommends air purifiers using high-efficiency particulate air (HEPA) filters in bedrooms and common rooms. These portable machines can help to remove germs from the air.

Questions to ask — and to avoid

If your doctor suspects your illness is caused by a virus, it’s important to not push for antibiotics if they aren’t recommended. Remember, antibiotics only help to treat bacterial infections. Still, “a lot of people request antibiotics for their bronchitis,” Kalsi says. Research suggests viruses cause 85 to 95 percent of acute bronchitis cases in healthy adults.

Here are some questions you should be asking your doctor if you have a bad cough:

• Should I be concerned if I develop a fever?
• Do I need a chest X-ray or other medical tests?
• What’s the best course of treatment?
• Can I take over-the-counter medications with my routine prescription drugs?
• What should I do if symptoms linger?
• Are there any severe signs I need to be on the lookout for?