Pneumonia Cough: How It Might Sound and Look Different From Other Coughs

While you can't diagnose pneumonia by cough alone, it may provide some necessary clues.

Sometimes a cough can be totally harmless—like when it's caused by a scratchy throat from allergies, or your run-of-the-mill common cold. Other times, well, it can be a symptom of something much more serious, like pneumonia.

But here's the tricky part: It's really tough for you (and sometimes even healthcare providers) to determine whether your cough is caused by pneumonia or something less severe. "Most pneumonia coughs usually are difficult to distinguish from regular coughs," Shweta Sood, MD, a pulmonologist and assistant professor of clinical medicine at Penn Medicine, told Health.

While it may be difficult to distinguish pneumonia from a cold or allergies from cough alone, there are clues that you can (and should) pay attention to that can help signal if you're dealing with a true pneumonia cough. Here, pulmonologists break down the signs that can show your cough is due to pneumonia—and how to help get rid of it.

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What Is Pneumonia?

Pneumonia is an infection in one or both of your lungs that causes the air sacs in your lungs to fill up with fluid or pus, according to the US National Library of Medicine's MedlinePlus resource. Pneumonia can range from mild to severe, and it all depends on a slew of factors, including the type of germ that caused the infection, your age, and how healthy you are overall.

Pneumonia is usually caused by bacteria, viruses, or fungi, but each often causes a cough, along with other uncomfortable symptoms.

Anyone can develop pneumonia, but factors like having a weakened immune system, being very young or very old, and certain lifestyle habits like smoking and heavy alcohol use can raise your risk, MedlinePlus says.

What Are the Most Common Symptoms of Pneumonia?

The symptoms of pneumonia can vary a little, depending on what is causing the infection, Raymond Casciari, MD, a pulmonologist at St. Joseph Hospital in Orange, California, told Health. In general, said Dr. Casciari, pneumonia in the US is most commonly caused by either a bacteria or a virus, and the symptoms can be slightly different.

According to Johns Hopkins Medicine, the symptoms of bacterial pneumonia include:

  • Bluish color to lips and fingernails
  • Confused mental state or delirium, especially in older people
  • Cough that produces green, yellow, or bloody mucus
  • Fever
  • Heavy sweating
  • Loss of appetite
  • Low energy and extreme tiredness
  • Rapid breathing
  • Rapid pulse
  • Shaking chills
  • Sharp or stabbing chest pain that's worse with deep breathing or coughing
  • Shortness of breath that gets worse with activity

Early symptoms of viral pneumonia are the same as those of bacterial pneumonia, per Johns Hopkins Medicine, which may be followed by:

  • Headache
  • Increasing shortness of breath
  • Muscle pain
  • Weakness
  • Worsening of the cough

What Does a Pneumonia Cough Sound (And Look) Like?

Keep this in mind: "The cough itself isn't necessarily different, but a cough in the setting of pneumonia-like symptoms is concerning," Khalilah Gates, MD, pulmonary and critical care specialist at Northwestern Medicine, told Health. Meaning you (and your healthcare provider) should take into account other factors to see if you could, in fact, be dealing with pneumonia, like whether you have a fever and loss of appetite.

The cough itself, though, can signal that something is off. "It is a new cough or a cough that has changed from the patient's usual cough that alerts physicians to investigate it further to figure out if there is a pneumonia," said Dr. Sood. Dr. Casciari added that pneumonia coughs tend to sound "deeper" than regular coughs.

As far as what you actually cough up with pneumonia, that can depend on what type of pneumonia you have and what stage it's in. With early-stage viral pneumonia, you may not cough up anything. But if your viral pneumonia has progressed or you're dealing with bacterial pneumonia, it's likely to be "more productive of mucus," said Dr. Casciari. Meaning, you should be able to cough up something. It can be greenish or yellowish in color, said Dr. Casciari.

"Usually, patients with pneumonia don't cough forever and nothing happens—they cough and something comes out," said Dr. Casciari. In addition to mucus, a pneumonia cough can be bloody. "Blood-tinged mucus is always abnormal and needs to be diagnosed," said Dr. Casciari. "But a severe cough for any reason can cause a blood vessel to break and mucus to be blood-tinged."

How To Treat a Pneumonia Cough

If you're uncomfortable, you should call your healthcare provider, whether you suspect that you have pneumonia or not. A painful cough can be a sign of a range of health issues, and it's really a good idea to get it checked out if it's bothering you and isn't getting better, said Dr. Gates. You should also seek help ASAP if you have a high fever and "significant" shortness of breath, said Dr. Gates.

If your healthcare provider diagnoses you with bacterial pneumonia, they'll likely prescribe an antibiotic to treat your infection—and your cough. If it's viral and caught early, they may prescribe an anti-viral medication and, if it's fungal, they'll likely have you take an antifungal medication, said Dr. Casciari.

Of course, those medications treat the underlying infection and, while they should help you to feel better, it may take a little time for your cough to clear up.

In the meantime, healthcare providers say there are a few things you can do to help your cough:

  • Get some rest. That will help your body recover, so you have the energy to fight the infection, said Dr. Sood.
  • Drink something with honey. "Beverages with honey can often be soothing for patients and reduce cough too," per Dr. Sood.
  • Drink plenty of water. "Any kind of liquid helps with mucus production," said Dr. Casciari.
  • Do steam treatments. This can be with a humidifier or even just hanging out in your steamy bathroom. "Inhaling humidified vapor can help get bacteria out," said Dr. Casciari.
  • Try a cough suppressant. This is "particularly helpful when you can't sleep because you're coughing," said Dr. Gates.

Just keep this in mind, per Dr. Gates: "The cough probably won't get better until the actual pneumonia is treated."

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