Bronchitis vs. Pneumonia: How to Tell the Difference, According to Experts

Either one could be causing that lingering cough.

During the fall and winter months, your respiratory system is opened up to the risk of quite a few different illnesses: colds, the flu, and now, COVID-19. Bronchitis and pneumonia are two more illnesses that directly affect your airways—and though they're different conditions, they can present similarly.

"There's not a bright line between bronchitis and pneumonia," William Schaffner, MD, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, tells Health—meaning their symptoms often blur into each other, making it hard to distinguish one illness from the other. Here's what you need to know about the similarities and differences between bronchitis and pneumonia, according to infectious disease specialists.

In general, what is bronchitis, and what is pneumonia?

The American Lung Association (ALA) says bronchitis—specifically acute bronchitis—is the sudden development of inflammation in the bronchial tubes, or the lungs' major airways. “The infection gets beyond the confines of the bronchial tubes and actually gets into the substance of the lung,” Dr. Schaffner says. “Then it causes inflammation in the tissues of the lung.”

Most cases of bronchitis are caused by viruses, often the same viruses that are responsible for common colds and the flu. “The same virus that causes the common cold settles lower down and causes bronchitis” in some people, Ephraim L. Tsalik, MD, PhD, associate professor of medicine in the division of infectious diseases at Duke Health in Durham, North Carolina, tells Health. But bronchitis is often not severe, is temporary, and usually doesn't cause any permanent lung damage.

Pneumonia, on the other hand, is an infection in one or both of the lungs, affecting the air sacs of the lungs, causing them to fill up with fluid or pus. according to the US National Library of Medicine's MedlinePlus resource.

Bacteria is the most common cause of pneumonia, per MedlinePlus, and it can occur on its own, or it can be the result of a viral infection, like the cold or the flu. Viruses, too, can cause pneumonia—like respiratory syncytial virus (RSV) or SARS-CoV-2 (the virus that causes COVID-19)—though those cases are often less severe. Fugal infections can lead to pneumonia too, but commonly only occur in those with chronic health issues or weakened immune systems.

In any case, however, pneumonia can range from mild to severe, depending what caused the infection, and the infected person's age or overall health. How much of the lung or lungs is affected can also determine the severity of the disease: “The larger the proportion it affects, the more seriously ill you are going to become,” Dr. Schaffner says.

What are the symptoms of bronchitis vs. pneumonia?

The most prominent symptom of bronchitis is a cough—often a cough that occurs in spells, Dr. Schaffner says. And during the first few days of bronchitis, symptoms often mimic the common cold. The ALA lists the following signs as more symptoms of bronchitis:

  • Runny, stuffy nose
  • Low-grade fever
  • Chest congestion
  • Wheezing or a whistling sound while breathing
  • A cough that may produce yellow or green mucus (sputum)
  • Feeling run-down or tired

The bronchitis infection itself usually lasts a week to 10 days, but don’t be surprised if the cough outlasts it—even by several weeks.

Pneumonia symptoms can be similar to those of bronchitis, but there are some pretty major differences—namely the severity of symptoms. According to MedlinePlus, those include:

  • Fever
  • Chills
  • Cough, usually with phlegm (a slimy substance from deep in your lungs)
  • Shortness of breath
  • Chest pain when you breathe or cough
  • Nausea and/or vomiting
  • Diarrhea

Those symptoms, however, can very between populations. Young children, for example, may experience the gastrointestinal issues, while older adults may experience more milder versions of the respiratory symptoms.

Generally, pneumonia lasts longer than bronchitis—a few weeks to a few months, according to MedlinePlus—and, unlike bronchitis, it can lead to more severe issues like bacteremia (when bacteria move to the bloodstream), lung abscesses, kidney failure, or respiratory failure.

How can you treat (and prevent) bronchitis and pneumonia?

Because bronchitis is almost always viral, antibiotic treatments aren’t effective. You may be able to relieve some symptoms with over-the-counter mucus-loosening drugs or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. A humidifier in your room or a couple of teaspoons of honey in tea or warm water may soothe the coughing as well.

The best way to prevent bronchitis is to continue practicing healthy habits, per the ALA—that means avoiding lung irritants in work settings, and staying on the defense during winter months, like washing your hands regularly, avoiding sick people, and getting a flu shot every year.

Antibiotics, however, can help treat bacterial pneumonia, while some people with viral infections may benefit from antiviral medication. No matter the cause, rest and fluids can help you recover from pneumonia, but more serious cases may involve hospitalization.

Luckily, there is a vaccine for one type of bacterial pneumonia. The pneumococcal vaccine is recommended for children under the age of 2, adults 65 years or above, and people in between who have certain chronic medical conditions. “That’s important for people with underlying illnesses of any kind,” says Dr. Schaffner. “Even smokers are at increased risk of pneumonia.”

But overall, if you have a really high fever, trouble breathing, or a cough that pulls up pus or blood, see your doctor no matter what you think the cause of your symptoms might be. Your doctor might order a chest X-ray to help determine whether your have bronchitis or pneumonia.

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