Bronchitis vs. Pneumonia: How to Tell the Difference

During the fall and winter months, your respiratory system is exposed to the risk of several different illnesses: the common cold, the flu, and viruses like COVID-19. Bronchitis and pneumonia are two other illnesses that 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, told Health. In other words, their symptoms often blur into each other, making it hard to distinguish one illness from the other. 

According to infectious disease specialists, here's what you need to know about the similarities and differences between bronchitis and pneumonia.

What Is Bronchitis?

Bronchitis—specifically acute bronchitis—is the sudden development of inflammation in the bronchial tubes, the airways in your lungs.

"The infection gets beyond the confines of the bronchial tubes and actually gets into the substance of the lung," said Dr. Schaffner. "Then, it causes inflammation in the tissues of the lung."

Viruses are responsible for most cases of bronchitis. In fact, the viruses responsible for common colds and the flu often are the culprit in cases of acute bronchitis.

"The same virus that causes the common cold settles lower down in the lungs and causes bronchitis" in some people, Ephraim L. Tsalik, MD, PhD, an associate professor of medicine in the division of infectious diseases at the Duke University School of Medicine, told Health.

Bronchitis is usually temporary and not severe. Also, the illness doesn't typically cause any permanent lung damage.

What Is Pneumonia?

Pneumonia is an infection in one or both of the lungs, affecting the air sacs of the lungs and causing them to fill up with fluid or pus.

Bacteria is one of the most common causes of pneumonia, but viruses and fungi can also cause illness.

For example, pneumonia can be a complication of respiratory syncytial virus (RSV), influenza viruses, and coronaviruses (including SARS-CoV-2, which causes COVID-19). Viral pneumonia is often less severe than bacterial and fungal pneumonia. Usually, fungal pneumonia only occurs in people with chronic health conditions or weak immune systems.

A mild form of pneumonia called atypical pneumonia or "walking pneumonia" can be caused by a virus or bacteria. With walking pneumonia, most people can continue their daily activities as if they only had a bad cold.

Usually, people feel better in three to five days, but sometimes symptoms, like fever, chills, and headache, can occur.

Pneumonia can range from mild to severe, depending on what caused the infection, the infected person's age, and their overall health. How much of the lungs are affected can also determine the severity of the disease.

"The larger the proportion it affects, the more seriously ill you are going to become," explained Dr. Schaffner.

What Are the Symptoms of Bronchitis vs. Pneumonia?

Bronchitis and pneumonia often cause similar symptoms, making it challenging to differentiate between them. However, there are some key differences. 

Bronchitis

One of the most prominent symptoms of bronchitis is a cough. Often, bronchitis causes a cough that occurs in spells, said Dr. Schaffner. 

Symptoms often mimic the common cold during the first few days of bronchitis. Some of the most common symptoms of bronchitis include:

• 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 usually lasts a week to 10 days, but don’t be surprised if the cough continues—even for several weeks.

Pneumonia

Pneumonia symptoms can be similar to those of bronchitis. But the major difference is the severity of the symptoms, which 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 
• Vomiting
• Diarrhea

Those symptoms, however, can vary between populations. Young children, for example, may experience gastrointestinal (GI) issues. In contrast, older adults may experience mild versions of respiratory symptoms.

Generally, pneumonia lasts a few weeks to a few months, typically longer than bronchitis. Additionally, some cases of pneumonia can lead to severe issues like:

• Bacteremia, which occurs when bacteria move to the bloodstream
• Lung abscesses
• Kidney failure
• Respiratory failure

How Do You Treat Bronchitis and Pneumonia?

Some mild cases of bronchitis and pneumonia only require managing your symptoms and getting rest and plenty of fluids. But depending on what causes your illness and severe your symptoms are, you may need specific treatments.

Bronchitis

Because bronchitis is almost always viral, antibiotic treatments aren’t effective. Instead, you may be able to relieve some symptoms with the following treatments:

• Plenty of rest and fluids
• Over-the-counter (OTC) cough suppressant or expectorant
• Pain relievers, including non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen)
• A humidifier in your room

Although not proven to work, a couple of teaspoons of honey in tea or warm water may be comforting and possibly soothe the coughing.

Pneumonia

On the other hand, antibiotics can help treat bacterial pneumonia. Some people with viral or fungal infections may benefit from antiviral or antifungal medications.

No matter the cause, rest and fluids can help you recover from mild cases of pneumonia. But severe cases of the illness may require hospitalization.

Luckily, there is a vaccine for one type of bacterial pneumonia. The Centers for Disease Control and Prevention (CDC) recommends the pneumococcal vaccine for children under 2, adults 65 years or above, and those in between with certain chronic medical conditions.

"That's important for people with underlying illnesses of any kind," explained Dr. Schaffner. "Even smokers are at increased risk of pneumonia."

Reducing the Risk of Bronchitis and Pneumonia

You can take some steps to prevent both bronchitis and pneumonia—including staying up-to-date on vaccines and practicing a healthy lifestyle.

Bronchitis

Certain people are at a higher risk for getting bronchitis than others, including people who:

• Are older
• Have been exposed to smoke or secondhand smoke
• Have a family history of lung disease
• Had respiratory diseases as a child
• Have gastroesophageal reflux disease (GERD)

One of the best ways to prevent bronchitis is practicing healthy habits, such as:

• Not smoking and avoiding secondhand smoke
• Avoiding lung irritants (like paint, paint remover, and varnish) or wearing a mask when exposed
• Washing your hands regularly
• Avoiding sick people
• Getting a flu shot every year

Pneumonia

Just like with bronchitis, certain people are more likely to get pneumonia than others, including:

• Adults 65 years and older
• Children under 5 years old
• People with ongoing health conditions
• People who smoke cigarettes

Vaccines can help prevent bacterial pneumonia caused by the bacterium Streptococcus pneumoniae. Also, getting your yearly flu shot can help prevent pneumonia caused by influenza viruses. 

To prevent pneumonia, the National Heart, Lung, and Blood Institute (NHLBI) recommends that you practice a healthy lifestyle, including:

• Quitting smoking
• Practicing good hygiene, including proper handwashing 
• Exercising regularly
• Making healthy food choices

When to Talk to a Healthcare Provider

Talk with a healthcare provider if you have a cough that doesn't go away after a couple of weeks or if you get bronchitis frequently.

If you have more severe symptoms, like a high fever, trouble breathing, or a cough that pulls up pus or blood, see a healthcare provider no matter what you think the cause of your symptoms might be. A healthcare provider might order a chest X-ray to help determine whether you have bronchitis or pneumonia.

It's always best to err on the side of caution and talk with a healthcare provider if your symptoms aren't going away or get worse.

A Quick Review

There are many similarities between bronchitis and pneumonia. The symptoms can be similar. But often, pneumonia symptoms are more severe than those caused by bronchitis. Treatment will vary depending on whether a virus, bacteria, or fungus causes your illness. 

Practicing healthy habits and getting vaccines when appropriate can help reduce the risk of bronchitis and pneumonia. Talk with a healthcare provider if you have symptoms that don't improve or become more severe.