Bronchitis or Pneumonia? How to Tell the Difference

Winter is upon us, and with it, the unwelcome arrival of “sickness season.” Among other winter illnesses, pneumonia-associated infections have increased over the past year. Since late spring 2024, the CDC has reported an increase in the percentage of emergency department visits with a discharge diagnosis of mycoplasma pneumonia (atypical pneumonia) or acute bronchitis.

Pneumonia, which can be more severe than bronchitis, results in 50,000 deaths per year in the U.S. Distinguishing between acute bronchitis and a more serious case of pneumonia can help you decide when to seek treatment.

‘Patients often wonder about the difference between bronchitis and pneumonia. Understanding these conditions can help alleviate unnecessary anxiety,” says Kamran Boka, MD, pulmonologist and critical care specialist at Covenant Health. “Bronchitis typically involves the inflammation of the airways, leading to a persistent cough, often with clear to yellowish mucus.  It is usually caused by a viral infection and resolves with supportive care.

“Pneumonia, on the other hand, can be more complex and is an infection of the lung tissue itself.  This can be more serious.  Symptoms like fever, chills, chest pain, and difficulty breathing are more pronounced in pneumonia and may require antibiotics or hospitalization depending on the cause and severity,” he says. 

“As a pulmonologist, I focus on guiding my patients through these distinctions, ensuring accurate diagnosis and personalized care for their respiratory health.“

Bronchitis vs. Pneumonia 

While bronchitis and pneumonia are both lung conditions, they impact different areas of the respiratory system. Bronchitis occurs when the lining of your bronchial tubes, which carry air from the windpipe to and from your lungs, becomes inflamed and filled with mucus. Pneumonia is an infection of the lung itself. It occurs when the air sacs, or alveoli, of one or both lungs fill with fluid.

What Causes Bronchitis and Pneumonia? 

Both bronchitis and pneumonia can be caused by a virus, bacteria, or mold (fungus). Bronchitis often develops after you’ve been sick with a viral infection like the flu or a cold. After the illness, inflammation and mucus clog the airways that carry oxygen to your lungs.

Pneumonia occurs when swelling and fluid in the lungs prevent oxygen from effectively reaching the bloodstream. Viral pneumonia, which represents about one-third of pneumonia cases, results from viruses such as the flu. Bacterial pneumonia, however, occurs when bacteria such as Streptococcus pneumoniae infect the upper respiratory tract. Viral pneumonia can resolve on its own, but bacterial pneumonia typically requires antibiotics for treatment.

Bronchitis Symptoms 

Acute bronchitis – commonly known as a chest cold – produces symptoms like cough, runny nose, and congestion.

“One of the hallmark symptoms of bronchitis is persistent cough, usually with significant mucus production. The cough can be aggravating and last several weeks, even as other signs and symptoms like mild fever, fatigue, and chest discomfort fade,” Dr. Boka says. “The norm is for acute bronchitis to clear up within two weeks, but the cough can linger for weeks into a couple of months in select cases. The airways are inflamed and take long to heal.” 

In rare cases, bronchitis can lead to pneumonia if the infection spreads from the bronchial tubes to the lungs, or if a secondary infection occurs. Individuals with weakened immune systems or underlying conditions are more susceptible to a spreading or secondary infection.

Acute vs. Chronic Bronchitis 

Chronic bronchitis is a long-term condition that causes constant irritation and inflammation of the bronchial tubes. It is caused by repeated exposure to irritants like smoking that keep the lungs inflamed. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD) and often requires medical attention. Symptoms can be managed but not cured. Over time, they can slowly deteriorate lung function.

Pneumonia Symptoms 

Pneumonia symptoms often mimic bronchitis symptoms and may include fever, shortness of breath, chest pain, and chills. Distinguishing symptoms are a productive cough and sharp chest pain when coughing or breathing deeply. Many people also have difficulty breathing and feel like their lungs are full or clogged.

Pneumonia vs. Atypical Pneumonia  

Some forms of pneumonia are more serious than others. The CDC reports approximately 150,000 Americans are hospitalized each year with pneumococcal pneumonia, a form of bacterial pneumonia that’s common among adults. Treatment for bacterial pneumonia almost always requires antibiotics.

Atypical pneumonia – commonly called walking pneumonia – is a less severe form of bacterial pneumonia. It occurs when an infection from mycoplasma pneumoniae bacteria gradually progresses to pneumonia.

Walking pneumonia infections can occur at any age, but are more common in children and young adults. “It is called ‘walking pneumonia’ becaue patients usually have milder symptoms compared to typical pneumonia — patients can ‘walk around’ rather than be bedridden or even hospitalized,” Dr. Boka explains. “Although it sounds less serious, it’s very important for patients to see their physician to ensure proper diagnosis and treatment.”

Bronchitis and Pneumonia – Comparison of Symptoms

The chart below notes by description or letter “x” the symptoms that may occur with bronchitis or pneumonia.

How to Prevent Bronchitis and Pneumonia 

Follow health guidelines to prevent the spread of respiratory germs. Wash your hands frequently, avoid touching your face, keep common areas clean, and avoid sharing personal items when someone is sick.

Avoid activities or exposure to things that might irritate your airway passages. These can include secondhand smoke, cleaning products, and even cold air. Using a humidifier can help moisten dry air and ease symptoms.

“Pneumonia vaccines are a vital tool in preventing serious illness in vulnerable populations such as older adults and those with severe underlying health conditions like diabetes, asthma, and COPD,” says Dr. Boka. “Although the vaccine does not completely eliminate pneumonia risk, it reduces patients’ risk of hospitalization and complications if they contract it.”

The pneumococcal vaccine is recommended for adults 19-64 with underlying medical conditions and for all adults 65 and older.

Treating Bronchitis 

Treatment for bronchitis depends on the type and cause of illness. Viral bronchitis does not respond to antibiotics and must run its course. For bacterial bronchitis, your doctor may recommend antibiotics. When you’re sick, be sure to get plenty of rest and increase your fluid intake. Over-the-counter medicines such as pain relievers and cough medications may also relieve symptoms.

“The first step is diagnosis by a physician, especially if you are unsure. Self-care for bronchitis should including staying hydrated to thin mucus, expelling mucus, considering over-the-counter mucolytics [medications that break up mucus in the lungs], and using a clean humidifier for easier breathing,” Dr. Boka says.

“Honey has been shown to alleviate throat discomfort and calm the cough temprarily. Preservative-free lozenges may work for some as well. Patience and rest are the best here. If you feel ill, treat your symptoms by staying rested and drinking plenty of fluids.”

Dr. Boka explaines that chronic bronchitis is not curable, but it can be managed with appropriate treatments. “As a lung physician, I focus on iproving a patient’s symptoms, preventing and reducing flare-ups as much as possible, and slowing disease progression.”

Both acute and chronic bronchitis are worsened by smoking. You can reduce your risk and prevent further damage by quitting smoking.

Treating Pneumonia 

Dr. Boka notes that self-treatment is not recommended for pneumonia, so seek a physician’s advice if you think you have pneumonia symptoms. Those more susceptible to pneumonia include children, the elderly, and people with pre-existing conditions such as asthma, COPD, and reactive airway disease. If you are recovering from a respiratory illness or have a weakened immune system, you are also at greater risk.

Pneumonia usually requires antibiotic treatment, because most cases stem from bacterial infections. If your doctor prescribes antibiotics, be sure to take the entire prescription, even when you start feeling better. This helps prevent the reinfection once you’re well.

Viral and fungal forms of pneumonia do not respond to antibiotics, but symptoms can be managed with at-home treatments. These can include over-the-counter pain medicine to relieve fever and chest pain, rest, and increasing fluids to clear phlegm from your airways. Your doctor may also recommend antiviral or steroid medications.

If you are hospitalized for pneumonia, healthcare providers may administer breathing treatments such as oxygen therapy, fluids by mouth or IV, and antimicrobial agents such as antibiotics or antivirals.

When to See a Doctor 

If your symptoms are severe or worsening, consult a healthcare provider to prevent your illness from progressing. Covenant Health’s primary care physicians can accurately diagnose your illness and get you on the path to recovery. We can also refer you to services such as cardiopulmonary rehabilitation to treat chronic bronchitis or more severe cases of pneumonia.

Contact your doctor if you experience any of these symptoms, especially if your immune system is weakened by pre-existing conditions:

• High fever (>100.4°F) lasting for multiple days
• Chest pain – especially sudden, sharp pain on one side
• Cough lasting more than three weeks
• Blood in mucus
• Shortness of breath
• Shaking chills
• Rapid breathing
• Drowsiness or confusion

Bronchitis and pneumonia both respond well to treatment, especially if you seek treatment early. Prompt medical care and at-home support can quickly get you on the path to recovery.

If you need a healthcare provider, learn more about Covenant Health’s primary care services.