Monday Medical: Bronchitis or pneumonia? How to tell the difference
February 4, 2019
If you've had a persistent cough, shortness of breath and feel run down, you may have bronchitis. Then again, it might be pneumonia.
Both illnesses have similar symptoms but require different treatments. And pneumonia is especially important to diagnose as it can become a serious health issue, fast.
Below, Crystal Henderson, a family nurse practitioner at UCHealth Primary Care Clinic in Craig, outlines how to distinguish between the two and when to seek medical attention.
Bronchitis causes the airways, or branching tubes that bring air into the lungs, to swell and produce mucus. It's usually caused by a virus, such as R.S.V., rhinovirus or influenza.
Symptoms include coughing, fatigue, wheezing, a runny or stuffy nose, muscle aches and fever. The sputum — or gunk that's coughed up — may be clear, yellow or green.
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"Bronchitis usually lasts five to seven days, but it can last up to three weeks and still not be bacterial," Henderson said. "That's why this is tricky. It may feel like pneumonia."
As the leading cause of death worldwide, pneumonia is much more serious. In the U.S., there are 4.5 million outpatient visits for pneumonia each year.
Just like bronchitis, symptoms of pneumonia include a cough and fatigue. Sputum may also be clear, yellow or green.
Additionally, pneumonia is more likely to result in a high, persistent fever, shortness of breath, sharp chest pain and chills.
"Pneumonia is more of an infection of the air sacs of one or both lungs," Henderson said. "Anybody can get it, though, we worry most about our older patients, patients with chronic illness and young children."
Pneumonia is often caused by a bacteria, which means it needs to be treated with antibiotics. It can also progress quickly, so should not be ignored.
When to see a provider
Since it can be difficult to tell the difference between bronchitis and pneumonia, Henderson recommends seeing a health care provider if you have symptoms of either.
"If people are really feeling ill and having shortness of breath, they should get it checked out," Henderson said. "Usually bronchitis is going to get better on its own — it just takes time. But we don't want to miss that pneumonia."
Patients most at risk include those older than 65, those with chronic illnesses, such as asthma, diabetes, heart disease and lung issues, and young children. Having previously had influenza is also a risk factor as the virus can lead to pneumonia.
"If it's progressing fast, you should seek medical attention immediately," Henderson said.
Diagnosis and treatment
Your doctor will check your vitals and take a history of your symptoms to make a diagnosis. The only way to confirm pneumonia is with a chest X-ray.
Since pneumonia is often bacterial, it is treated with an antibiotic. Your provider will prescribe an appropriate antibiotic, taking into consideration any antibiotic-resistance in your area. As a viral infection, bronchitis does not require an antibiotic.
For both bronchitis and pneumonia, treatment includes rest and hydration. Over-the-counter medications, such as cough syrup, decongestants and nonsteroidal anti-inflammatories — such as ibuprofen — may help with symptoms, but always check with your provider to make sure a medication is safe for you. Saline nasal rinses can also help, especially if the patient has upper respiratory symptoms.
Getting a flu vaccine can help prevent both bronchitis and pneumonia, as does regularly washing your hands and not smoking. A pneumonia vaccine may be recommended for at-risk patients.
"Both bronchitis and pneumonia are really common, and it's hard to distinguish between them," Henderson said. "So don't hesitate to see your health care provider if you have symptoms of either."
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.