What’s the Difference Between Bronchitis and Pneumonia?

October is here, ushering in shorter days, cooler temps, and pumpkin-spice everything — along with increased respiratory infection and illness as cold and flu season ramps up. At Fivestar Pulmonary Associates, our team is ready for an uptick in community cases of: 

• Influenza
• COVID
• Pneumonia
• Bronchitis 

Just as people often confuse early symptoms of the flu for COVID (and vice versa), many patients who visit our office with a persistent cough, chest tightness, and shortness of breath aren’t sure whether they have pneumonia or bronchitis. 

While these two illnesses can share a similar set of symptoms as well as overlapping underlying causes, their differences — from infection location and severity to potential complications and treatment — are significant. Here’s what you should know. 

Bronchitis and pneumonia similarities 

Acute bronchitis and pneumonia are both infections of the lower respiratory tract, or airway. Neither illness is contagious, but their underlying causes often are. 

Usually, bronchitis develops on the heels of a viral infection (i.e., the flu, a cold), as do about one in three pneumonia infections. Both illnesses can be caused by a bacterial or fungal (mold) infection, too, and both can cause symptoms like:

• Persistent coughing
• Chest discomfort 
• Shortness of breath
• Body chills and aches
• Fever
• General fatigue 

When a viral infection is the underlying cause of bronchitis or mild “walking” pneumonia, treatment often involves at-home symptom management as the infection runs its course. 

How bronchitis differs from pneumonia

For all the characteristics they share, bronchitis and pneumonia are actually markedly different — even when each develops following an initial flu or cold infection. Let’s take a closer look at five distinguishing aspects of these two respiratory illnesses: 

1. Infection location 

The acute infections that cause bronchitis and pneumonia typically begin in your upper respiratory tract (nasal passages and throat), then travel to the lower airway. 

Bronchitis occurs when infection reaches the major airways (bronchial tubes) of your lungs, leaving them inflamed and filled with mucus. Essentially, bronchitis inflames and clogs the airways that carry oxygen from your nose to your lungs. 

Pneumonia is an infection in the alveoli, or the tiny air sacs deep in your lungs, where oxygen passes into your bloodstream. It causes swelling and fluid buildup in these tiny sacs, interfering with the transfer of oxygen from your lungs to your body. 

2. Symptoms

Pneumonia and bronchitis may share a similar symptom set, but those symptoms tend to vary in severity: 

Bronchitis

Characterized by a persistent cough that may (or may not) bring up mucus, acute bronchitis is associated with mild chest discomfort, wheezing, and a low-grade fever. Chills, sore throat, and nasal congestion are also common. 

Pneumonia 

Distinguished by a productive (wet) cough that often brings up phlegm, pneumonia is more likely to cause significant chest tightness or sharp chest pain, rapid or shallow breathing, and a fever above 101℉.

Pneumonia symptoms tend to be body-wide and more severe; body aches, headache, nausea, extreme fatigue, and confusion are other possible effects. 

3. Illness severity 

Typically, acute bronchitis is a less severe, self-limiting illness, meaning its effects are mostly respiratory, and body-wide symptoms, like fever or chills, tend to be milder. 

Pneumonia, on the other hand, has a much greater potential to become severe, causing more intense respiratory and body-wide symptoms. Bacterial pneumonia, which tends to be more common and severe than viral pneumonia, is more likely to require hospitalization.

4. Potential complications

Acute bronchitis can progress into chronic bronchitis if the infection isn’t treated properly or lasts a long time, or if regular bouts of acute bronchitis are exacerbated by smoking or exposure to other lung irritants. Both acute and chronic bronchitis can lead to pneumonia.

Pneumonia is associated with serious potential complications, ranging from lung abscess (pus in the lungs) and pleural effusion (fluid buildup in the lungs) to sepsis (a life-threatening blood infection). This is why pneumonia is more likely to lead to hospitalization. 

5. Medical treatment 

Treatment for both these respiratory illnesses varies based on the underlying cause, but pneumonia is more likely to require specific medications like antibiotics or antivirals, while viral bronchitis often runs its course with supportive care.

Don’t ignore that nagging cough 

Given that most people can’t tell the difference between acute bronchitis and pneumonia on their own — and that pneumonia often requires medical treatment and has a higher potential for serious complications — you should always seek prompt expert care when you suspect you have either illness. 

This is even more important if you have a higher risk of complications from either illness, either because you’re older, you smoke, you have a weakened immune system, or you have a chronic disease like asthma, diabetes, or heart disease. 

Think you may have bronchitis or pneumonia? Don’t second-guess yourself — schedule an evaluation at Fivestar Pulmonary Associates in Allen, McKinney, or Plano, Texas, today.