When cold and flu season strikes, pneumonia isn’t far behind. The same viruses that make you sneeze and spike a fever can also infect your lungs. And doctors say if you’re fighting a cold or the flu, you’re more susceptible to acquiring a bacterial form of pneumonia too.
But don’t be lulled into thinking you’re safe from infection once winter is done. Despite a seasonal uptick, this common lung disease can occur any time of the year. Pneumonia is spread through coughs, sneezes, and touch, or by breathing germy air. You can also get it from inhaling foreign matter into the lungs.
Young children, older adults, and people with compromised immune systems are particularly vulnerable, doctors say. But even healthy young adults can land in the hospital or die from pneumonia when it’s severe.
“The pneumonias that a person can get will differ at different points in their life and with different risk factors,” explains Aaron Glatt, MD, chief of infectious diseases at South Nassau Communities Hospital in Oceanside, New York, and a spokesperson for the Infectious Diseases Society of America.
Normally, your nose and airways filter out unwanted bugs. But when these invaders pass through to one or both lungs (often after you’ve had a cold or the flu), or if your immune system is too weak to defend against an infectious assault, tiny air sacs in your lungs, called alveoli, become inflamed and fill with fluid or pus.
Different types of pneumonia strike different people. Some tend to occur when folks are in the hospital for something else. This is known as “hospital-acquired pneumonia” or “healthcare-associated pneumonia.” When food, liquid, saliva, or vomit makes its way into the lungs, it’s called “aspiration pneumonia.” The most common type is “community-acquired pneumonia,” also called “walking pneumonia,” because it’s a milder type of infection.
Pneumonia in adults is usually due to a bacterial infection. Streptococcus pneumoniae (also known as pneumococcus) is often responsible. Viruses are more typically the culprit in children. Causes of viral pneumonia include influenza (the flu virus), rhinovirus (the common cold), and RSV (respiratory syncytial virus, which is common in infants and children). Fungi and chemicals may also infect the lungs.
Dr. Glatt says the signs and symptoms of pneumonia can vary too: “It’s a constellation of symptoms that the doctor looks at, not one particular finding.” When making a diagnosis, your doctor will consider your physical exam, diagnostic test results, and medical history.
Here are some common signs and symptoms of pneumonia. If you’ve been troubled by any of these, go get checked out!
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Depending on the type of pneumonia and other factors, you can have a dry cough or a chesty, sputum-producing one.
“People that have a typical bacterial pneumonia will more frequently have a phlegmy kind of a cough,” explains Dr. Glatt. The mucus they cough up is “dirtier, thicker, and ugly,” he says.
By contrast, viral pneumonia often (but not always) produces less phlegm, and people whose immune systems are not working well may not produce any at all, he adds.
An elevated body temperature is very frequently associated with bacterial and viral pneumonia.
“However, the absence of a fever doesn’t rule out pneumonia,” Dr. Glatt cautions. He says a low temperature, known as hypothermia, may also be a sign of bacterial pneumonia, and it’s possible to contract pneumonia and have a normal temperature as well.
Teeth-chattering chills may be a sign of pneumonia–and we’re not talking about the goose bumps you get when the temperature drops. Pneumonia-related chills usually come on quickly, and they can be pretty intense.
This type of shivering is typically accompanied by fever and may signal the growth of bacteria in the bloodstream, explains Charles Dela Cruz, MD, PhD, associate professor at Yale School of Medicine and director of the Center for Pulmonary Infection Research and Treatment in New Haven.
If you have pneumonia, you may have difficulty breathing. You might increase your breathing rate to try to compensate, which in turn can leave you feeling short of breath, Dr. Glatt says.
If the infection is compromising your lung function, you may not be able to deliver enough oxygen to your blood. Some people require supplemental oxygen or treatments to help them breathe with pneumonia. In severe cases, a tube may be inserted into the airway to help the person breathe, he says.
A child with pneumonia who is having a hard time getting enough oxygen might have lips or fingernails that turn bluish. Contact your doctor immediately if you notice this in your kids.
Labored breathing or coughing can exhaust the muscles, making it hurt to breathe or cough, doctors say. Or, you might have some pneumonia-related chest discomfort because it’s your lungs that are infected.
But if you’re having sharp chest pain, it could be due to the inflammatory effects of pneumonia throughout the body. “There are some instances where pneumonia can lead to heart attack,” cautions Dr. Dela Cruz. Call your doctor or 911 if you have sudden chest pain and other symptoms of a heart attack.
When pneumonia becomes sepsis, the body’s own immune system begins to wreak havoc. Blood pressure drops, urine output is low, and even your mental capacity can be affected. You may feel dizzy or confused, a sign that you need hospital care–stat!
“These are really bad signs that the pneumonia is out of control,” says Dr. Dela Cruz.
Much like adults, infants, toddlers, and young children with pneumonia may have a fever, chills, or labored breathing.
But watch for less specific symptoms as well. Infants may feed poorly and become dehydrated, for example. Children may have a loss of appetite. Babies and toddlers will cry more than usual. Your little one won’t be full of energy. Pneumonia in kids can also lead to abdominal pain or vomiting.
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How to tell if it’s bronchitis vs. pneumonia
The key difference between bronchitis and pneumonia? Usually, it’s the scope of symptoms and their severity.
Bronchitis is an infection of the inner mucous lining of the branch-like passageways (called bronchial tubes) that carry air to the lungs.
“In an [otherwise] healthy person, bronchitis would be more of a hacking type of cough,” says Dr. Glatt. You start to think of pneumonia when the cough is coupled with a fever and breathing problems, adds Dr. Dela Cruz.
Of course, when you’re sick with one of these conditions, it may be impossible for you to distinguish one from the other–another reason why it’s important to seek medical attention. A doctor may order a chest X-ray to help determine whether bronchitis or pneumonia is causing your symptoms.