Acute bronchitis (“chest cold”) and pneumonia are inflammations of the lower respiratory tract that can both cause a cough with phlegm and chest pain. Acute bronchitis is usually a self-limiting disease, while pneumonia can be life-threatening, so it is important to know the difference between them.
Chart 1. Acute Bronchitis vs Pneumonia |
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Acute Bronchitis |
Pneumonia |
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| What is it? |
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| Causes |
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| Coughing up mucus |
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| Difficulty breathing |
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| Fever |
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| Other symptoms |
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| Diagnosis |
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| Treatment |
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| Recovery time |
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| Complications |
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Chart 1 sources: [1,2,3,4,5,6,7]
Summary
- Symptoms alone may not be enough to differentiate between acute bronchitis and pneumonia. Fever is usually absent in bronchitis and present in bacterial and viral pneumonia but may be absent in atypical pneumonia. Mucus can be present or absent in both diseases; its color does not help to distinguish between pneumonia and bronchitis or between bacterial or viral bronchitis [4].
- A doctor can make a diagnosis of acute bronchitis by excluding pneumonia and similar diseases. X-ray in acute bronchitis is normal and in pneumonia it shows white patches.
- Acute bronchitis in otherwise healthy persons usually heals on its own without any specific treatment; antibiotics probably do not help [10]. Pneumonia may require treatment in hospital with antibiotics or other drugs.
Can bronchitis turn into pneumonia?
In otherwise healthy persons, acute bronchitis rarely leads to pneumonia, but it may do so in elderly and those with impaired immunity, for example, due to HIV/AIDS, sarcoidosis, cystic fibrosis, cancer, steroid treatment or chemotherapy [9].
Is bronchopneumonia bronchitis plus pneumonia?
No. Bronchopneumonia is a type of bacterial pneumonia with inflammation of the small airways called bronchioli and the associated air sacs, while bronchitis is–usually a viral–inflammation of the large airways, that is bronchi and trachea [11,12].
Differential Diagnosis
A doctor can make a diagnosis of acute bronchitis by exclusion of other conditions with a cough or chest pain:
- Common cold (head cold)
- Strep throat (bacterial pharyngitis)
- Influenza
- Asthma
- Gastroesophageal reflux disease (GERD)
- Pneumonitis–lung inflammation due to inhalation of gastric acid, vomit or toxic fumes
- Pulmonary edema, for example, in heart failure
- Tuberculosis
In small children:
- Bronchiolitis–an infection of small bronchi (bronchioli) in infants
- Whooping cough (pertusis)
- Cystic fibrosis
- References
- Kamangar N, Bacterial pneumonia, clinical presentation Emedicine
- Mosenifar Z, Viral Pneumonia, overview Emedicine
- Bono MJ, Mycoplasmal pneumonia, clinical presentation Emedicine
- Albert RH, 2010, Diagnosis and Treatment of Acute Bronchitis American Family Physician
- Fayyaz Y, Bronchitis Emedicine
- Fayyaz Y, Bronchitis, workup Emedicine
- Fayyaz Y, Bronchitis, workup Emedicine
- Sethi S, Acute bronchitis Merck Manual, Professional Version
- Sethi S, Acute bronchitis, Merck Manual, Consumer Version
- Smith SM et al, 2014, Antibiotic treatment for people with a clinical diagnosis of acute bronchitis Cochrane
- Bronchopneumonia (lobular pneumonia) Atlas of Pathology
- Hacking C et al, Bronchopneumonia Radiopedia