What is double (bilateral) pneumonia?

Published: February 26, 2016
Last reviewed: June 15, 2017


Double or bilateral pneumonia affects both lung wings. It is not a special type of pneumonia; the term just denotes the distribution of lung inflammation.

Historically, the term double pneumonia was used for acute respiratory distress syndrome (ARDS).

Related terms:

  • Single (unilateral) pneumonia affects one lung wing.
  • Triple pneumonia is double pneumonia that has healed but recurred.


Any type of pneumonia can affect both lungs. Bacterial pneumonia most often affects only a part of one lung, though. Pneumonia caused by Pseudomonas, or by Staphylococcus after flu is often bilateral [6].

Viral pneumonia is usually bilateral [5].

Legionnaires’ disease, which is atypical pneumonia caused by the bacterium Legionella, often appears as double pneumonia, especially when severe [2,3].

In Mycoplasma pneumonia (walking pneumonia) [4] and aspiration pneumonia [8], one or both lungs ca be involved [4].

Septic pneumonia as a result of blood poisoning usually affects both lungs.


Symptoms of pneumonia can include a cough with or without mucus, fever, shortness of breath and fatigue. In double pneumonia, symptoms may be more severe and may include bluish discoloration of the lips and fingers (cyanosis) because of lack of oxygen in the blood.


A doctor can make a diagnosis of pneumonia from the results of a laboratory test of sputum and from the presence of white patches on an X-ray image.

Double (bilateral) pneumonia

Picture 1. Double (bilateral) pneumonia with widespread white patches in both lung wings (the dark branches are the bronchi)
(source: StartRadiology, by permission)

Double (bilateral) pneumonia

Picture 2. Double (bilateral) pneumonia with white patches in both lungs
(source: Southwest Journal of Pulmonary and Critical Care)

How serious is it?

In general, bilateral pneumonia is more serious than unilateral pneumonia, it leads to more complications (sepsis) and has greater death rate. Bilateral lobar pneumonia is usually more severe than bronchial pneumonia. This is especially true for bacterial pneumonia in which 2 or more lung lobes (multilobar pneumonia) or all lobes (panlobar pneumonia) in both lungs are severely affected.

On the other hand, scattered infiltrates in both lungs in viral or atypical pneumonia do not already mean severe disease. The denser the infiltrates appear on X-ray, the more severe the pneumonia is.

Is it contagious?

Pneumonia by itself is not contagious but microbes that cause it are. This means if you contract microbes from a person who has single or double pneumonia you may not develop any disease or possibly some milder disease, like the flu, and only sometimes pneumonia, especially if you have weak immunity.

Recovery and Prognosis

In general, double pneumonia has longer recovery time and worse prognosis than single pneumonia and it more often causes death. But again, the term double pneumonia by itself does not mean that the disease is very serious. Recovery time in severe pneumonia may be longer than 6 weeks [7].

Double Pneumonia in Elderly

Hypostatic pneumonia means the collection of fluid on the back side of both lungs in bedridden and elderly persons [1].

Differential Diagnosis

Lung conditions that may look similar to bilateral pneumonia:

  • Pulmonary edema– collection of fluid on the bottom of both lungs
  • Pneumoconiosis and silicosis


Treatment of double pneumonia is similar than treatment of single pneumonia. In severe cases, it needs to be treated in hospital with intravenous antibiotics, oxygen mask or mechanical ventilation.

30 Responses to What is double (bilateral) pneumonia?

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  2. Kay says:

    My 3 month old daughter died of bilateral lobar pneumonia. She was asymptomatic and only started showing signs of breathing difficult in the morning as was dead late afternoon .

    • Kay says:

      I mean she had difficulty in breathing and died that same day she started showing the signs while she was on oxygen support.

  3. Catherine says:

    Sept of 2017 my senior year of high school I was diagnosed with bi-lateral multi faceted pneumonia. Any symptoms or signs of sickness went undetected until day of hospitalization. I was rushed to Boston children’s hospital, I was given 26 numerous medications and antibiotics, I was in the ICU for 11 days and my heart lapsed twice causing me to go unconscious and my heart stopped. I had an oxygen tank for 2 weeks, had to learn how to walk again and get back to a healthy weight. I have experienced memory loss, recovery to feel even slightly back to myself was about 1yr and a half. So whoever experiences this please have hope because I am now 19 and able to live the rest of my life.

  4. JBG says:

    My friend is 32 and has been in the hospital for 10 days for a severe case of bilateral pneumo. He’s doing better, but seems to have plateaued on treatment. He is on breathing treatments, O2, and antibiotics; but the Dr won’t let him go until his O2 is above 90 without O2 (it’s like 88 on O2 now). Is this normal? Anyone experienced anything like this? I want to tell him to check out AMA and rest at home.

    • JBG says:

      Sorry, I should have clarified “but the Dr won’t let him go until his O2 saturation is above 90 without O2 (it’s like 88 saturation on O2 now)”

  5. Jane says:

    I am looking up this term because I have never heard of it. I am young in shape a non smoker and before I got this diagnosis was in excellent health. I waited along time to see a doctor. It feels like When you are swimming and suck up water. It’s a terrible feeling and dosnt go away even when you cough. I know I will recover but if I was weak or old I think this would have killed me. I feel sorry for the very young and older people with this condition. Thoughts and prayers are with you.

  6. Barbara Greer says:

    I have been home recovering from bilateral bacterial pneumonia for almost 3 weeks after 4 days in hospital to deal with it plus perhaps more immediately life-threatening imbalance in electrolytes (low potassium in particular). I didn’t know at the time that your heart can stop if these minerals are too low/out of balance. Anyway after 3 + weeks since diagnosis and treatment I am still very tired and still coughing. Dr. says it will probably be at least 3 more weeks before can resume normal activity. Bottom line, we need to REST & be PATIENT.
    Some practical things that have helped me:
    1 ZAND menthol cough drops-help calm the spasmodic coughing(order at iherb.com)
    2 Deep breathing using these cough drops seems to open airways & increase lung capacity
    3 Probiotics 3 to 4 times per day to restore intestinal balance caused by antibiotics(stop
    loose stools) Also plain unsweetened organic yogurt for same purpose.
    4 my body has craved protein so I am eating lots of eggs
    5 Use this healing time as an opportunity for spiritual growth: reading, prayer, reflection
    6 If we have survived this serious illness we have been given a “new lease on Life”
    How do we want to live the rest of it ?
    7 Feel and express much gratitude to medical personnel, friends & family for support and to
    God for the power to heal.
    Blessing to you all !

    • Fate Anne dela Rosa says:

      Thank you for testimony. It is a reminder for me to rest and grow deeper spiritually. God bless you

  7. John gregory says:

    My partner of nearly 40 years Barbara passed away last thursday 8 th February and death certificate says bilateral pneumonia and copd i am going to find out why on the day she died some clever physio decided she should be out of bed and sat up in a chair and i got nurses to put her bavk in bed 3 hrs later she passed away i am so angry seeing her in that chair and so ill

  8. sallie josephs says:

    I feel a fraud. I am 56 and have COPD I was admitted to hospital on 27th Dec 2017 for 5 days. Symptoms were chronic cramping sensation across my back worse on breathing out. Cold sweats and just general exhaustion. I came off a night shift, tried to sleep but ended up at the docs being told I was going to hosp with poss lung clot/pleurisy or pneumonia after an x-ray I was hooked up to antibiotics and told I’d got community acquired bi lateral pneumonia. At no point before during or after has my respiratory system been compromised I just felt crap with back pain no cough no phlegm production. I’m still off work with exhaustion and have developed labyrinthitus which is driving me crackers lol.

    • Jan Modric says:

      I don’t know, but bilateral pneumonia can be mild and does not necessary triggers cough.

    • Heather Brown says:

      I just go the coroners report on my mother’s death. She went to the doctor the day before complaining of chest pain and back pain. They gave her an EKG and said there was nothing wrong but recommended a cardiologist. The next morning she stayed home from work because she was feeling tied. My brother found her dead in bed when he got home from work. She was 54 and died of bilateral pneumonia. We are heart broken. Please take care of yourself.

  9. Marilyn Uy says:

    My 4years old daugther was diagnosed to have a bilateral pneumonia. Is this very serious condition or severe? I am afraid since she doesn’t want to take the antiobiotics that the doctor had gave us as a prescription. She sometimes vomit the whole medicine when intake. What should I do? Please help me.

    • Jan Modric says:

      Double pneumonia means that the both lungs are affected; it may be mild or severe, I can’t say what it is in your daughter’s case. If she does not want to take antibiotics, I urge you to discuss with a doctor about what to do. Pneumonia can be very serious and even fatal disease without treatment.

    • Mauva Lindsay says:

      I was admitted to the hospital for a total of 2 weeks in 2 stays. I was discharged after 3 days in the ICU and 4 days in a ward. After a few days home and still having breathing issues, I had to call 911 again. It was found that there was still too much fluid in both sides of my lungs. With the bilateral pneumonia, I only had 43% oxygen in my blood. Thanks to the doctor who check my blood. As one doctor told me, he didn’t expect that I would have lived; glad he didn’t give up on me! This was in May/2017 and I was on oxygen at home until late August. I am grateful to be alive; I wish this on no one! Please, don’t hesitate to seek a physician, follow their directions; you might save your own life or of your loved ones!

  10. Leah says:

    I also just got home from 8 days in the hospital with bilateral pneumonia. I NEVER heard the words “critically ill” and ” near death ” as much as I have in the last 2 weeks. It was the worst experience of my life. I guess I still don’t realize how sick I was and still am. I thought that after a week of resting st home I’d be up and around. Boy am I wrong. Drs say recovery time could take months. I wouldn’t wish this on anyone. Sure does wake a person up. Have to take better care of myself. I sure do appreciate things a lot more.

  11. Melissa says:

    I am 32 and am in the hospital now with bilateral pneumonia and it’s nothing like I’ve ever experienced. I came to the ER because my feet were swollen 3 times their normal size and whenever I would fall asleep, my body would seize and jerk so hard that it was throwing me out of my bed. Pneumonia was never on my radar of things that I may have so I was very lucky. I’ve been in the hospital for 4 days now and my doctors and I are still trying to figure out where I could have gotten it. I had a surgery on the 13 th of this month and a scope procedure for peptic ulcer about a week later and ended up here on the 24th. I had bronchitis around the first of this month and a sinus and ear infection to boot, I’ve never been so scared in my life and God willing, I’ll be okay and more than one thing in my life will benefit from this experience. I wish everyone well and pray for their recover! And I also want to thank those who share their stories in here, it’s given me more hope than you’ll ever know! Thank u!

  12. Krystal says:

    Yes, bilateral pneumonia means both lungs are effected and if it is bacterial not viral or fungal it gets more serious. Having this illness is the most painful I have experienced. If ever contracted be aware of the sevre shortness of breath,excruciating pain while coughing, high fevers of 101.0-103.5, body chills, muscle aches & barely being able to walk or lay down.

    • Kevin says:

      I am leaving the hospital tomorrow from exactly what you just described. It almost killed me.

    • Mizanur Rahman says:

      My wife has bilateral pneumonia.He has been suffering for 3 months. His recovery was good but it back again in right side lungs..why is it happens?what can we do now?

      • Jan Modric says:

        This is a question for a doctor. One reason why pneumonia does not heal well is treatment withe wrong antibiotics, for example.

  13. Krystal says:

    I just got out of hospital with bilateral pneumonia and it is serious. Those who say it isn’t has never experienced it. I was hospitalized for 5 days undergoing intravenous treatments of antibiotics, fluids and oral pain meds. Had I waited a day or more, the Dr. Said I would have been in icu. So, yes prognosis of untreated bilateral pneumonia will put up in intensive care if not kill you.

  14. Nigel P. Herbert says:

    My partner has bi-lateral Pneumonia, and Sepsis, so the outlook is not altogether good. He has been under very heavy sedation for the past eight days, and he is being kept alive by the machines that surround him.
    Should he recover from this, it is highly possible that he will have to live with other complications.

    April 2017

    • Jan Modric says:

      Bilateral pneumonia as such is not that dangerous – it only means that parts of the lungs on both sides are affected. Sepsis is more of a problem. The person’s doctors can give you much more info based on their experiences.

    • Harpreet Singh says:

      How severe it was because my uncle is facing very serious bilateral pneumonia from last 13 days they are admitted from a week and there saturation is not maintained it is near 91 how much does it take i am greatly worried about there well being please reply thanks alot.

  15. Kate says:

    I had bilateral viral pneumonia in april 2016. Both lungs were completely full and i spent 9 days in ICU 4 of which in a coma. Im 42years old and the near death experience changed my outlook on life. I thank god for keeping me alive for my daughter’s.

    • Anthony says:

      Hi Kaite I had this also in march I still can’t believe it only what people told me

      • Krislovelife says:

        I’m getting over in now,, both lungs were full plus I had whooping cough and my potassium levels were 2.4 ( almost died from just that )
        It’s been two and a half week now, contracted a viral infection off my daughter so feeling like death warmed up again ! Would not wish this on anyone, I told my husband I was dying & I actually was.

  16. I experienced double pneumonia when it attacked my 60 years old husband on the 4th of January when we were on holiday in western cape. We was in hospital for 7 days, started in High Care for four days,to General ward for three days. He was on O2, intravenous analgesics and intravenous antibiotics. On nebulizers and close monitoring. It is really a dangerous condition that one must not ignore its signs and symptoms. Im glad he is home and recuperating. Thanx to the Hospital staff who stood up and made it a point that he recovers.I thank God to instil knowledge in them and blessed their hands.

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