Difference Between Bronchitis and Pneumonia: Symptoms, Antibiotics

Published: February 26, 2016
Last reviewed: March 20, 2018

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

Acute Bronchitis


What is it?
  • Inflammation of the lining of the windpipe (trachea) and smaller airways (bronchi)
  • Viruses (>90%), bacteria, smoking and other irritants
  • Bacteria, viruses or (rarely) fungi
Coughing up mucus
  • Clear, yellow or green mucus, possibly containing blood, or just dry cough
  • Bacterial: yellow, green or rusty mucus, possibly containing blood
  • Viral or atypical: dry cough or little mucus
Difficulty breathing
  • No or only subjective feeling of shortness of breath
  • Severe bacterial or viral p.: shortness of breath during rest
  • Atypical p.: shortness of breath during exercise
  • Usually not
  • Bacterial: High
  • Viral or atypical: Yes or no
Other symptoms
  • Relatively mild
  • Usually starts as a common cold or the flu with runny nose and dry cough, followed by chest pain, wheezing and coughing up mucus.
  • Can be severe.
  • Bacterial: severe fatigue, pain on either side of chest during deep breathing (in pleurisy), wheezing
  • Viral or atypical: Muscle pain or headache, sore throat, runny nose, wheezing
  • By exclusion of similar diseases
  • Sputum analysis: usually not helpful
  • X-ray: normal
  • Sputum and blood culture can reveal microbes
  • X-ray: white patches
  • Bed rest
  • NO antibiotics in otherwise healthy individuals
  • For pain: NSAIDs (ibuprofen), acetaminophen
  • In severe cases, if 6 years or older: cough suppressants (codeine, dextromethorphan), beta agonists (albuterol, theophylline)
  • Bacterial: bed rest, antibiotics
  • Viral: bed rest, antivirals
  • Atypical (walking): antibiotics
Recovery time
  • 2-3 or up to 8 weeks
  • Bacterial: 1-2 weeks
  • Viral: 1-3 weeks
  • Atypical: few weeks to months
  • In smokers: chronic bronchitis
  • In low immunity: viral pneumonia
  • Pleural effusion, lung abscess, acute respiratory distress syndrome (ARDS), sepsis, death

Chart 1 sources: [1,2,3,4,5,6,7]


  • 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

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