Overview

Bronchitis and Pneumonia are lung conditions that show similar symptoms which is why they are often mistaken for each other. However, there are clear differences which will eventually emerge in a few days. Bronchitis is rarely fatal while Pneumonia can be life-threatening. That is why, it is important to take any breathing disorder or difficulty seriously and consult a doctor immediately. Only a doctor is qualified to say what the exact condition is. In this article, we will examine how to tell the 2 conditions apart

Bronchitis in brief

The trachea or the wind-pipe branches into two tubes called bronchii, one each in both lungs. The bronchii in turn branch into multiple, smaller branches called bronchioles before terminating in the alveoli or air-sacs. The bronchii and bronchioles are the air-carrying pipes in the lungs. Bronchitis is a condition in which a virus infection causes inflammation in the bronchioles. As the tubes get inflamed, they swell and fill up with pus or fluid, which hugely hinders breathing.  As a natural reaction of the body, the person coughs repeatedly in order to clear the tubes. The person also expels yellow-green phlegm from the lungs.

Again, there are 2 types of Bronchitis:

• Acute: Short-term condition with severe symptoms. Caused by a virus, lasts 2 weeks, and is contagious. Spreads through droplet infection and fomite contamination (similar to Covid-19)
• Chronic: Long-term condition with mild to moderate symptoms. Caused by respiratory infections or irritants in the air. Can last up to 3 months and is rarely contagious.

Pneumonia in brief

We have covered Pneumonia in depth in earlier articles. Pneumonia is an infection or inflammation in the alveoli which are tiny air-sacs in the lung that help in gas-exchange. The alveoli swell and fill up with mucous which hugely hinders breathing.  Here too, the person coughs repeatedly and expels yellow, green or blood-tinted mucous. Other complications include fluid accumulation in the lungs and a cavity in the lungs that is filled with pus (condition called as lung abscess). Like Bronchitis and Covid-19, Pneumonia also spreads through droplet infection and fomite contamination.

Also Read: Pneumonia in Old Age

Similarities and differences between the two

Causes

Bronchitis	Pneumonia
Acute Bronchitis is caused by viruses such as Adenovirus, Parainfluenza virus and Influenza A & B, and rarely by bacteria such as Mycoplasma pneumoniae, Bordetella pertussis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae	Bacterial pneumonia: caused by bacteria, the most common one being Streptococcus pneumoniae. The condition is then called pneumococcal pneumonia. Other bacteria include Legionella pneumophila and Haemophilus influenzae.
Chronic Bronchitis is caused by:	Viral pneumonia: Viral pneumonia is caused by viruses such as Rhinovirus, COVID-19, Influenza A & B, Human metapneumovirus and Respiratory syncytial virus (RSV)
Above viruses and bacteria	Mycoplasma pneumonia: caused by tiny organisms called Mycoplasma which have the characteristics of both viruses and bacteria.
Cigarette smoking	Fungal pneumonia. Fungal pneumonia is caused by fungi, such as Pneumocystis jiroveci, Coccidioides and Blastomyces
Exposure to dust, polluted air, fumes of toxic chemicals, and 2nd hand tobacco smoke

Also Read: The top 6 reasons for Chronic Cough

Symptoms

Common symptoms between the two conditions include coughing with or without mucous, mucous that is yellow-green in color, fever and chills. Unique symptoms are as below:

Bronchitis	Pneumonia
Wheezing	Rapid breathing
Tightness in the chest	Trouble breathing
	Blood-tinted mucous
	Fatigue
	Sore throat
	Sweating
	Chest pain
	Weakness
	Loss of appetite
	Muscle pain

Diagnosis

When it comes to diagnosis, there are no differences between the two conditions and the same methods are used for both. This includes:

• Using a stethoscope to listen to the breathing: This is the first step always. Any rattling, whistling, bubbling or crackling sounds are signs of either bronchitis or pneumonia.
• Sputum culture: A sample of the phlegm coughed up by the person is examined under the microscope for specific pathogens.
• Chest X-ray: Chest X-ray will help doctor see where the infection is in the lungs, which will help pinpoint whether it’s bronchitis or pneumonia.
• Pulse oximetry: A pulse oximeter is clipped to the forefinger of either hand, and the oxygen level in the blood measured. A low count indicates either bronchitis or pneumonia.
• Spirometry: One of the prominent tests for lung function. Here, the person blows forcefully into a device called a spirometer. How forcefully or quickly the person can blow will indicate how much lungs the air can hold. A good result indicates the absence of either bronchitis or pneumonia. A bad result indicates either of them is present.

Treatment

Bronchitis	Pneumonia
Medications	Medications
Over-the-counter drugs such as bronchodilators (inhalers), nonsteroidal anti-inflammatory drugs (NSAIDs) and cough suppressants	Over-the-counter drugs such as cough suppressants, fever relievers and pain relievers like acetaminophen and ibuprofen
Antibiotics	Antivirals
Corticosteroids	Antibiotics
Lifestyle changes	Antifungals
Quitting smoking	Lifestyle changes
Avoiding second-hand smoke	Staying hydrated with plenty of fluids
Staying hydrated with plenty of fluids	Getting adequate rest
Therapies	Therapies
Pulmonary rehabilitation (for chronic bronchitis)	Supplemental oxygen
Supplemental oxygen (for chronic bronchitis)	Hospitalization
Surgery	For severe cases of pneumonia. The person will be given antibiotics and intravenous fluids
Lung-volume reduction surgery (to remove damaged lung tissue) – rare	Surgery
	To remove damaged or infected parts of the lung(s) – rare

NOTE: Take medications only when prescribed by your doctors, self-medication must be avoided under any circumstances.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801

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