How do I know if my cough is pneumonia?

Coughs and colds are rife this time of year, but how can you tell when they might be a sign of something more serious, like pneumonia?

Recognising the difference between an ordinary cough and a potentially dangerous lung infection can play a crucial role in ensuring timely treatment and a smooth recovery.

To help clarify the signs, we spoke to Dr Claire Agathou, co-founder of the A-Z General Practice at The Wellington Hospital, part of HCA Healthcare UK, who explained exactly what pneumonia is, what its key symptoms are, and when to seek medical advice.

What is pneumonia?

“Pneumonia is an infection of the lungs which causes inflammation in the tiny air sacs in the lungs, which are called alveoli, which then fill with fluid or pus,” explains Agathou. “This makes it much harder for oxygen to pass into the bloodstream which leads to coughing, breathlessness and fever.

“It can affect just one lung or sometimes both and ranges from mild to life threatening.”

According to Asthma + Lung UK, there were 518,525 hospital admissions for pneumonia alone in England last year and almost a fifth of these patients were readmitted again after 30 days.

What causes it?

“Pneumonia is most often caused by bacteria called streptococcus pneumoniae, but viruses and less commonly fungi can also trigger it. We often call this an atypical pneumonia,” says Agathou. “Pneumonia can develop after a viral illness like a flu when the immune system is really run down or when bacteria is inhaled into the lungs.”

How can I tell if my cough is likely to be from pneumonia vs from a viral infection or allergies? Are there any key differences to look out for?

“Typically a more viral or an allergic cough tends to be on the drier side. Sometimes, if it’s viral, it’s also linked to a sore throat or feeling a bit congested and usually improves itself after a week or two,” says Agathou.

However, she highlights that pneumonia coughs are typically “productive”, i.e, bring up mucus or phlegm.

“If you’re bringing up green, yellow or rusty-coloured phlegm and start to feel very feverish, are experiencing any breathlessness, those would be the sort of things that would start to make you think it might be pneumonia,” says Agathou. “You will generally feel more unwell and weak with a pneumonia than you would with a simple cold or hay fever-like symptoms, if it was allergy related.”

Any there any other key symptoms to look out for?

“Another big thing to look out for is chest pain, or pain when breathing in,” highlights Agathou. “Another common symptom that we see, particularly in older adults, is confusion. In addition, when you’ve got a pneumonia you may pass much less urine and tend to be dehydrated, so these are some other things to look out for.”

Who is more at risk?

“It is possible for anyone to develop pneumonia and many healthy adults recover well with antibiotics,” says Agathou. “However, the rates are much higher in vulnerable communities – so in the elderly or people with reduced immune function or respiratory conditions.

“It’s really important that babies, the elderly or those with chronic conditions, weaker immune systems or respiratory conditions displaying symptoms are seen to very promptly.”

When should you go to a GP about your symptoms?

“If you’ve got a cough that’s just lingering and persisting after five to seven days, you should be seen by a doctor,” advises Agathou. “But, irrespective of time frame, if you have a really severe cough, feel really unwell and start to feel that your breathing is off the norm, then I would get checked out very quickly by a GP.

“If there is a pneumonia there, we want to treat it as soon as possible when it’s mild, to prevent you from getting much worse.”

How is pneumonia diagnosed?

“When you go to a GP, we check your oxygen levels, your breathing rate, your temperature, your pulse and all of these things that can indicate to us how severe the infection is,” explains Agathou. “We also listen to your chest to see if we can hear anything unusual and if we are very concerned we can organise an X-ray.”

How is pneumonia treated and managed?

“If it’s a typical pneumonia, antibiotics and fluids are the primary sources management,” says Agathou. “Oral antibiotics are usually prescribed, provided that the person is able, is not vomiting, and is in a suitable condition to be managed at home. However, the most severe cases need hospital care, oxygen support and fluid.”

Why are people more susceptible to pneumonia in the colder months?

“In the colder months, our immune systems are working harder because of the stress from a cold response, and also because infections tend to spread more,” says Agathou. “We also know that flu is more common in the winter months, and when people have flu or viruses it means their immune systems can be weaker and that’s why you’re more susceptible to getting pneumonia.”

Are there any ways to prevent yourself from getting pneumonia?

“It is all about making sure that your immune system is kept as strong as possible,” says Agathou. “For example, doing things that can help us fight infection better, like making sure you’re dressed warmly and taking multivitamins.

“In addition, if you are eligible for the flu and/or Covid vaccine you should consider having these.”

For more information on protecting your lung health this winter, visit asthmaandlung.org.uk/withyouthiswinter