Can Bronchitis Turn Into Pneumonia?

Introduction

Bronchitis and pneumonia are infections of the lower respiratory system. Lower respiratory tract infections have different etiologies, and they can be viral, bacterial or caused by fungi; however, environmental and chemical factors can cause modifications in our respiratory system and lead to the development of other diseases.

The lower respiratory system has different zones, including bronchi, bronchioles and alveoli. Bronchitis is an inflammation of the bronchi, the main airways that carry air to the lungs. When the bronchitis progresses this inflammation goes to the final bronchi or alveoli causing pneumonia.

What is Bronchitis? (Brief)

Bronchitis is the inflammation of the tissue lining the large airways called bronchi, which are the tubes that carry air to the alveoli for oxygenation of the inhaled air. Inflammation in the bronchi is usually caused by infectious agents, either viral or bacterial, generally viral in origin. Infection in the bronchi will cause mucus production, which leads to the inflammation and swelling of the bronchi, decreasing the diameter of the lumen, making airflow more complicated, and resulting in coughing as a mechanism to free the airways. 

Bronchitis has two classifications: acute, which can affect people for four weeks, or chronic, also known as a chronic obstructive pulmonary disease (COPD), which is a non-reversible condition and usually worsens over time.

Causes and Risk Factors

Different risk factors can cause you to suffer from bronchitis. Viral and bacterial agents, in general, are the leading causes of inflammation of these airways. However, exposure to chemicals and cigarette smoke can also cause bronchitis. In addition, gastric reflux is a risk factor for suffering from bronchitis since irritating substances ascend through the digestive tract and can pass into the respiratory tract.

Symptoms

The bronchitis symptoms are similar to those of a common cold. However, it is usually a little more prolonged and causes discomfort in the thorax. The symptoms of bronchitis typically are:

  • Frequent cough, often with yellow or green mucus.  
  • Chest pain when coughing or taking deep breaths.
  • Noisy breathing such as wheezing or whistling.
  • Shortness of breath.
  • Body aches.
  • Fever or chills.
  • Sore throat.
  • Stuffy nose.

Treatment

The treatment for mild bronchitis is usually the same as for the common cold. It consists of using antipyretics such as paracetamol and antihistamines to reduce mucus secretion and syrups to treat dry cough. In moderate cases, inhaled steroids are used to help reduce the inflammation of the bronchi. In cases where there is no improvement, it is best to consult with your doctor, who might prescribe the antibiotics. 

What is Pneumonia? (Brief)

Pneumonia is an infection that affects the distal region of the airways. It affects our terminal bronchi or the alveoli. Like bronchitis, pneumonia can be caused by viruses, bacteria, mycotic agents and mycobacteria.

Pneumonia is an extensive infection of the lungs that can lead to many health complications. Since pneumonia mainly affects the alveoli, where the inhaled air is oxygenated, it can lead to decreased oxygen transportation in our body, causing hypoxia. Pneumonia can be classified into two types, community-acquired pneumonia and hospital-acquired pneumonia. Figuring out where the infection was acquired is critical for diagnosing its etiological agent and assigning suitable treatment. To diagnose pneumonia, doctors need to conduct a thorough medical exam and may ask you about your symptoms and perform physical examinations, chest x-rays and blood tests. The results of the assessments will guide your doctor about the infection aetiology.

Causes and Risk Factors

As mentioned above, the causes of pneumonia can be viral, bacterial, mycotic or mycobacterial, depending on where the patient has acquired the infection. However, some predisposing factors make people more likely to suffer from this disease. These include pronounced smoking habits, advanced age, immune illnesses, brain disorders that favour bronchial aspiration, bedridden patients with limited mobility, and recent hospitalisations.

Symptoms

People with pneumonia usually have a cough, constant fever that is difficult to manage, chills, shortness of breath, low energy, and lack of appetite. Sometimes people have nausea, diarrhoea and/or chest pain. In some cases, people experience frequent states of confusion, elevated urea, increased respiratory rate, and low blood pressure. It is also possible to have pneumonia without a cough or fever, called atypical pneumonia.

Treatment

Treatment of community-acquired pneumonia may require antibiotic therapy at home and a re-evaluation with your physician at the end of the medication. However, in some cases, especially in older patients, it requires hospitalisation and intravenous antibiotic treatment. Treatment of hospital-acquired pneumonia always requires delivery of antibiotics, either orally or intravenously. 

How do you know if bronchitis turns into pneumonia?

Bronchitis is usually of viral origin, and this can be self-limiting after 2 weeks without producing major symptoms, like any viral syndrome in the first 3 to 5 days can produce fever, malaise and then these symptoms are subsiding, something very characteristic of bronchitis is dry and constant cough but when the weeks have passed and you have followed treatment, you have prolonged fever difficult to handle, there is yellow or green mucus, loss of appetite, chest pain is time to go to your health provider for a medical evaluation may have become pneumonia a respiratory infection.

How long does it take for bronchitis to turn into pneumonia?

Bronchitis is usually of viral origin and can be self-limiting after two weeks without producing significant symptoms. However, like other diseases of viral origin, bronchitis is characterised by fever and physical discomfort in the first 3 to 5 days, which then subside. Dry and constant cough is very characteristic of bronchitis, which usually resolves with time and treatment. However, if you still experience any of the following symptoms after weeks of treatment, you should see your health provider: 

  • Prolonged and difficult-to-handle fever
  • Yellow and green mucus 
  • Loss of appetite 
  • Chest pain

Upon your visit to the practice or hospital, the medical evaluation might show that bronchitis has developed into pneumonia. 

Which is worse: Pneumonia or Bronchitis?

When we talk about lower respiratory infections, we must be in a state of alert and constant vigilance of the symptoms. For instance, bronchitis affects the ducts where the air passes to the alveoli. Usually, bronchitis symptoms are not severe, and recovery can be spontaneous or with treatment at home. On the other hand, pneumonia occurs when the infection has spread to the most distal or distant region of our lungs, affecting the alveoli, where the blood is oxygenated to be distributed to all our tissues. Pneumonia can lead to severe symptoms and fatal consequences if not diagnosed and treated in time.

Summary

Bronchitis and pneumonia are considered infections of the lower respiratory system. Their aetiology can be viral, bacterial, or chemical, and risk factors include age, stroke, weak immune system, bronchial aspiration and hospitalisation. It is important to note that if you experience any prolonged respiratory symptoms and chest pain, you should visit your health care provider to be examined and diagnosed early. Most respiratory infections occur in the elderly, but when bronchitis is not treated correctly or timely, it can lead to complications at any age. 

References

  1. World Health Organization. Pneumonia [Internet]. Who.int. World Health Organization: WHO; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/pneumonia
  2. American Thoracic Society. PATIENT EDUCATION | INFORMATION SERIES What causes pneumonia? [Internet]. 2015. Available from: https://www.thoracic.org/patients/patient-resources/resources/what-is-pneumonia.pdf
  3. Pneumonia - Causes and Risk Factors | NHLBI, NIH [Internet]. www.nhlbi.nih.gov. Available from: https://www.nhlbi.nih.gov/health/pneumonia/causes
  4. Acute Bronchitis Overview Diagnosis Experience [Internet]. Available from: https://lungfoundation.com.au/wp-content/uploads/2018/09/Factsheet-Acute-Bronchitis-Aug2018.pdf
  5. American Thoracic Society Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease [Internet]. 1995. Available from: https://www.thoracic.org/statements/resources/copd1-45.pdf
  6. Yankaskas JR. Bronchitis, bronchiectasis and cystic fibrosis [Internet]. Elsevier; 2010 [cited 2022 Apr 12]. p. 276–83. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/bronchitis

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Hugo Uriepero

Medical Doctor - Medicine, Universidad Nacional Experimental de los Llanos Centrales 'Rómulo Gallegos', Venezuela
Experienced as a Medical assistant to tourists through telemedicine platforms with international reach, Rural Doctor and Resident emergency physician.

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