How To Tell If A Cough Is A Chest Infection?

Facts about cough

Cough is one of the primary complaints presented at primary health care centres and below are some interesting facts about cough that you should know^1,2,3

• Cough isn't a disease but a symptom of some disease conditions
• Cough can also be a normal reflex action that helps to clear our throats and airways of dust, germs and mucus
• Coughing can spread germs
• Not all coughs are contagious
• Depending on the duration a cough can be acute, subacute or chronic
• Viral infections are usually the cause of acute cough
• Several billion dollars are used for cough treatment worldwide
• Home remedies can be helpful for most coughs
• Women are more likely to develop coughs because they have elevated cough reflexes than men
• Coughing can propel air and droplets out of your lungs and airways at speeds close to 50 miles per hour
• A cough could be a symptom of a more serious medical problem when it is persistent, associated with mucus production, shortness of breath or bloody phlegm

Causes and risk factors of a chest infection

Chest infection is an infection of the lungs, bronchi (large airways) and windpipe. 

Chest infection can be bronchitis, pneumonia or tuberculosis. The most common types are acute bronchitis and pneumonia. 

Bronchitis is the inflammation of the bronchial tubes which conducts air to and from the lungs. It is often caused by a viral infection, in some cases, the infection may progress to the lungs and cause a more serious infection (pneumonia). Acute bronchitis (chest cold) is the most common type of bronchitis which is mild and often clears on its own. Bronchitis can also be chronic.

Pneumonia is when your lungs are infected, it can be caused by bacteria, viruses, fungi and aspiration or inhalation of foreign objects which get trapped in the lungs and start to rot, increasing the chance of an infection. Pneumonia ranges in severity from mild, to moderate to severe. Walking pneumonia or atypical pneumonia refers to the milder case of pneumonia that does not interfere with your daily activities but should be treated.

You may also develop a chest infection when you inhale droplets expelled when a person with an infection coughs or sneezes.

Your risk of having a chest infection is increased if you^4,5

1. Smoke or exposure to secondhand smoke damages your lungs, reduces your natural defence against microorganisms and makes you more susceptible to infection
2. Consume excessive alcohol
3. Are in hospital
4. Are older than 65 your immune system response is reduced
5. Are below 5 years this is because the immune system isn't fully developed
6. Are pregnant
7. Have a weak immune system due to illness, chemotherapy, steroid medication or HIV infection.
8. Have a long-term health condition such as asthma, chronic obstructive pulmonary disease (COPD), sickle cell disease, kidney or liver disease
9. Have factors that could increase the risk of aspiration such as stroke, Parkinson's Disease, and reduced consciousness

Signs and symptoms that your cough is possibly a chest infection

Your cough is most likely a symptom of a chest infection when it is³

• A persistent chesty cough
• Lasts more than ten days
• Accompanied by thick mucus/phlegm that is greenish or yellowish in color which might also have an odour

You may also experience shortness of breath shallow breathing, and chest pain. As well as general symptoms of infection such as fever, headache, and muscle aches.

How to reduce the risk of getting a chest infection from coughing?

There are measures you can take to reduce your risk of getting a chest infection¹

1. Avoid smoking as well as second-hand smoke
2. Practice good hygiene: clean your hands regularly, use a tissue to cover your mouth while coughing and avoid contact with someone who has an infectious disease
3. Cut down on alcohol intake: excessive alcohol can make you more susceptible to chest infection by weakening your lung's natural defence against infection
4. Diet: eat a healthy and balanced diet which includes fruits and vegetables that help to improve your general well-being and boost your immunity against infection
5. Immunisation: get recommended vaccines, such as the flu and pneumococcal vaccine, as they help you reduce the risk of getting a chest infection in the future

When to consult your doctor?

Usually, coughing is unpleasant. When it is more bothersome, you should communicate your concerns with your doctor. It could also be an indication of a more serious medical issue and consulting your doctor is necessary when¹

1. Your cough is getting worse or doesn't seem to get better
2. You have repeated episodes of cough or chest infection
3. Your cough is associated with:
   • Bloody phlegm (coughing up blood)
   • Difficulty breathing
   • Worsening or high-grade fever
   • Difficulty swallowing
   • Pain in your chest
   • Vomiting
   • Weight loss
   • Dizziness or confusion
   • Swelling or lump in your neck area
4. You have been in contact with someone who has an infectious disease

Furthermore, you should see a doctor when you suspect you have a

• Chest infection
• Pregnant
• Have a weak immune system
• Older than 65
• Have a long-term health condition

Diagnosis and treatment

Most chest infections are self-limiting and clear up within a few days or weeks. A visit to the doctor is usually not needed, you can recover at home by⁴ 

• Having sufficient rest
• Drinking lots of fluid
• Avoiding smoking
• Using lozenges
• Take paracetamol or ibuprofen to reduce fever and over-the-counter decongestants that loosen the mucus in your chest
• Home remedies such as inhaling vapour with menthol or taking a honey or lemon drink

However, if your symptoms suggest that you have a more serious infection, you should go to a health centre, your doctor will diagnose you by evaluating your symptoms. They may perform a physical examination and order a blood & sputum test to determine the microorganism responsible, as well as a chest X-ray to determine the extent and severity of your infection.⁴

Treatment depends on the causative organism which can be antibiotics if your chest infection is caused by bacteria or symptomatic treatment in the case of viral infection, antibiotics do not work for viral infections. An antimicrobial susceptibility test might also be needed to help your doctor decide the best antibiotics that will clear your infection.⁴

Summary

Coughs can be annoying and bothersome but, usually, they relieve you with time. However, you may notice certain signs that indicate that your cough is caused by a chest infection, some infections (bronchitis) clear up on their own while others (pneumonia and tuberculosis) need treatment. You should seek medical attention when you notice signs that indicate you have a more serious infection.