Chest infection symptoms and treatment

The main symptoms that could indicate a chest infection are:

• a new persistent cough
• coughing up yellow or green phlegm (mucus)
• wheezing or shortness of breath
• chest pain or tightness
• a high temperature (fever)
• a rapid heartbeat
• a headache
• muscle aches and pains
• feeling ill and tired, loss of appetite

Chest infections can feel similar to the common cold and the flu but symptoms are often worse and can lead to considerable discomfort. Signs of a chest infection can include coughing up yellow or green mucus, shortness of breath, chest pain, wheezing, a high fever, or rapid heartbeat.

Acute bronchitis (often viral) and pneumonia (often bacterial) are the two main types of chest infection. Viral and bacterial chest infections have overlapping symptoms but pneumonia causes more severe symptoms while acute bronchitis symptoms are milder and usually get better within a week. Symptoms that suggest pneumonia include:

• shortness of breath
• chest pain in one place when breathing in
• coughing up mucky phlegm with blood in it
• high fever
• feeling very ill

Acute bronchitis can sometimes develop into pneumonia.

Pneumonia can lead to serious health complications that require hospital treatment including:

• Lack of oxygen – this can make you breathless and have blue discolouration to your lips.
• Pleurisy – inflammation of the pleura (the lining around the outside of the lungs) that causes chest pain. This can get worse when you take a deep breath.
• Septicaemia – bacteria spreading to and poisoning the blood, which can also cause low blood pressure and damage to the kidneys, brain, liver and heart.
• Fluid around the affected lung (a pleural effusion, which can become infected).

A viral chest infection can affect healthy people with otherwise strong immune systems. Viruses account for 85 to 95% of cases of acute bronchitis and about 20% of pneumonia cases. Common viruses that cause chest infections are often the same as those that cause the common cold and the flu.

Viruses that cause most cases of acute bronchitis include:

• Respiratory Syncytial Virus
• Parainfluenza Virus
• Influenza A and B
• Coronavirus SARS CoV2 (COVID-19)

A bacterial chest infection often affects people with underlying health conditions, including those with weaker immune systems and those with a recent viral respiratory infection. Bacterial infections are often the main cause of pneumonia, but can also cause acute bronchitis. Bacterial chest infections are usually prescribed treatment with antibiotics.

Acute bronchitis is an infection of the bronchi – the main airways between the trachea and lungs. The infection is usually viral but can also be bacterial. It causes the bronchi to become inflamed and produce excess mucus. Common symptoms include coughing (to clear the mucus which is produced as phlegm), wheezing, shortness of breath or fever.

Early signs of acute bronchitis may appear to be the common cold or the flu, particularly in winter. Symptoms are usually mild and can often be managed at home. Although rare, acute bronchitis can turn into pneumonia – a more serious health condition. Acute bronchitis is not a direct cause of its namesake, chronic bronchitis.

Severe or chronic bronchitis, known as chronic obstructive pulmonary disease (COPD), is not caused by an infection. Instead, the lungs and airways become inflamed and damaged over time due to breathing in harmful substances. Smoking is the main cause of COPD, but other factors that can cause COPD include occupational exposure to certain dusts and fumes.

Pneumonia causes inflammation of the tiny air sacs (alveoli) in one or both lungs. The alveoli fill up with fluid or pus making it difficult to breathe. Common symptoms include coughing up phlegm (mucus), shortness of breath, fever and chest pain. Pneumonia is usually caused by a bacterial infection but can also be caused by a virus, or rarely by a fungus.

Early symptoms of pneumonia may be similar to the flu or bronchitis. However, pneumonia is more severe and can be life-threatening. If you suspect that you have pneumonia you should see a doctor for diagnosis and treatment.

Acute bronchitis and pneumonia are the two most common chest infections. They share similar symptoms (mainly a productive cough) making it difficult to tell what condition you may have. If your symptoms are more severe it is likely you have developed pneumonia. You should see a doctor if you suspect you have pneumonia. Symptoms that suggest you may have pneumonia rather just acute bronchitis include:

• shortness of breath
• chest pain in one place when breathing in
• coughing up mucky phlegm with blood in it
• high fever
• feeling very ill

Five steps to help clear a chest infection:

1. Get plenty of rest to help your body recover
2. Drink lots of water to loosen the mucus so it is easier to cough up
3. Take medication like paracetamol or ibuprofen to lower your fever and relieve headaches and muscle pains
4. Elevate your head and chest at night with extra pillows to clear your chest of mucus
5. Use your inhaler if you are asthmatic or have another lung condition to relax the muscles in your airways

There are other home remedies you can follow to help get rid of a chest infection.

Two things you should avoid if you have a chest infection:

1. Avoid smoking, being around secondhand smoke or inhaling other irritants. Smoking aggravates symptoms and increases the risk of developing a more serious condition.
2. Avoid taking cough medicines – there’s little evidence they help. Coughing helps you clear mucus from your lungs to get over the infection faster.

Antibiotics do not work on viral infections (like most cases of acute bronchitis) but may be prescribed for bacterial infections (like pneumonia). Mild cases of pneumonia can be treated with oral antibiotic tablets taken at home. More serious cases require admission to hospital for antibiotics (sometimes given intravenously), oxygen, and infusion of fluids.

The typical antibiotic prescribed for a chest infection is amoxicillin (a type of penicillin). If you are allergic to amoxicillin, alternatives can be used like clarithromycin or doxycycline. It is important to always take the full course of antibiotics even if you start to feel better; a five day course should be sufficient for pneumonia and bacterial bronchitis.

Antibiotics may result in side effects including:

• nausea
• vomiting
• diarrhea
• rashes

To diagnose pneumonia your GP may ask:

• what symptoms you have and how severe they are
• if you feel breathless, have difficulty breathing or if you are breathing faster than normal
• if you have a cough, if you cough up mucus and what colour it is
• if you have chest pain and if it is worse when you breathe in and out
• if you feel drowsy or confused
• when your symptoms started

Your GP may also run other tests like:

• listen to your lungs with a stethoscope to check for crackling or whistling which can be a sign of infection
• listen to your chest by tapping on it to see whether your lungs are filled with fluid due to infection
• take your temperature with a thermometer
• measure the amount of oxygen in your blood with a pulse oximeter (finger probe)
• measure how quickly you can blow out air from your lungs with a spirometer or a peak flow meter

If you have more severe pneumonia, you may need:

• a chest X-ray to determine where the infection is in your lungs, and to help distinguish between bronchitis and pneumonia
• a throat or nose swab to test for respiratory viruses
• a sputum culture to analyse the mucus you cough up to identify the bacteria causing the infection
• blood tests to measure your infection and inflammation markers
• oxygen to increase supply to the lungs
• fluids to help with rehydration

You can find your nearest clinic to see a Medicspot doctor today or learn more about how we can help with chest infections.

3 natural remedies for chest infections include:

• Inhale steam from a bowl of hot water (not for small children due to scalding risk). The added moisture helps break down mucus. Menthol crystals can be added to the water to help decongest the nose and throat.
• Drink hot peppermint tea. Peppermint contains menthol that helps thin mucus.
• Wear a face mask or a scarf if cold outside as cold air may cause shortness of breath.

You may lose your appetite if you feel unwell or produce a lot of mucus. It is important to maintain a healthy diet with all the nutrients you need to keep your body strong. Certain foods can help reduce the severity of your symptoms and give you the vitamins you need to fight the infection.

Some foods help with chest infections:

• wholegrain carbohydrates like bread, pasta and rice are the easiest form of energy to digest
• soups and yoghurts help soothe throat pain

Acute bronchitis usually clears up on its own within a few days or sometimes weeks. You may find that your cough lasts several weeks after other symptoms have passed. You should see a doctor if you cough lasts longer than 3 weeks or if your fever lasts longer than a week. The duration of acute bronchitis can vary depending on your age, the severity of symptoms and overall health condition.

Percentage of people by [acute bronchitis cough duration]:

Common stages of pneumonia recovery:

| Recovery time | Prognosis| |————— |———————————————————————– | | 2 days | your temperature should start to settle after 48 hours of antibiotics | | 1 week | your fever should be gone | | 4 weeks | your chest pain and mucus production should be substantially reduced | | 6 weeks | your cough and breathlessness should be substantially reduced | | 3 months | most symptoms should be gone but you may still feel very tired | | 6 months | you should feel back to normal |

Your doctor will probably schedule a follow up appointment to check on your recovery. You should see your doctor again if your symptoms do not begin to improve within 3 days of starting antibiotics, if they get worse or are slow to disappear. Some people may need an X-ray 6 weeks after they started their course of antibiotics to check that the infection has completely gone.

Recovery time for pneumonia varies from person to person. You can take steps to improve recovery time like deep breathing exercises and slowly increasing activity levels. Pneumonia is a serious lung disease and can take time to get fully better. Most people fully recover from pneumonia, but it can lead to complications and death. Elderly people or those with pre-existing health conditions are most at risk of severe complications of pneumonia.

In most cases, a 5 day course of antibiotics is sufficient and will be more successful if the course is completed. You should always complete the full course of antibiotics even if you start to feel better. Bacterial pneumonia can become resistant and may come back if you stop taking the antibiotics before the course ends.

Hospital treatment may involve two different antibiotics at the same time. In some cases, your doctor may increase the course length of your first antibiotic or prescribe a different antibiotic to kill the infection.

Chest infections are mainly caused by a virus or bacteria that affects the airways or lungs making it difficult to breathe. You can catch a chest infection from an infected person coughing or sneezing or from touching the same surface as an infected person. Chest infections are more common during autumn and winter.

Some groups of people are more susceptible to developing a chest infection:

• babies and very young children
• elderly people
• pregnant women
• people who smoke
• people with long term chest problems
• people with a weakened immune system
• people with pre-existing long term health conditions

Smoking makes acute bronchitis or pneumonia much more likely. Smoking damages your lungs so can aggravate symptoms of acute bronchitis, increase the chance of a chest infection and increase the risk of developing COPD. Vaping is also likely to have a similar effect but not enough is known about it as yet. Research on vaping and its impact on respiratory infections is limited but the Lung Institute does not recommend vaping for anyone.

It is important to stop smoking if you have a chest infection or lung disease. When you stop smoking it can be a great opportunity to quit smoking completely. The NHS has two useful resources to help stop smoking altogether:

• Read 10 self-help tips to stop smoking
• Call 0300 123 1044 to get advice and support from the Smokefree helpline

Pneumonia can be caused by:

• Bacteria (like Streptococcus pneumoniae). Bacterial infections are the most common cause of pneumonia.
• A virus (like the Respiratory syncytial virus or Influenza type A or B), known as viral pneumonia. Viral infections are common causes of pneumonia in young children.
• Fungi (like Pneumocystis jirovecii). Fungal infections are rare unless someone has a very weakened immune system.
• Choking on food or breathing in vomit can cause what is known as aspiration pneumonia.
• Being in intensive care on a breathing machine allows bacteria to enter the lungs more easily, and this can cause what is known as ventilator-associated pneumonia.
• People being treated in a hospital or having an operation are often not very mobile and less able to clear their chest. This can lead to what is called a hospital-acquired pneumonia.

Streptococcus pneumoniae is the most common cause of bacterial pneumonia. There are more than 100 different strains of this bacteria – some are more likely to cause severe infection than others. Streptococcus pneumoniae causes a pneumococcal infection which can be non-invasive (like bronchitis), partially invasive (like pneumonia), or highly invasive (like septicaemia, septic arthritis, or meningitis).

Pneumococcal vaccines are available to help protect against certain Streptococcus pneumoniae strains. These are given to:

• children (learn more)
• people aged 65 or over
• other adults at high risk of pneumonia due to underlying chronic diseases

The pneumococcal polysaccharide vaccine (PPV) is used in adults and protects against 23 strains; it is given once only (although some doctors suggest booster doses every 5 years in the elderly).

Other bacteria that can cause pneumonia include:

• Haemophilus influenzae
• Staphylococcus aureus
• Moraxella catarrhalis
• Streptococcus pyogenes
• Klebsiella pneumoniae

If you are worried that your child might have a chest infection, here are a few tell-tale signs to look out for:

• coughing and vomiting with coughing
• difficulties breathing
• problems with feeding or drinking
• change in skin colour
• drowsiness

Children under 2 years old are susceptible to bronchiolitis. Learn more about bronchiolitis

The infection itself can last between 3 to 10 days in children. However, your child might still have a cough from the chest infection for up to 3 weeks. It can sometimes be difficult for your child to cope with a chest infection for this long. Read our tips on how to treat chest infection in children to help relieve some of your child’s symptoms.

You should take your child to see a GP if your child:

• is under 5 and you suspect they have a chest infection
• has a cough that is causing them pain or making them breathless
• is feeling very unwell or their symptoms are getting worse
• has a weakened immune system, e.g. from diabetes or chemotherapy
• has a long-term health condition

When you take your child to see a GP, they will be able to examine your child by listening to their lungs using a stethoscope and monitoring their oxygen levels. The doctor will then be able to make an assessment on what type of chest infection your child has and provide them with the right treatment.

There are some things that you can do to help your baby’s cough. This includes:

• Making sure your baby gets plenty of rest.
• Giving your baby extra breastfeeding or bottle feeding to help them get the fluids they need to fight off the infection.
• Breathing in steam can help relieve a baby’s cough. Try taking your baby into the bathroom while the shower is on, being very careful to keep your baby away from the hot water to prevent them from getting burned.
• Babies are nasal breathers so a blocked nose can be troublesome. Tickling their nostrils with tip of a tissue can make them sneeze. The natural remedy for a blocked nose!
• Infant paracetamol or infant ibuprofen, making sure to give the correct dose. Infant paracetamol can be given to babies from 2 months old if they weigh at least 4 kg and were born after 37 weeks. Infant ibuprofen can be given to babies from 3 months old if they weigh at least 5 kg.

Signs that your baby may have a chest infection:

• coughing
• wheezing
• breathing differently or fast
• indrawing of the flesh between the ribs when breathing
• difficulty feeding
• exhaustion

Sometimes, babies with a chest infection will also have a fever but this isn’t always the case.

The infection itself tends to clear up between 5 and 7 days but the accompanying cough might persist for a little while longer. Understandably, this can seem like a long time. Read our advice on how to treat chest infection in babies to help relieve some of your baby’s symptoms.

If your baby has a viral chest infection, this will usually clear up on its own without intervention. If your baby has a bacterial chest infection, your GP might prescribe antibiotics to help fight the infection. Some infections will respond better to antibiotics than others, your doctor will be able to make an assessment on the best treatment for your baby.

If your baby is over the age of 1, you could try giving them a warm drink of lemon and honey to help with their coughing. Watch this video to find out how this is made.

Chest infections can sometimes be difficult to prevent, but there are some things you can do to reduce the chances of your baby catching a chest infection. One way is to make sure your baby is up to date with all of their routine immunisations. This should help to prevent your baby from catching infections such as whooping cough. Another is to avoid smoking in the home or around your child as this is a major risk factor for chest infections in children.

To stay updated with your baby’s routine immunisations, the NHS provides a handy timeline of vaccinations required for your baby and throughout their childhood.

Bronchioles are the small tubes in the lungs that control the flow of air. Bronchiolitis is inflammation of the bronchioles caused by the Respiratory Syncytial Virus (RSV). The inflammation restricts air flow making it difficult to breathe. Early bronchiolitis symptoms are usually similar to symptoms of the common cold, including a cough, fever, and blocked or runny nose.

Symptoms often get worse over a few days before showing signs of improvement. Further symptoms of bronchiolitis can include:

• a rasping, persistent dry cough
• wheezing
• brief pauses when breathing
• being irritable
• difficulty feeding or feeding less
• vomiting after feeding
• having fewer wet nappies

Bronchiolitis is a common infection that affects babies and young children under 2 years old. Approximately 1 in 3 children will have developed bronchiolitis in the UK by the age of 1. There is no medication to treat bronchiolitis – the infection usually clears up on its own within 2 weeks. Most children can be cared for at home as you would the common cold.

Approximately 2-3% of babies with bronchiolitis require hospitalisation. Dangerous symptoms in babies and children include:

• your baby has difficulty breathing
• your baby’s lips or tongue are blue
• long pauses in your baby’s breathing

It may take a little longer for your chest infection to clear as changes to your immune system occur during pregnancy. This largely depends on the type of chest infection that you have. If you have a bacterial chest infection, your GP might prescribe you with suitable antibiotics for pregnancy to help fight your infection. Some antibiotics have to be avoided in pregnancy (for example tetracyclines such as doxycycline); but amoxicillin is safe.

For advice and things you can try at home, learn how to get rid of a chest infection at home.

Painkillers like paracetamol are considered safe during pregnancy and can help relieve the symptoms of a chest infection. It is also safe to apply some Vicks chest rub to help speed up your recovery.

Speak with your GP who will be able to examine your chest and provide you with relevant treatment.

Having a cough while pregnant, whether it be from a chest infection or cold and flu, generally will not cause harm to your baby. Your baby is safely protected by your amniotic fluid which helps to absorb the shock of a hard cough.

Despite being a common myth that coughing hard can cause a miscarriage, this isn’t something you should worry about.

If you are pregnant and suspect that you might have a chest infection, you should visit your GP. They will be able to examine you by listening to your lungs and monitoring your oxygen levels. If there is evidence to suggest your chest infection is bacterial, your GP might prescribe you with some suitable antibiotics for pregnancy to help fight your infection.

The Medicspot diagnostic station allows doctors to remotely listen to your chest, measure your oxygen levels, and take your temperature to effectively diagnose your condition.

Find your nearest clinic.

Dr Sufian Ali is a Medicspot GP based in the West of Scotland, having attended Aberdeen Medical School and completed his GP training in Glasgow. He has enjoyed working in a number of specialties including paediatrics, psychiatry and emergency medicine; while also working in a variety of settings.

Professor Brown qualified as a doctor in 1988 and has been a consultant respiratory physician at University College London Hospitals since 2003. He has a particular interest in lung infection, an area in which he has published many research and review articles. As well as his clinical practice he leads a research group at University College London investigating how pneumonia develops and new vaccines and other approaches to prevent lung infections.

Dr Maheinthan Yogeswaran qualified as a doctor from Aberdeen Medical School in 2007. He subsequently trained as a GP and now works as a GP for Medicspot alongside an NHS practice in Essex. He has a wide spectrum of experience; notably in palliative care. Dr Yogeswaran also works on training future generations of GPs as a GP trainer.

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions. Medic Spot Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. In the event of an emergency, please call 999 for immediate assistance.