Can Bronchitis Turn Into Pneumonia?

Bronchitis is a type of lower respiratory tract infection. When you’re sick with bronchitis, the tubes (bronchi) that connect your windpipe (trachea) to your lungs get irritated and fill with mucus. This leads to inflammation and symptoms like cough and shortness of breath. 

If you’re sick with bronchitis, you may be wondering if your illness can get worse or if it can turn into something more concerning, like pneumonia. Bronchitis can’t turn into pneumonia. But it’s possible to develop both illnesses at the same time or one after the other. Here’s what you should know. 

What’s the difference between bronchitis vs. pneumonia?

Both bronchitis and pneumonia are types of lower respiratory tract infections. But the conditions affect different parts of your lower respiratory tract. 

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When you develop bronchitis, your bronchi becomes infected and inflamed. The bronchi are the tubes that connect your windpipe (trachea) to your lungs. Meanwhile, pneumonia is when the tiny sacs that make up your lungs (alveoli) become infected and inflamed. 

There’s another form of bronchitis, called chronic bronchitis, that’s caused by irritants like cigarette smoke. Chronic bronchitis never really goes away. This is a different condition than acute bronchitis, which is what people develop when they get sick with a chest cold. We won’t be covering chronic bronchitis here.

Bronchitis and pneumonia can both be caused by germs like viruses, bacteria, and fungi. Viruses are the most common cause of bronchitis and pneumonia. 

Bronchitis and pneumonia cause similar symptoms because they are both lower respiratory tract infections. Symptoms of both bronchitis and pneumonia include:

• Fever

• Cough

• Phlegm (mucus)

• Chest discomfort or tightness

• Fatigue

• Body aches

• Headaches

• Wheezing

• Shortness of breath

But pneumonia can also cause more serious symptoms like:

• High-grade fever

• Trouble breathing especially with movement

• Chest pain

• Nausea, vomiting, diarrhea

• Lightheadedness

• Confusion

Quiz: Do I have pneumonia or bronchitis?

Can bronchitis turn into pneumonia?

Bronchitis and pneumonia are different illnesses. So bronchitis cannot turn into pneumonia or vice versa. But you can get sick with both illnesses either at the same time or one after the other. This is often what people really mean when they ask if bronchitis can “turn into” pneumonia.

Here’s how you can get sick with both bronchitis and pneumonia. 

Dual infection

Some people develop dual infections, which means they develop bronchitis and pneumonia at the same time. In these cases, the same virus causes both pneumonia and bronchitis. People quickly develop symptoms of both bronchitis and pneumonia and may feel very sick.

Misdiagnosis

Bronchitis and pneumonia can be hard to tell apart. Both illnesses can cause similar symptoms. They can also cause similar changes in how your lung sounds, which a healthcare professional can detect during your physical exam. And a chest X-ray may not be able to tell the difference between bronchitis and pneumonia at the start of an illness. So you may get diagnosed with bronchitis and later get diagnosed with pneumonia if your symptoms get worse. But in reality, you had pneumonia the entire time. 

Secondary or superimposed pneumonia

Some people develop bronchitis first and then develop pneumonia while they’re still sick with bronchitis. Sometimes, bacteria are able to cause pneumonia because the person’s immune system is busy fighting off the virus that’s causing bronchitis. This is called a superimposed bacterial pneumonia. In these cases, people may have mild symptoms at first and then become very sick after a few days. This is the most serious situation. People can get very sick if they have a secondary pneumonia and need to start treatment with antibiotics as soon as possible.

How common is it to develop pneumonia from bronchitis?

Most people don’t develop a secondary pneumonia on top of bronchitis. But you are more likely to develop a superimposed bacterial pneumonia if you:

• Are older than 65 years 

• Have a weakened immune system

• Have an underlying lung condition

Infants and people who smoke are also at higher risk of developing a superimposed bacterial pneumonia. 

How can you tell if your bronchitis is getting worse?

Bronchitis is usually caused by a virus. Bronchitis will get better on its own, but it can take up to 3 weeks for your symptoms to completely go away. Antibiotics and steroids will not help you get better faster. 

Even though it takes time to get back to normal, you should notice that you feel a little bit better each day. Worsening symptoms or new symptoms can be a sign that your bronchitis is getting worse or that you’re developing a secondary pneumonia. 

You should get medical care if you develop:

• A new or worsening fever

• A return of fever that had previously resolved

• New or worsening shortness of breath

• New or worsening trouble breathing

• Chest pain

• Weakness

• Confusion

• Inability to eat or drink

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Written by:

Tracy Norfleet, MD, FACP

Dr. Tracy Norfleet is a board-certified Internal Medicine physician, health expert, and physician leader with over 20 years of experience practicing adult medicine. Dual-certified by the American Board of Obesity Medicine and the American Board of Lifestyle Medicine, Dr. Tracy possesses a wealth of knowledge and expertise in both traditional medical practices and innovative lifestyle interventions for chronic disease management and reversal.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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