Asthma Versus Pneumonia

Asthma and pneumonia. Both cause inflammation of the airways and symptoms like cough, shortness of breath, chest tightness, and wheezing, this one may be misdiagnosed as the other. In asthma, the airways narrow and swell and may produce extra mucus but there is no infection. Pneumonia is an infection that causes inflammation of the air sacs in the lungs. The air sacs of the lungs can be filled with fluid or pus. 

How can you tell the difference between asthma and pneumonia? While you need to see a doctor evaluate your condition, run some tests, and recommend treatment. You may get an idea, too, about which one is affecting you if you know more details about these two conditions. Read on to learn about the differences and similarities between asthma and pneumonia. 

How can you tell the difference between asthma and pneumonia?

  • Asthma symptoms include cough, tightness of chest and wheezing. Wheezing and shortness of breath are also typical symptoms of asthma. Symptoms can range from mild to severe, lasting from minutes to days. Some individuals experience very few symptoms (ie only cough) between flare-ups.  Breathing and pulse rate are elevated during an acute attack. In many cases, the trigger of the symptoms is identified, which  can be an allergen like pollen, dust mites or pet dander, air pollution, smoke, various chemicals, dry cold air or exercise.  
  • Pneumonia also causes cough, tightness of chest and shortness of breath, Respiratory rate and pulse rate may be higher as the infection progresses. Wheezing is not a typical sign, but fever can be present. Bacterial pneumonia usually triggers higher body temperatures compared with viral pneumonia. Elderly and those with weak immune systems may actually have lower body temperature, and both can cause excess sweating and chills. Some experience digestive symptoms like nausea, vomiting and diarrhea, as well as fatigue. Mild cases of pneumonia resemble a regular cold or flu, but the symptoms tend to last longer. More severe cases may cause confusion or altered mental awareness, especially in older individuals. Newborns and young children may have vomiting, fever, cough and look lethargic, while some do not show any sign of infection at all. Risk factors for pneumonia include smoking, chronic diseases like COPD, asthma and heart diseases; weakened immune system and being hospitalized. 

Asthma vs pneumonia. Complications

Asthma flare-ups are associated with increased risk for emergency visits and hospitalization, decreased lung function, increased risk for infections. The symptoms cause sleeping difficulties, daytime fatigue, and overall reduced quality of life.

Complications of pneumonia include infections entering the bloodstream, lung abscess, accumulation of fluid around the lungs (pleural effusion), and severe breathing difficulties. 

Asthma vs pneumonia. Diagnosis and treatment

The diagnosis of asthma includes physical examination and lung function tests. Allergy tests are important to identify potential allergens that may trigger the symptoms. The treatment includes long-term preventive drugs (ie inhaled corticosteroids, leukotriene modifiers, or combination inhalers) and rescues medication for acute attacks (quick-relief bronchodilators, anticholinergic agents, oral or iv corticosteroids).

The diagnosis of pneumonia is based on a physical exam and confirmed with blood tests, chest X Rays, pulse oximetry, sputum tests, and other investigations, as needed. The treatment is based on the cause, the severity of the symptoms, age, and overall condition. Bacterial pneumonia is treated with antibiotics. Cough medicine, pain relievers, and drugs to reduce fever can also be prescribed. Elderly, those with severe symptoms, kidney dysfunction, who need breathing assistance may need to be admitted to the hospital.  

What is the link between asthma and pneumonia?

Things can get even more complicated when an individual has both asthma and pneumonia. How are they connected? 

Asthma causes inflammation, excess mucus of the airways which become more narrow and hyperactive when exposed to a trigger. These changes increase the risk of getting an infection, including pneumonia. Pneumonia is mostly infectious in nature and can be caused by bacteria, viruses, and fungi. According to the Center for Disease Control and Prevention (CDC), common causes of viral pneumonia are influenza, respiratory syncytial virus, and SARS-CoV-2  while pneumococcus is a common cause of bacterial pneumonia. People with asthma are more likely to have complications of flu, including pneumonia. Furthermore, the use of inhaled corticosteroids is also associated with an increased risk of respiratory infections, including pneumonia. The other way around is also possible. Severe cases of pneumonia can lead to the development of asthma o, aggravate pre-existing asthma, and trigger flare-ups. 

As you can see, asthma and pneumonia share some similarities, but also many differences- especially when it comes to the underlying cause, possible complications, and treatment. You can keep a journal and try to identify any triggers that make your symptoms worse, your energy levels, how you sleep at night, and any recent respiratory infections. Also, notice how you respond to the medicine and tell your doctor these details. You may need adjustment to the treatment or other investigations to better manage your condition. 

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