Symptoms of Pneumonia

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Pneumonia, an infection in your lungs, can affect anyone, but children under age 2 and adults over 65 are at the highest risk of developing it and having more serious cases. Symptoms in children include fever, fast breathing, no energy, vomiting, and cough. In adults, symptoms can be similar to a cold, progressing to a fever, chest pain, muscle aches, shortness of breath, chills, and a productive cough, though some people may first only experience fever and malaise.

pneumonia symptoms
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Frequent Symptoms

In young children, pneumonia can be difficult to spot because the most common symptoms often differ from those in adults. Pneumonia may also be harder to spot in adults who are over the age of 65 because they tend to have fewer symptoms than younger adults.


Newborns and infants may not show any signs of infection at all, but if they do, symptoms can include:

  • Vomiting
  • Fever and cough
  • Restlessness
  • Low energy
  • Difficulty eating due to having a hard time breathing
  • Seeming sick


The symptoms of pneumonia in children can be both subtler and more varied than those of adults. After having symptoms of a mild upper respiratory tract infection, such as a runny nose and mild cough, children who develop pneumonia may worsen suddenly and develop other symptoms and signs, including:

  • Fever: Sometimes the only sign that a child may have pneumonia is the presence of a fever.
  • Rapid respiratory rate (tachypnea): An increased respiratory rate can be an important sign of pneumonia in children. Respiratory rate is unfortunately often called the "neglected vital sign" because even though it can give important information, it's often overlooked. Tachypnea is defined by the World Health Organization (WHO) as a respiratory rate greater than or equal to 50 breaths per minute for infants 2 to 12 months of age; 40 breaths or more per minute for children between the ages of 1 and 5 years; and 30 breaths or more per minute for children over the age of 5.
  • Nasal flaring and retractions (tightening of neck muscles): These symptoms may be a sign of labored breathing.
  • Wheezing: Wheezing is common, especially with viral pneumonia.
  • Cyanosis: This is signaled by a bluish appearance to a child's lips, nose, and fingers, which means there's not enough oxygen in the blood.
  • Vomiting: This is often due to labored breathing.
  • Cough: A cough may be either dry or produce phlegm, which can be clear, white, yellow-green, or even blood-tinged.

If your child has any of these symptoms it doesn't necessarily mean he or she has pneumonia. Children can sometimes appear very ill with simple viral infections, especially if they have a high fever. Remember, too, that not every cough is pneumonia. A child's cough can be caused by asthma, bronchitis, allergies, reflux, and a host of other infectious and non-infectious factors.


Because adults who are older than age 65 tend to show fewer or milder symptoms than younger adults, they are more likely to be at a dangerous point by the time they seek medical attention. A quick response when any of these symptoms are present can result in less chance of hospitalization and death.

Common symptoms in adults include:

  • Cold symptoms: Your initial symptoms may be similar to a cold and include sneezing, runny nose, sore throat, mild cough, and maybe a low-grade fever. If you develop a fever over 101 degrees, see your doctor as soon as possible because this may indicate that you've developed a bacterial infection, which can lead to bronchitis or pneumonia.
  • Fever: Though you may have a fever with pneumonia, you won't necessarily have one.
  • Chest pain: You may have pain in your chest that worsens when you take deep breaths or cough. It may feel like an ache or pressure under your breastbone.
  • Productive, frequent cough: This is the opposite of a dry, hacking cough, meaning that you're producing phlegm or sputum, which is a mixture of saliva, mucus, and sometimes pus, when you cough. The sputum may be clear, but it may instead be green, yellow, or bloody. Any of these can mean you have pneumonia, though the presence of blood means you most likely have a severe infection.
  • Fatigue and muscle aches: You may feel a general sense of being tired and uncomfortable and/or have achy muscles or joint pain.
  • Shortness of breath: You may feel like you can't get enough air, even when you're not really exerting yourself. However, this may only happen with increased activity.
  • Sweating and chills: You may feel so chilled that it doesn't matter how warm the room is or how many blankets you have on, you can't get warm. You may also feel sweaty and your teeth may chatter.
  • Headaches: This symptom sometimes occurs, and it's more likely if you have a fever.
  • Change in mental awareness or confusion: This is far more common in adults who are over the age of 65.
  • Lower body temperature than normal: This symptom commonly occurs in adults over 65 and in people with compromised immune systems.
  • Gray or bluish skin color: This usually occurs around your mouth and it means that you're not getting enough oxygen in your blood.
  • Nausea, vomiting, or diarrhea

Walking Pneumonia

Walking pneumonia is the term to describe mild pneumonia that doesn't cause hospitalization. In fact, you can usually go about your normal activities if you have it. Walking pneumonia usually infects people under the age of 40, but it can infect anyone at any age.

The most common symptom is a dry, hacking cough that may change to a productive cough later. In adults, other symptoms include: 

  • Headache
  • Chest pain
  • Fatigue
  • Sore throat
  • Wheezing
  • Low-grade fever, possibly with chills

Though walking pneumonia has fairly mild symptoms, it can take a month or more to get over it, especially if you're a young child, an older adult, or someone with a compromised immune system.

In children: The first symptoms of walking pneumonia in kids can be similar to a cold or the flu and usually begin gradually with decreased activity, fever, sore throat, and a headache. Children then develop a dry cough, which can be worse at night.

Unlike a cough from a cold, which you would expect to start getting better after five to seven days, children with walking pneumonia will often cough more as time goes on, even as the fever and other symptoms are going away. Their cough will likely even become productive, may become streaked with blood, and may linger for three to four weeks. This illness can occur at any time of the year.

Other signs and symptoms might include:


Most people recover well from pneumonia, but some develop complications, particularly those in high-risk groups such as young children, older adults, people who are hospitalized, and people with compromised immune systems. Potential complications include:

  • Bacteremia: This complication occurs when bacteria from your lungs get into your bloodstream. This can cause the infection to spread to other organs and result in septic shock, which can lead to death.
  • Pleural effusions: Sometimes people develop a pleural effusion or empyema with pneumonia. The pleura are the membranes that surround and cushion the lungs with each breath. If pneumonia occurs near the outer regions of the lung, this region can become inflamed and filled with fluid or pus. When this occurs, the fluid or pus may need to be drained. This sounds frightening, but it's a fairly easy procedure in which a fine needle is inserted into the pleural cavity to withdraw fluid. If a large empyema is present, a chest tube may need to be placed while the infection clears.
  • Lung abscess: These are usually treated with antibiotics, but sometimes you will need surgery or drainage with a long needle or tube to get the pus out.
  • Respiratory failure: You may have enough trouble breathing that you need to be hospitalized and put on a respirator for a period of time. For children, sedative medications are usually used in this case so that your child isn't scared.
  • Kidney problems

When to See a Doctor

In general, if you have a fever that's 101 degrees or higher, breathing difficulties, chest pain, or a cough that won't go away, see your doctor. If you are in a high-risk group (over age 65, you're hospitalized, or you have a compromised immune system) or have an underlying chronic condition such as asthma, heart failure, or chronic obstructive pulmonary disease (COPD), it's vital that you see your doctor as soon as you suspect that you have an infection of any sort.


If your baby has any of the symptoms listed for infants, or your child is over age 2, be sure to see his or her doctor as soon as possible. If your child has a lingering cough or he or she has symptoms of pneumonia or walking pneumonia, you also need to see your pediatrician. Seek immediate medical attention if your child has any of these symptoms:

  • Rapid breathing
  • Shortness of breath
  • Retractions (labored breathing)
  • Nasal flaring
  • Cyanosis
  • Signs of dehydration
Causes and Risk Factors of Pneumonia
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View Article Sources
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