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.

Infants

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

Children

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.
  • 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.
  • Rapid respiratory rate (tachypnea): An increased respiratory rate can be an important sign of pneumonia in children. Respiratory rate is often called the "neglected vital sign" because it is so frequently overlooked.

Irrespective of the other symptoms, you should seek immediate care if the respiration rate is ever over 50 breaths per minute (BPM) in infants 2 to 12 months, 40 BPM in children 1 to 5 years, or 30 BPM in children older than 5.

Adults

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.

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.

Adults

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

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.

With walking pneumonia, a cough won't resolve within a week as it might with a cold. It will continue to increase even after the other symptoms are gone and become increasingly productive, often with blood-streaked sputum.

Other signs and symptoms might include:

Complications

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

The annual death rate for pneumonia in the United States is over 56,000, most often as a result of seasonal influenza. Most of the deaths are seen the elderly and young children with underdeveloped immune systems.

A Word From Verywell

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.

That's not to say that anyone else with symptoms of pneumonia should ride it out. Even in people with intact immune systems, pneumonia can turn deadly if left untreated. In fact, when combined with influenza, it is the eighth leading cause of death overall in the United States.

When to See a Doctor

Call your doctor if you develop a fever over 100.4 F, breathing difficulties, chest pain, or shaking chills. Seek emergency care if your child experiences rapid breathing, shortness of breath, nasal flaring, cyanosis, or signs of dehydration

Causes and Risk Factors of Pneumonia
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Article Sources
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