Pneumonia Signs and Symptoms

Signs and symptoms of pneumonia vary widely, differ from person to person, and mimic a bad cold or the flu. Know what needs checked.

Helpful Highlights

  • Early detection of pneumonia can be difficult.

  • There are several signs and symptoms of which to be aware.

  • Pneumonia typically doesn't resolve on its own.

  • Pneumonia can lead to serious complications if left untreated.

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When to see a provider

See a provider if your loved one has difficulty breathing, chest pain, persistent fever (≥ 102 F or 39 C), or persistent cough, especially if the cough produces discolored phlegm.

It's especially important that your loved one see a provider if they are 65 or older, have a chronic health condition (like heart or lung disease) or weakened immune system, or are receiving chemotherapy or taking medication that suppresses the immune system.

For people with heart failure or chronic lung disease, pneumonia can quickly become a life-threatening condition.

What are the signs?

Early symptoms are similar to a bad cold or the flu: fever, dry cough, headache, muscle pain, and weakness. Within a day or two, the symptoms typically get worse, with an increasing cough that starts to produce mucus, shortness of breath, and chest pain (or even stomach pain). There may be a high fever (≥102 F or 39 C), or there may be a low body temperature (below their normal), and shaking chills.

Advanced signs also include a sudden change in mental state, no appetite, extreme fatigue, and a bluish tint around the lips.

What are the symptoms?

Pneumonia symptoms can vary from so mild as to be undetectable, to so severe that hospitalization is required. How the body responds to pneumonia depends on the type of germ causing the infection, age, and overall health.

Mild signs and symptoms are often similar to those of a cold or the flu, but they last longer (more than 1-2 weeks).

  • Chest pain that gets worse with coughing or deep breathing

  • Confusion or changes in mental awareness (adults 65 and older)

  • Cough, which may produce dark yellow, green, brown, or bloody phlegm

  • Extreme tiredness, weakness, or low energy

  • Fever, sweating, and shaking chills

  • Lower than normal body temperature (adults 65 and older, and people with weak immune systems)

  • Loss of appetite

  • Nausea, vomiting, or diarrhea

  • Shortness of breath that gets worse with activity

  • Rapid, shallow breathing

  • Rapid, weak pulse

  • Bluish color to lips and fingernails

  • Persistent headache

  • Worsening muscle pain

  • Restlessness and irritability

  • Inability to sleep

  • A change in voiding habits (most likely decreased urination)

What are the potential complications?

Complications of pneumonia in older adults and the elderly are pleurisies, lung abscesses, and acute respiratory distress syndrome (ARDS), which can lead to respiratory failure and organ damage from a lack of adequate circulating oxygen. It can also worsen pre-existing conditions.

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