What are the symptoms of pneumonia?

The symptoms of pneumonia can vary and generally overlap with other symptoms of the common cold or flu. This variability makes it sometimes difficult to recognize pneumonia. Many people attribute it to a cold that just won't go away. However, pneumonia can be life-threatening if it is not properly treated.

• Some symptoms of pneumonia include: shaking and chills; fever; a cough that produces mucus or phlegm, which usually appears rust colored or burnt orange; shortness of breath; chest pain worsened by deep breathing or coughing; and night sweats. When pneumonia is caused by bacteria, an infected individual usually becomes sick relatively quickly and experiences the sudden onset of high fever and unusually rapid breathing. When pneumonia is caused by viruses, symptoms tend to appear more gradually and are often less severe than in bacterial pneumonia. Wheezing may be more common in viral pneumonia.
• In extreme cases, the individual has a desperate need for air and extreme breathlessness. Viral pneumonias may be complicated by an invasion of bacteria, with all the typical symptoms of bacterial pneumonia.
• Mycoplasma, or walking pneumonia, causes signs and symptoms similar to those of other bacterial and viral infections, although symptoms appear more gradually and are often mild and flu-like. The individual may not be sick enough to stay in bed or to seek medical care and may never even know they have had pneumonia.
• The incubation period for pneumonia varies, depending on the type of virus or bacteria causing the infection. Some common incubation periods are: respiratory syncytial virus, four to six days; influenza, 18-72 hours.
• With treatment, most types of bacterial pneumonia can be cured within one to two weeks. Viral pneumonia may last longer. Mycoplasma pneumonia may take four to six weeks to resolve completely.

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Bacterial pneumonia: Symptoms of pneumonia caused by bacteria in otherwise healthy people younger than 65 usually come on suddenly. They often start during or after an upper respiratory infection, such as the flu or a cold. Symptoms may include:

• Cough, often producing mucus, also called sputum, from the lungs. Mucus may be rusty or green or tinged with blood.
• Fever, which may be less common in older adults.
• Shaking, "teeth-chattering" chills, one time only or many times.
• Fast, often shallow, breathing and the feeling of being short of breath.
• Chest wall pain that is often made worse by coughing or breathing in.
• Fast heartbeat.
• Feeling very tired or weak.
• Nausea and vomiting.
• Diarrhea.

Nonbacterial pneumonia: Symptoms of pneumonia not caused by bacteria may come on gradually and are often not as bad or as obvious as symptoms of bacterial pneumonia. Many people don't know that they have nonbacterial pneumonia, because they don't feel sick. But symptoms may include:

• Fever.
• Cough.
• Shortness of breath.
• Little mucus when you cough.

When symptoms are mild, your doctor may call your condition "walking pneumonia."

In older adults and children - Older adults may have different, fewer or milder symptoms, such as having no fever or having a cough with no mucus (a dry or nonproductive cough). The major sign of pneumonia in older adults may be a change in how clearly they think (confusion or delirium) or when a lung disease they already have gets worse.

In children, symptoms may depend on age:

• In infants younger than 1 month of age, symptoms may include having little or no energy (lethargy), feeding poorly, grunting or having a fever.
• In children, symptoms of pneumonia are often the same as in adults. Your doctor will look for signs such as cough and a breathing rate over 60 breaths a minute.

Some conditions with symptoms similar to pneumonia include bronchitis, COPD and tuberculosis.