Chest Infections: Signs and Recovery

"Chest infection" is a broad term that covers two main conditions: acute bronchitis (infection of the large airways) and pneumonia (infection of the lung tissue). The difference matters because they vary in severity and treatment.

Bronchitis is common, usually viral, and resolves on its own. Pneumonia is less common but more serious, usually bacterial, and typically requires antibiotics. Both cause a cough, but pneumonia makes you feel considerably worse.

Acute bronchitis

Bronchitis inflames the bronchial tubes (the main airways leading to the lungs). It's most commonly caused by the same viruses that cause colds and flu. You'll have a persistent cough — often productive, bringing up clear, white, yellow, or green mucus — along with a sore throat, mild headache, and general tiredness.

Despite what many people expect, green or yellow mucus doesn't necessarily mean you need antibiotics. The colour comes from white blood cells fighting the infection, not from bacteria specifically.

Most bronchitis clears within 1-3 weeks. The cough may linger for up to 6 weeks while the airways recover. Rest, fluids, paracetamol, and honey in warm drinks are the mainstays of treatment. NICE is clear that antibiotics should not be prescribed for uncomplicated acute bronchitis.

Pneumonia

Pneumonia is an infection of the alveoli (the tiny air sacs in the lungs where oxygen exchange happens). It's usually caused by bacteria — Streptococcus pneumoniae being the most common — though viral and fungal causes exist.

Symptoms come on more aggressively than bronchitis: a high temperature, often with rigors (uncontrollable shaking), breathlessness, chest pain that's sharp and worsens when you breathe in (pleuritic pain), rapid breathing, and a cough that may produce rust-coloured or bloody sputum.

Doctors use the CRB-65 score to assess pneumonia severity. This looks at confusion, respiratory rate, blood pressure, and age over 65. A score of 0 usually means you can be treated safely at home. A score of 2 or more typically requires hospital assessment.

Pneumonia is treated with antibiotics, usually a 5-7 day course. Most people start to feel better within 48 hours of starting treatment, but full recovery takes weeks. Tiredness can persist for a month or more, even after the infection has cleared.

Who is most at risk?

Chest infections can affect anyone, but certain groups are more vulnerable to complications. Adults over 65, smokers, people with chronic lung conditions (COPD, asthma), those with weakened immune systems, and people with heart disease or diabetes are all at higher risk of developing pneumonia from what starts as a simple bronchitis.

The annual flu vaccine and the pneumococcal vaccine both reduce the risk of chest infections in vulnerable groups. If you're in a high-risk category, make sure you're up to date.

How we can help

A same-day GP appointment (£150) includes a thorough chest examination, oxygen saturation check, and clinical assessment. If pneumonia is suspected, we can arrange an on-site chest X-ray and blood tests (including CRP and white cell count) to confirm the diagnosis and guide antibiotic choice.

If your symptoms are more consistent with bronchitis, your GP will explain why antibiotics aren't the answer and advise on what will actually help. If you've been unwell for more than three weeks and aren't improving, investigation is warranted to rule out other causes.