What Does a Pneumonia Cough Sound Like and How Is It Different From Others?

Coughing can be a symptom of various health conditions, including pneumonia. Pneumonia is a lung infection and/or inflammation of the air sacs of one or both lungs. Bacteria, viruses, and fungi can cause it. Pneumonia causes various symptoms, including cough.

A pneumonia cough may sound deeper or louder than a cough associated with other viral and bacterial conditions. It also tends to be wet and productive (produces mucus). Features of a pneumonia cough, such as the type of mucus you cough up, will depend on the type and stage of the pneumonia.

Symptoms can range from mild to severe and may include cough, fever, and chest discomfort. A recovery timeline for pneumonia can vary from person to person and based on symptom severity.

What a Pneumonia Cough Can Sound Like

Pneumonia produces deep or loud coughs. Your healthcare provider will consider cough sound when determining the cause of your symptoms, but it isn't the only symptom they will rely on.

One study reported in 2021 used artificial intelligence and cough sounds to identify pneumonia coughs. Researchers found that coughing linked to pneumonia became louder toward the end of the cough. Factors contributing to cough severity included mucus amounts, wheezing (a high-pitched whistling sound with breathing), and dyspnea (shortness of breath).

Common features of a pneumonia cough include:

• Rales or cracking sounds in the lungs, which is especially common with bacterial pneumonia
• A loud, deep cough 
• Increasing cough volume
• A hacking cough (dry, irritating cough), which may be seen with walking pneumonia
• Chest pain or discomfort with coughing
  

Crackles (rales) are breath sounds a healthcare provider can hear with a stethoscope. Crackles indicate the spaces in the lungs normally filled with air are filling with fluid or other material (lung consolidation).

A cough alone is not enough to determine if a person has pneumonia. This is because other illnesses can cause coughs similar to pneumonia, including COVID-19 and the flu. Some of these conditions may also lead to pneumonia.

Are They Productive (Wet) Coughs?

A wet, productive cough brings up mucus. Bacterial pneumonia typically leads to a wet, productive cough. 

Various conditions can cause mucus, such as respiratory infections and congestive heart failure. In some cases, the type of cough can help your healthcare provider determine the cause. 

A dry cough differs from a wet one because it produces no mucus. It is usually the result of irritation or inflammation of the airways. Viral pneumonia can sometimes lead to a dry cough, but if it gets severe, it may become wet and produce mucus.

Additional causes of a dry cough are: 

• Allergies
• Asthma
• Certain medications 
• Gastroesophageal reflux disease (GERD) (chronic acid reflux)
• Pulmonary fibrosis (chronic scarring of lung tissue)
• Viral infections, including upper respiratory infections

Wet, productive coughs are not always caused by pneumonia. Additional health conditions that may cause wet, productive coughs are:

• Bronchiectasis (permanent widening of the airways in the lungs)
• COVID-19
• Eosinophilic bronchitis (a type of airway inflammation)
• Idiopathic chronic productive cough
• Immunodeficiency that leads to recurrent lower respiratory infections
  
• Influenza 
  

What Does the Mucus Look Like?

Productive coughs bring up mucus. Mucus not associated with an infection or illness looks clear, slippery, and gel-like. Mucous membranes produce mucus to trap germs and other harmful substances so the immune system can react to these possible threats.

Mucus can become thick and sticky. If someone has an infection, it may also be white, yellow, or green. 

Pneumonia coughs can produce green, yellow, or bloody mucus. Bacterial pneumonia may produce bloody mucus or mucus with pus. Viral pneumonia may cause watery mucus that comes with pus.

How Type and Stage Affect the Cough

Most pneumonia coughs last about two weeks. However, some people may have more severe coughs that last three or more weeks. It is uncommon for a pneumonia cough to last longer than a month.

If your cough has lasted eight weeks or longer, it is considered chronic. You should see a healthcare provider to determine the cause. 

The severity of a pneumonia cough and what you cough up depends on the stage. For example, early-stage pneumonia does not cause you to cough anything up. As pneumonia progresses, the cough can worsen and can cause you to cough mucus. A severe pneumonia cough may also cause pain.

With viral pneumonia, cough may present several days after fever, runny nose, muscle pain, and other initial symptoms. With bacterial pneumonia, the cough may present within a day or two after initial symptoms. 

Other Signs of Pneumonia

Pneumonia symptoms range from mild to severe, depending on the cause. Symptoms may include:

• Confusion (in older adults)
• Cough with green, yellow, or bloody mucus
• Fast breathing or heartbeat
• Fever, sweating, and shaking chills
• Severe fatigue
• Sharp or stabbing chest pain that is felt with coughing or deep breaths 
• Shortness of breath

Symptoms of pneumonia may vary and present with different severity based on the pneumonia type.

• Bacterial pneumonia: If bacteria are the cause, your symptoms can come on slowly or quickly. Bacterial pneumonia is the most severe pneumonia type. It may cause a high fever, shortness of breath, and a faster pulse. It may also lead to confusion in older adults.
• Viral pneumonia: With pneumonia caused by a virus, it may take several days to notice symptoms. Early symptoms, such as fever, dry cough, and headache, will present, similar to those of the flu or common cold. Shortness of breath, muscle pain, and a productive cough will occur several days later.
• Walking pneumonia: This type of pneumonia is caused by the bacterium Mycoplasma pneumoniae. It causes mild symptoms and typically does not require bed rest. However, symptoms can vary, and complications may arise in some cases.

Pneumonia vs. Bronchitis

Bronchitis affects the bronchial tubes that carry air to the lungs, while pneumonia affects the alveoli. Left untreated, acute bronchitis may increase the risk of developing pneumonia, particularly in individuals with weakened immune systems or underlying health conditions. 

Bronchitis can be acute or chronic. A viral or bacterial infection causes an acute type. Chronic bronchitis refers to long-term inflammation of the lungs. 

It is difficult to tell whether you have bronchitis or pneumonia based on cough and congestion alone. However, pneumonia's symptoms are much more severe, and it causes whole-body symptoms like fatigue, fever, and chills.

Bronchitis will affect the bronchial tubes only, while pneumonia develops and worsens deep into lung tissue.

How to Tell If You Have Pneumonia

Cough alone does not always mean pneumonia. Most people with pneumonia will have multiple symptoms of the condition, including shortness of breath, pain with breathing and coughing, and severe fatigue. 

If you think you or a child may have pneumonia, you should immediately seek medical treatment. Pneumonia can be fatal if left untreated. It can also lead to a severe, life-threatening infection. 

Severe infections are more common in high-risk individuals. This includes:

• Adults age 65 and older
• Infants and small children
• People who smoke
• People who take medications that suppress their immune system
  
• People with certain medical conditions 

Diagnosing Pneumonia

Your healthcare provider will use a variety of diagnostic tests to confirm pneumonia. These may include:

• A review of your symptoms 
• Blood test to identify whether a bacterium, fungus, or virus has caused the pneumonia
• Chest X-ray to view how the infection is affecting the lungs
• Pulse oximetry to measure your blood oxygen levels
• Sputum test to examine mucus and identify the source (bacterial or fungal)

Once a diagnosis of pneumonia is made, the healthcare provider can make decisions on how to treat it best.

When to Contact a Healthcare Provider

Contact your healthcare provider if you are sick and think you may have pneumonia. This is especially important if you have an underlying medical condition or if you are a high-risk individual due to age or other risk factors. 

You should make an appointment with your healthcare provider for new or worsening symptoms, such as:

• Cough with mucus
• Fever
  
• Severe fatigue
• Shortness of breath

Head to an emergency room or call 911 if:

• For confusion or inability to think clearly
• For new or worsening chest pain
• High fever (103 degrees Fahrenheit or higher)
• You or a loved one is struggling to breathe or have shortness of breath without exertion
  

Tips to Find Relief

Your healthcare provider may prescribe antibiotics to treat bacterial or walking pneumonia. They may prescribe antiviral medication if the cause is viral, but antiviral medicines do not affect all viruses that cause pneumonia. Antifungal medicines may be prescribed for fungal pneumonia. 

Severe pneumonia may require hospitalization and additional treatment.

Medicinal treatment can help treat the underlying infection. These medicines will also help improve symptoms, but it may take a little time for your cough to clear up.

Here are a few things you can do to manage your cough while symptoms improve and you recover:

• Steam treatments: Inhaling vapor from a humidifier can help loosen mucus, making coughing easier. It may also clear your airways, helping you breathe better.
• Stay hydrated: Drinking plenty of fluids can make it easier to loosen mucus and prevent dehydration. 
• Rest: Get plenty of rest to help your body recover quickly and fight the infection off. 
• Try a cough suppressant: A cough suppressant can manage your cough and help you sleep better. Check with your healthcare provider to see whether it is safe for you to take a cough suppressant. 
• Try a guaifenesin medication: Check with your healthcare provider if you can take a medication like Mucinex, which reduces mucus production and secretion. Guaifenesin also loosens mucus, allowing it to be coughed up much quicker.  
• Stop smoking and avoid secondhand smoke: Smoking can make pneumonia symptoms, especially cough, much worse. It can also prolong your recovery and put you at risk for complications. 

A Word From Verywell

Vaccination is crucial for preventing pneumonia, particularly with pneumococcal and influenza vaccines. These vaccines protect against severe forms of pneumonia and secondary bacterial infections. High-risk individuals (e.g., older or immunocompromised) should receive these vaccines to reduce their pneumonia risk.

— KASHIF J. PIRACHA, MD, MEDICAL EXPERT BOARD

Summary 

Pneumonia is an infection of one or both lungs. Symptoms range from mild to severe and may include cough, fever, chest pain, and shortness of breath. 

Coughing associated with pneumonia sounds deeper and louder than a regular cough. Pneumonia coughs are typically productive or wet because they produce mucus. 

Viral pneumonia may not always produce mucus, but bacterial pneumonia typically does. Mucus may be green, yellow, or bloody, or it may contain pus. The severity of a pneumonia cough may depend on the type of pneumonia or its stage.

Coughing is only one symptom of pneumonia. If you think you have pneumonia, contact a healthcare provider. They can determine the cause of cough and other symptoms and figure out the best treatment course. 

Contact a healthcare provider for new or worsening symptoms of pneumonia, especially if you have risk factors. Seek emergency treatment for breathing troubles, chest pain, or a very high fever.