Chest infections unveiled

In his latest online article, Dr Edward Cetti gives us his insights into chest infections. He talks about the common symptoms and causes, diagnosis, treatment options and prevention.

What are the common symptoms and causes of a chest infection?

Common symptoms of a chest infection include a cough that often produces sputum, which may become thicker and vary in colour from yellow to green, or even dark green. Other associated discomforts in the chest include tightness, occasional wheezing, and a potential progression to increased breathlessness. Additionally, there are general infection symptoms such as feeling unwell, lethargy, fatigue, possible temperature, sweats, and a diminished appetite. These manifestations are typical of chest infections, which can be caused by various respiratory viruses, with COVID being prominently discussed in recent years, as well as influenza and other viral triggers and also bacteria.

Distinguishing between viral and bacterial chest infections is challenging, as it is an imprecise science. Bacterial infections generally respond to antibiotics, while the majority of chest infections are viral and do not. As a result, the typical advice is that if you lack an underlying chronic chest condition and are not severely unwell, you can manage a cough with rest, ample fluids, and recovery without antibiotics. However, if you have an underlying chronic chest issue or your symptoms are worsening, especially with a fever and changes in sputum characteristics, antibiotics may be necessary to address a potential bacterial infection.

How are chest infections diagnosed by doctors?

Different types of chest infections affect various parts of the lungs. Bronchitis impacts the bronchial tubes, causing a cough and phlegm. Pneumonia, on the other hand, affects the lung tissue, filling air sacs with fluid, which can be detected on a chest x-ray or CT scan. Most chest infections are diagnosed based on symptom patterns. Pneumonia, which can be more severe, is often identified through symptom progression, changes in chest X-rays, and possibly altered blood test results.

What are the treatment options for chest infections?

Treatment for chest infections is primarily supportive, involving taking time off work, resting, and staying hydrated for a quicker recovery. In more severe cases, especially with bacterial involvement or underlying lung issues, antibiotics may be considered. While rare, chest infections can become serious, leading to significant breathlessness and, in some cases, oxygen deficiency. Serious cases may require hospitalisation, including oxygen therapy and intravenous antibiotics. For severe pneumonia, intensive care and ventilator support may be necessary. Specific drugs developed during the pandemic, particularly for viruses like COVID and influenza, are available for severe cases and can be considered during hospitalisation.

Are there ways to prevent chest infections?

It's impossible to prevent all chest infections, especially bronchitis during winter. Even if you isolate yourself for a year, you might still get a chest infection. The most effective preventive measures include getting available vaccines, such as influenza and COVID vaccines each winter if you're eligible. Those with chronic lung disease can also opt for a pneumonia vaccine, which doesn't eliminate all pneumonia risks but reduces the likelihood of a specific bacterial type causing pneumonia. This vaccine is a one-time shot lasting about 10 years. Quitting smoking is crucial as it significantly raises the risk of pneumonia and other chest infections. While vaping is likely safer than smoking, it may still increase the chances of chest infections to a lesser extent.

Dr Edward Cetti is a consultant respiratory physician with over 25 years of experience. You can schedule an appointment with Dr Cetti on his Top Doctors profile.