Pneumonia is an infection of the lungs that can cause people to develop a very distinctive cough. The sounds of a pneumonia cough can help identify the illness and determine if someone needs medical treatment. In this article, we will explore what pneumonia is, what causes it, the stages of the disease, and describe in detail the various sounds that a pneumonia cough makes.
What is Pneumonia?
Pneumonia is an infection of one or both lungs caused by bacteria, viruses, or fungi. The infection leads to inflammation in the alveoli (air sacs) of the lungs, which fill up with fluid or pus. This causes a reduction in lung function and oxygen intake. The inflammatory response also triggers coughing, which helps the body try to expel the infection.
Pneumonia can range from a mild to serious illness that requires hospitalization. Those at higher risk of developing pneumonia include:
- Children under age 2
- Adults over age 65
- People with compromised immune systems
- Those with chronic illnesses like asthma, heart disease, diabetes
- Cigarette smokers
Pneumonia often starts out seeming like a common cold or flu with symptoms like fever, chills, body aches, and fatigue. After a few days, the telltale pneumonia cough develops. Getting medical attention at the first sign of pneumonia is important, especially for those at higher risk of complications.
What Causes Pneumonia?
There are several ways people can develop pneumonia:
- Bacterial pneumonia – Caused by bacteria like Streptococcus pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. This is the most common type.
- Viral pneumonia – Caused by viruses like influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 (COVID-19).
- Fungal pneumonia – Caused by fungi like Pneumocystis jeroveci and Histoplasma capsulatum. More common in those with compromised immune systems.
- Aspiration pneumonia – Caused by inhaling food, liquid, gases or dust into the lungs. More common in those with swallowing issues.
Pneumonia can affect one lung (lobar pneumonia) or both lungs (double pneumonia). The infection triggers fluid and pus to fill up the alveoli, limiting oxygen intake and causing the distinctive pneumonia cough.
Stages of Pneumonia
Pneumonia typically develops through the following stages:
- Congestion – Fluid and pus start to build up in the lungs, causing congestion.
- Red Hepatization – The congested lung tissue turns red and liver-like in consistency due to increased blood flow.
- Gray Hepatization – As the disease progresses, the lung tissue changes to a gray color with granular texture.
- Resolution – With treatment, the lung congestion starts to resolve as the infection clears up.
The sounds of the pneumonia cough correlate with these stages of the illness. Let’s look closer at the pneumonia cough.
Sounds of a Pneumonia Cough
A pneumonia cough has very distinctive sounds that set it apart from a regular cough. Here are the main audible characteristics of a pneumonia cough:
Productive
A pneumonia cough is often productive, meaning it loosens and brings up phlegm or mucus. This is because the lungs are filled with fluid and pus from the infection, which the cough is trying to expel.
The mucus may start out thin and watery but become thick, heavy, sticky, and discolored as the pneumonia progresses. You may hear gurgling or wet sounds as the person tries to clear this phlegm from their chest.
Painful
A pneumonia cough is often described as painful. This is due to inflammation from the infection irritating the bronchial tubes and lungs. The alveoli fill up with fluid, making the lungs stiff and sore.
Strong coughing fits to bring up phlegm can also cause pain in the chest and abdominal muscles. The person may grunt or make other noises indicating discomfort while coughing.
Persistent
The pneumonia cough is persistent, meaning it occurs frequently throughout the day. Coughing bouts may be triggered by any activity that expands the lungs, like talking, eating, laughing, or moving around. The person cannot get relief from the constant urge to cough.
Nighttime coughing fits are also common with pneumonia, which prevents restful sleep. The person may sound extremely fatigued due to this disruptive cough.
Hacking
The pneumonia cough often has a coarse, hacking sound. This relates to the sticky, tenacious mucus sticking to and irritating the respiratory tract. The cough is the body’s attempt to forcefully hack up this phlegm.
Hacking coughs can also indicate pneumonia progression to the more serious gray hepatization stage, where the lung tissue takes on a granular, gritty texture.
Wheezing
Wheezing and whistle-like sounds may accompany the pneumonia cough. This wheezing occurs as air has trouble passing through the inflamed, mucus-filled breathing passages. The lungs have diminished capacity, so breathing takes more effort.
Wheezing is more common with viral pneumonia cases. Bacterial pneumonia tends to produce a cough with less wheeze and more prominent crackling sounds.
Crackling
Crackling sounds are common in pneumonia coughs. This crackling noise is called pulmonary rales or crepitus. It occurs as the sticky, fluid-filled alveoli pop open during breathing. The sound is similar to rubbing hair close to your ear or walking on fresh snow.
The location and timing of the crackling can indicate what lung region is affected. Bubbling, rattling sounds suggest a buildup of secretions deep in the lungs. Crackling when inhaling points to pneumonia versus on exhalation, which is more common with chronic bronchitis.
When to See a Doctor
It’s important to get medical attention if you or a loved one develops pneumonia symptoms like the following:
- Fever over 101 F
- Shaking chills
- Lowered alertness and confusion
- Chest pain with breathing
- Rapid, shallow breathing
- Blue tinge to lips or nails
- Unrelenting cough that brings up thick mucus
Seeking prompt treatment can help prevent complications and shorten pneumonia recovery time. People at higher risk should especially get examined quickly after pneumonia cough symptoms arise.
Let your doctor listen to your breathing, as they can detect pneumonia crackles and other lung sounds. A chest X-ray can confirm the diagnosis and pinpoint the location of lung inflammation. Sputum and blood tests help identify the type of infection.
Treatment involves antibiotics, antivirals, or antifungals to fight the underlying cause. Hospitalization with oxygen therapy and fluids may be required for more severe cases. Rest is key for the lungs to fully recover.
Conclusion
In summary, a pneumonia cough has several distinctive audible characteristics. Being familiar with the various sounds like wet productive coughs, chest pain, persistent hacking, wheezing, and crackling can help identify pneumonia and determine when to seek medical care. Catching pneumonia early is key, especially for high-risk groups. With proper treatment, the unmistakable pneumonia cough usually clears up as the lung infection resolves.
References
Here are some references used in researching this article:
- Luks, Andrew M., and Paul Garudadri. “Pneumonia.” StatPearls [Internet]. U.S. National Library of Medicine, 15 Nov. 2021, https://www.ncbi.nlm.nih.gov/books/NBK513321/.
- Kaysin, Amanda, and Ashwin Varghese. “Pneumonia, Bacterial.” StatPearls [Internet]. U.S. National Library of Medicine, 15 Oct. 2022, https://www.ncbi.nlm.nih.gov/books/NBK532961/.
- Earis, John, and Mark Woodhead. “Cough in COVID-19.” Thorax, BMJ Publishing Group, 1 Mar. 2021, https://thorax.bmj.com/content/76/3/248.
- Pratter, Melvyn R, et al. “Anatomy and Physiology of Airway Obstruction with Emphasis on Exhalation and Cough.” Chest, American College of Chest Physicians, 1 Nov. 2021, https://journal.chestnet.org/article/S0012-3692(21)03696-1/fulltext.