Chest infection, adult

Chest infections are common, especially after a cold or flu during autumn and winter.

Although most are mild and get better on their own, some cases can be serious or even life-threatening.

Signs and symptoms of a chest infection

The main symptoms of a chest infection can include:

• a persistent cough
• coughing up yellow or green phlegm (thick mucus), or coughing up blood
• breathlessness or rapid and shallow breathing
• wheezing
• a high temperature (fever)
• a rapid heartbeat
• chest pain or tightness
• feeling confused and disorientated

You may also experience more general symptoms of an infection, such as a headache, fatigue, sweating, loss of appetite, or joint and muscle pain.

What causes chest infections?

A chest infection is an infection of the lungs or airways. The main types of chest infection are bronchitis and pneumonia.

Most bronchitis cases are caused by viruses, whereas most pneumonia cases are due to bacteria.

These infections are usually spread when an infected person coughs or sneezes. This launches tiny droplets of fluid containing the virus or bacteria into the air, where they can be breathed in by others.

The infections can also be spread to others if you cough or sneeze onto your hand, an object or a surface, and someone else touches it before touching their mouth or nose.

Certain groups of people have a higher risk of developing serious chest infections, such as:

• babies and very young children
• children with developmental problems
• people who are very overweight
• elderly people
• pregnant women
• people who smoke
• people with long-term health conditions, such as asthma, heart disease, diabetes, kidney disease, cystic fibrosis or chronic obstructive pulmonary disease (COPD)
• people with a weakened immune system – this could be due to a recent illness, chemotherapy or a health condition, such as an undiagnosed HIV infection

Read more about the causes of bronchitis and the causes of pneumonia.

Caring for your symptoms at home

Many chest infections aren't serious and get better within a few days or weeks. You won't usually need to see your GP, unless your symptoms suggest you have a more serious infection (see below).

While you recover at home, you can improve your symptoms by:

• getting plenty of rest
• drinking lots of fluid to prevent dehydration and to thin the mucus in your lungs, making it easier to cough up
• treating headaches, fever and aches and pains with painkillers such as paracetamol or ibuprofen
• drinking a warm drink of honey and lemon to relieve a sore throat caused by persistent coughing
• raising your head up with extra pillows while you are sleeping to make breathing easier
• using an air humidifier or inhaling steam from a bowl of hot water to ease your cough (hot water should not be used to treat young children with a cough due to the risk of scalds)
• stopping smoking (if you smoke)

Avoid cough medicines, as there's little evidence they work, and coughing actually helps you clear the infection more quickly by getting rid of the phlegm from your lungs.

Antibiotics are not recommended for many chest infections, because they are only effective if the infection is caused by bacteria rather than a virus.

Your GP will usually only prescribe antibiotics if they think you have pneumonia, or you are at risk of complications such as fluid building up around the lungs (pleural effusion).

If there is a flu outbreak in your local area and you are at risk of serious infection, your GP may also prescribe antiviral medication.

Read more about treating bronchitis and treating pneumonia.

When to see a doctor

You should see your GP if:

• you feel very unwell or your symptoms are severe
• you have a persistent fever
• your symptoms last longer than three weeks
• you feel confused, disorientated or drowsy
• you have chest pain or difficulty breathing 
• you cough up blood or blood-stained phlegm
• your skin or lips develop a blue tinge (cyanosis)
• you are pregnant
• you are 65 or over
• you are very overweight and have difficulty breathing
• you think a child under five has a chest infection
• you have a weakened immune system
• you have a long-term health condition

Your GP should be able to diagnose you based on your symptoms and by listening to your chest using a stethoscope (a medical instrument used to listen to the heart and lungs).

In some cases, further tests – such as a chest X-ray, breathing tests and testing phlegm or blood samples – may be necessary.

Preventing chest infections

There are measures you can take to help reduce your risk of developing chest infections, and to stop them spreading to others.

Good hygiene

Although chest infections aren't generally as contagious as other common infections, like flu, you can pass them on to others through coughing and sneezing.

Therefore, it's important to cover your mouth when you cough or sneeze and to wash your hands regularly. Put tissues in the bin immediately.

Read more about preventing germs from spreading.

Stop smoking

If you smoke, one of the best things you can do to prevent a chest infection is to stop. Smoking damages your lungs and weakens your defences against infection.

Read more about information and advice about stopping smoking.

Alcohol and diet

Excessive and prolonged alcohol misuse can weaken your lung’s natural defences against infections and make you more vulnerable to chest infections.

If you drink alcohol, do not exceed the recommended daily limits (three to four units a day for men and two to three units a day for women).

Eating a healthy balanced diet can help strengthen the immune system, making you less vulnerable to developing chest infections.

Read more about healthy eating and tips on cutting down on alcohol.

Vaccinations

If you are at an increased risk of chest infections, your GP may recommend being vaccinated against flu and pneumococcal infections (a bacterium that can cause pneumonia).

These vaccinations should help reduce your chances of getting chest infections in the future.

Flu and pneumococcal vaccinations are usually recommended for:

• babies and young children
• pregnant women (flu jab only)
• people aged 65 and over
• people with long-term health conditions or weakened immune systems

Read more about the flu vaccine and the pneumococcal vaccine.