Chest infection

A chest infection is an infection of the lungs or airways. The main types are bronchitis (infection of the bronchi — the larger airways) and pneumonia (infection of the lung tissue itself). Bronchitis is usually milder and often viral; pneumonia is more serious, can be bacterial or viral, and sometimes needs hospital treatment.

Symptoms

• Cough — often producing yellow, green, or blood-streaked phlegm
• Fever, sometimes with chills
• Chest pain or discomfort, often worse with coughing or breathing
• Shortness of breath
• Rapid breathing
• Wheezing
• Feeling generally unwell, tired
• Loss of appetite
• Muscle aches

When to seek urgent care

Dial 112 or go to hospital urgently if:

• Severe difficulty breathing, or you can't speak in full sentences because of breathlessness
• Blue lips or face
• Confusion
• Coughing up blood
• Severe chest pain
• High fever with chills that won't settle
• A baby or young child with fast breathing, difficulty feeding, or drowsiness
• An older adult or anyone with chronic lung disease (COPD, asthma) who is deteriorating

Diagnosis

A doctor's examination, listening to the chest, is often enough for straightforward cases. Additional tests for more severe illness:

• Chest X-ray
• Blood tests
• Sputum tests — looking for bacteria, or TB in India given the high background TB burden
• Oxygen saturation (pulse oximetry)
• In severe cases: CT chest, blood gas analysis

Treatment

• Bronchitis — most viral bronchitis settles with rest, fluids, and paracetamol. Antibiotics don't help viral infections and can do harm. Bacterial bronchitis (less common) needs antibiotics.
• Pneumonia — usually treated with antibiotics. Mild cases can be managed at home with oral antibiotics; more severe cases need hospital care with IV antibiotics, oxygen, and sometimes additional supportive treatment.
• Supportive care — rest, plenty of fluids, paracetamol for fever and pain
• Oxygen — for low oxygen saturation
• Hospital admission — for severe illness, very young/old patients, those with chronic diseases, or failure of outpatient treatment

In India, a persistent cough lasting more than 2-3 weeks (especially with fever, weight loss, or night sweats) should prompt TB testing — tuberculosis remains common and is curable with proper treatment. Free TB diagnosis and treatment are available at all government health facilities.

Prevention

• Annual flu vaccine — particularly for older adults, children, pregnant women, and people with chronic conditions
• Pneumococcal vaccine — for children (in the UIP) and at-risk adults
• COVID-19 vaccination
• Don't smoke; avoid secondhand smoke
• Hand washing
• Treat chronic lung conditions (asthma, COPD) well