Chest Infections

Overview

A chest infection is an infection in the airways or lungs. Most are caused by viruses and get better on their own. Some are caused by bacteria and can be more serious, especially in babies, older adults, and people with long-term health conditions. This information is general and does not replace advice from a healthcare professional.

Yes. Chest infections are a common reason people visit a doctor, especially in winter.

Anyone can get one. They are more common and can be more serious in children under five, adults over 65, pregnant people, smokers, and people with asthma, COPD (a long-term lung disease), diabetes, or a weakened immune system.

Symptoms

Common symptoms

• Cough, often bringing up phlegm (thick mucus)
• Feeling short of breath or breathing faster
• Chest discomfort or pain when coughing
• Fever or feeling feverish
• Tiredness and aching
• Sore throat, runny nose, or headache
• Wheezing or a tight chest

Symptoms in children

• Fast or noisy breathing, or grunting
• Pulling in between the ribs or under the ribs when breathing
• Poor feeding, fewer wet nappies, or unusual sleepiness
• Cough, fever, or being more unsettled than usual
• Vomiting after coughing

Symptoms in older adults

• New confusion or drowsiness
• Falls or reduced mobility
• Poor appetite or not drinking enough
• Breathlessness that gets worse
• Fever may be low or absent
• Cough may be less obvious

Causes

Main causes

• Viruses are the most common cause, including cold and flu viruses.
• Bacteria can cause some chest infections, including pneumonia.
• Sometimes food, drink, or vomit gets into the airways and causes infection, especially in people who have trouble swallowing.
• Fungi are a rare cause, mostly in people with a weakened immune system.

Risk factors

• Smoking or breathing in second-hand smoke
• Asthma, COPD, or other long-term lung conditions
• A weakened immune system or certain long-term illnesses
• Being very young or over 65
• Pregnancy
• Recent flu or a bad cold
• Living in crowded places or being exposed to lots of smoke or pollution
• Trouble swallowing or a history of aspiration

When to see a doctor

See a doctor urgently if:

• You or your child is breathing faster or harder than usual
• You cannot keep fluids down or feel very dizzy
• A fever is high or lasts more than a few days
• You have chest pain or a cough that is getting worse
• You have a long-term condition and your usual breathing is worse
• Your baby is feeding poorly, has fewer wet nappies, or is very sleepy

Book a routine appointment if:

• A cough that lasts more than three weeks
• Repeated chest infections
• Symptoms that keep coming back or do not fully settle
• You are unsure whether you need treatment

Diagnosis

A doctor will ask about your symptoms and examine you. They may listen to your chest with a stethoscope, a tool for listening to your breathing, and check your breathing, temperature, and oxygen level. Most chest infections can be diagnosed without tests. Tests are used when pneumonia or another problem is suspected.

Tests that may be done

• Pulse oximetry: a small clip on your finger checks the oxygen level in your blood.
• Chest X-ray: a picture of the lungs, used if pneumonia or another problem is suspected.
• Blood tests: to check for signs of infection or how well your body is coping.
• Sputum sample: a sample of phlegm to look for the germ causing the infection.
• Breathing tests: sometimes used if a long-term lung condition is suspected.

What to expect at your appointment

You may be asked to wait and see if symptoms improve, or you may be given treatment. If you are very breathless, confused, or have other serious signs, you may need to go to hospital for monitoring and support.

Treatment

Most viral chest infections get better with rest and supportive care. The goal is to ease symptoms, keep you comfortable, and watch for signs that you need more help. Bacterial infections may need antibiotics, but only when a doctor thinks they are likely.

Self-care at home

• Rest and get plenty of sleep.
• Drink fluids regularly, especially water, to keep your throat and chest comfortable.
• Use a cool-mist humidifier or sit in a steamy bathroom to loosen mucus.
• Avoid smoking and second-hand smoke.
• For adults and children over one year, a spoonful of honey in a warm drink may soothe a cough. Never give honey to babies under one year.
• Take time off work or school while you have a fever or feel very unwell.
• Ask a pharmacist before using any over-the-counter cough or cold medicine, especially for children.

Medical treatments

Doctors treat chest infections based on the likely cause and how serious they are. For viral infections, treatment is mainly rest, fluids, and symptom relief. If a doctor suspects a bacterial infection such as pneumonia, they may prescribe antibiotics; antibiotics do not work on viruses. Some people need oxygen, fluids through a drip, or hospital monitoring. A doctor may also review and adjust treatment for asthma or COPD. Always ask a pharmacist or doctor before taking any medicine, including over-the-counter remedies, and follow their advice.

When is surgery considered?

Surgery is rarely needed for a chest infection. It may be considered if there is a complication such as a collection of pus in the chest (empyema) or another problem that does not settle with other treatment.

Living with this condition

Recovery can take time. You may feel tired for a week or two, and a cough can last several weeks. Pace yourself, keep drinking fluids, and avoid strenuous activity until you feel stronger. Ask your employer or school about flexible arrangements if you need them.

Lifestyle tips

• Stop smoking, and avoid smoky places. Ask for help to quit if you need it.
• Keep rooms well ventilated and avoid close contact with people who have colds or flu when possible.
• Wash your hands often.
• If you have a long-term lung condition, follow your agreed action plan and keep routine reviews.
• Get plenty of sleep and manage stress where you can.

Diet and exercise

Eat a balanced diet and drink enough fluids. When you feel ready, gentle activity such as short walks can help you rebuild strength. Avoid intense exercise while you have a fever or are breathless. Build up slowly over days or weeks.

Mental health and emotional wellbeing

Being unwell can be worrying, especially if you are caring for a child or have a long-term condition. Poor sleep and time away from normal life can affect your mood. Talk to someone you trust, and tell your doctor if anxiety or low mood is lasting. If you feel overwhelmed or unsafe, contact your local crisis support service.

Prevention

You can lower the risk of some chest infections, but no one can prevent every infection. Good hand hygiene, avoiding smoke, and keeping up to date with recommended vaccines all help.

Vaccines

Ask your healthcare provider whether you are up to date with vaccines that help prevent chest infections, including flu and pneumococcal vaccines if they are recommended for you. Vaccine advice varies by age, health condition, and country.

Screening programmes

There is no routine screening test for chest infections. If you smoke or have a long-term lung condition, ask about lung health checks and stop-smoking support.

Complications

If left untreated

• Pneumonia, which is an infection deep in the lungs
• A collection of fluid or pus around the lungs
• Sepsis, when the body reacts dangerously to infection
• Worsening asthma or COPD
• Respiratory failure, where breathing needs support
• Dehydration or severe tiredness, especially in older adults

Long-term outlook

Most people recover fully. A cough can linger for a few weeks after you feel better, which is normal. Serious complications are more likely in babies, older adults, and people with long-term conditions, so get advice early if you are worried. With rest, support, and medical care when needed, the outlook is usually good.

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