This article discusses the symptoms, causes, diagnosis, treatment, and prognosis of bronchopneumonia.

Symptoms

The symptoms of bronchopneumonia and its severity vary widely. Your symptoms may be more severe if you fall into one of the following high-risk categories:

You are immunocompromised. You are younger than 5 years old. You are older than 65. You have a preexisting health condition or comorbidity, specifically one that impacts the lungs .

Symptoms of bronchopneumonia may include:

FeverChillsSweatingShortness of breathChest pain that may get worse with coughing or breathing deeply (inspiration)Productive cough (coughing up mucus or phlegm)Muscle achesLow energy and fatigueLoss of appetiteHeadachesConfusion or disorientation, especially in older adultsDizzinessNauseaVomitingCoughing up blood (hemoptysis) 

Causes

Bronchopneumonia is a lower respiratory lung infection that is mainly caused by bacteria, such as:

Streptococcus pneumoniaeHaemophilus influenzae type b (Hib)Staphylococcus aureusKlebsiella pneumoniaePseudomonas aeruginosaEscherichia coli (E. coli) 

In rare cases, viruses such as SARS CoV-2 (the virus that causes COVID-19) and fungi, such as Aspergillus fumigatus, may also cause bronchopneumonia. 

Diagnosis

Bronchopneumonia is a clinical diagnosis based on your symptoms and findings on chest X-ray imaging.

The diagnosis of bronchopneumonia always begins with your healthcare provider taking a thorough clinical history and performing a focused physical exam, listening to the heart and lungs with a stethoscope for wheezing and other abnormal breathing sounds.

Initially, blood tests looking for signs of infection—like a complete blood cell count (CBC)—and a chest X-ray may be ordered.

Bronchopneumonia has a very distinct appearance on chest X-rays, often looking like patchy consolidations involving one or more lobes (sections of the lungs). Inflammation and its by-product (neutrophilic exudates) are usually centered in the bronchi (air passages in the lungs) and bronchioles (smaller air passages that branch off the bronchi), which spread to the adjacent alveoli (tiny air sacs).

An assessment of your oxygen levels and the flow of oxygen throughout your body will also be made using pulse oximetry and administering an arterial blood gas test.

If you present with a productive cough (coughing up phlegm) a sputum culture, that analyzes mucus for signs of bacterial infection, may be performed.

In addition, your healthcare provider may perform a bronchoscopy, a fairly routine procedure that involves passing a thin tube with a light and camera through your mouth, down your windpipe, and into your lungs. This looks for signs of infection and areas of suspicion worth taking a closer look at via biopsy (removing sample tissue for examination in the lab).  

Treatment

Bronchopneumonia is usually caused by bacteria, so it can generally be treated effectively with antibiotics.

Picking the right antibiotic is very important, though, especially with the rise of antibiotic- resistant strains of bacteria that prevent once-effective drugs from killing them. Your healthcare provider may use a sputum culture to determine the antibiotic that is most effective at eliminating your infection.

Prognosis

The outlook for bronchopneumonia is generally good but it depends on many factors, including:

AgeHealth historyHospital setting

If you are generally healthy, your symptoms will typically resolve in one to three weeks with treatment.

While more severe cases of bronchopneumonia may require hospital treatment, most cases can be treated with rest, outpatient antibiotics, and routine follow-up.

When to See a Healthcare Provider

In severe cases, bronchopneumonia can lead to lung abscesses, the formation of pus-filled pockets in one area of the lung. At times, the infection spreads to the pleural space (the fluid-filled cavity surrounding the lungs), filling it with pus (also called an exudate) and forming an empyema (a collection of pus). Symptoms of emphysema may include:

Dry coughFever and chillsExcessive sweating, especially night sweatsGeneral discomfort, uneasiness, or ill feeling (malaise)Unintentional weight lossChest pain, which worsens on deep inhalation (inspiration)

If you experience one or more of these symptoms or your symptoms do not improve despite taking your medications as prescribed, seek immediate medical attention.

Summary

Bronchopneumonia is a lower respiratory infection of the lungs that is commonly caused by bacteria such as Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) and is characterized by widespread inflammation of the lungs.

A Word From Verywell

The outcomes for people with bronchopneumonia who usually are in good health are positive, but the frequent use of antibiotics has led to a rise in bacterial resistance. Severe complications can result from increasing bacterial resistance and a late or difficult-to-make diagnosis. Therefore, it is important to see a healthcare provider if you feel ill or have been in contact with someone who has had a bacterial infection in the days or weeks prior to the onset of your symptoms.