What's the difference between double pneumonia and pneumonia?

Pneumonia and double pneumonia

In the UK, more people die from pneumonia than anywhere else in Europe¹. It's vital that we know when to see a doctor and how to distinguish between this serious lung infection and a run of the mill chest infection.

Dr Margarita Kitova-John is a GP and founder of The Lantern Clinic, which specialises in gut health and women's health. She sums up what happens during pneumonia: "The infection affects the small air sacs that make up the lung tissue, which fill with fluid or pus. This causes the lung to be unable to properly expand, labouring the breathing."

Pneumonia is an infection in one of your lungs - double pneumonia simply means that the infection is in both your lungs. This may sound more serious - and it can be - but the severity of this illness really depends on how many segments of your lungs are infected. For example, it could be that one person has more infected segments in one lung than someone else does across both of their lungs.

What are the symptoms of single lung and double pneumonia?

The symptoms of pneumonia are the same, no matter whether you have double pneumonia or not. You should see your doctor if you experience the following.

Symptoms of pneumonia include:

• Fast breathing or shortness of breath.

• Chest pains.

• A worsening fever or headache.

• Coughing up blood or your saliva becoming dark or rusty-coloured.

• A cough that lasts for longer than 3-4 weeks.

• Becoming drowsy or confused.

• Repeated bouts of acute bronchitis.

Having double pneumonia doesn't necessarily mean your symptoms will be twice as bad as pneumonia in one lung. However, for many people they are more severe. Chest pain, for example, may be felt on both sides of the chest rather than one. Likewise, it can be even harder to breathe when both lungs are unable to expand as normal.

How serious is single lung and
double pneumonia?

Fatalities

Double pneumonia and pneumonia of a single lung can both be fatal if the infection is left to spread. In the UK each year, more than 25,000 people die from this illness¹.

A case of double pneumonia may be more severe, but it depends on a few factors, including:

1. How many segments of the lungs are infected - more segments are more likely to be affected in someone with double pneumonia, but it's also possible for a person with one infected lung to have more affected segments.

2. Whether a person has underlying risk factors - for example, young children and the elderly are more likely to die.

Complications

According to Dr Kitova-John, pneumonia often requires hospitalisation, so that the person can receive breathing support. It can also lead to several other health complications, such as:

• Sepsis - a life-threatening reaction to infection.

• Pleural effusions - fluid around the lung.

• Lung abscess - a pus-filled cavity in your lung.

• Pleurisy - inflammation of the tissue between your ribcage and lung.

• Organ failure - if the infection spreads to other organs.

Full recovery

It's important to note that most people make a full recovery from single lung and doublepneumonia. Although serious, it's very treatable when it's discovered before the infection has had time to establish itself.

Patient picks for Chest and lung infections

Chest and lungs

How is pneumonia treated?

Pneumonia is an inflammation of the lung which is usually caused by an infection. Pneumonia varies a lot in severity with many people making a full recovery, but in some cases it can be life-threatening.

by Dr Doug McKechnie, MRCGP

Chest and lungs

Pneumonia

Pneumonia is inflammation (swelling) of the lung tissue. It's usually caused by bacterial infections such as Streptococcus pneumoniae. However, it can also be caused by viral infections, including flu and coronavirus (COVID-19), and fungi. This infection causes the air sacs in the lungs (alveoli) to be filled with fluid, making it hard for oxygen to reach the bloodstream. As a result, patients could have trouble breathing.

by Dr Mohammad Sharif Razai, MRCGP

What causes single lung and double pneumonia?

Double pneumonia and single lung pneumonia have the same causes - having an infection in both lungs rather than one can be down to chance, although common risk factors may play a part.

"The most common cause of pneumonia are bacteria and viruses," says Dr Kitova-John. "The COVID pandemic has led to greater education around respiratory conditions. Sometimes, what starts as a common seasonal upper respiratory infection then becomes complicated with a secondary bacterial infection, causing pneumonia."

How is single lung and double pneumonia diagnosed?

The doctor explains that the presentation of double pneumonia is not clinically more distinct than pneumonia. "The diagnostic process involves an examination by a clinician, followed by a chest X-ray, and if the results are still unclear a chest CT scan. Blood tests are also helpful in determining the seriousness of the condition."

How to treat pneumonia

Treatment methods are no different for pneumonia and double pneumonia. Instead, your treatment plan will depend on other factors, such as your general health, your age, and the severity of the infection. According to Dr Kitova-John, your doctor should monitor you closely, and tailor a treatment plan that suits the severity of your pneumonia.

At home

Your doctor may advice that you can treat pneumonia at home, and may recommend over-the-counter drugs to help relieve pain and fever, like ibuprofen and aspirin, and cough medicines to help manage your cough.

The cause can also determine your treatment. For bacterial pneumonia, you may be prescribed a course of antibiotics; for viral pneumonia, anti-viral drugs may be helpful but often people get better on their own.

In hospital

Those with a higher risk of becoming ill - like young children, the elderly, and people with weakened immune systems - may be required to stay in hospital. Treatments here may include breathing machines and intravenous (IV) antibiotics - antiobiotics supplied directly to the veins.

Further reading

1. Asthma + Lung UK: UK has highest number of pneumonia deaths in Europe..