Difference between Pneumonia and Asthma

Pneumonia vs Asthma

Respiratory disorders are manifested by very similar symptoms like cough, fever, etc. On taking a closer look, one can understand there are multiple symptoms that separate the two conditions of asthma and pneumonia.

Pneumonia is an infection of the lung tissue which involves the air sacs within them called alveoli. Also called as consolidation, in pneumonia there is an accumulation of fluid and cell debris within these air-filled sacs leading to a solidification of the empty spaces. Asthma, in contrast, is a widespread hypersensitivity of the air passages in lungs that communicate with the alveoli. It is an exaggerated reaction to seemingly harmless agents within and more commonly outside the body. in short, it is an allergic response which leads to severe constriction of the air passages causing a sudden cut-off of oxygen supply to the lungs and body.

The causes of pneumonia are infectious agents like viruses, bacteria and fungi. Often aspiration i.e. accidental swallowing of vomit or contents of stomach in bed-ridden patients or paralytic patients can lead to pneumonia.

Asthma can be due to a host of factors from the environment like allergy to dust, animal hair or dander, pollen, cold weather, paint, strong odors, heavy particles like plastic, metals, wood etc. Foods like oysters, milk, peanuts, shell fish, etc are known to cause severe allergies leading to episodes of asthma. Even exercise can lead to an attack of asthma in few patients.

Pneumonia typically presents with high grade fever with shivering and chilliness. There is a bad cough with yellow coloured sputum; sometimes with coughing up of blood. There might be accompanying chest pain, breathlessness and severe body pain. Loss of appetite and nausea are occasionally witnessed too. Asthma on the other hand presents with sudden, severe breathlessness, cough and wheezing. Wheezing is a raspy, whistle like, blowing sound that seems to be emanating from the chest and is characteristic of asthma. Asthma attacks are typically more common in the early morning or after contact with triggering allergen like pollen etc. Asthmatic patients experience periods of worsening interspersed with times when there may be no attack of breathlessness for months at end. The patient explains an episode feels as if he just can’t take a whole breath with a sense of impending death.

Pneumonia can be diagnosed with a chest x-ray, CT scan and blood count that shall reveal infection. Asthma is diagnosed clinically with an allergy test being done for identifying the culprit allergen.

Prognosis is good for pneumonia if treated vigorously early on, else it can rapidly turn fatal. Asthma has a good prognosis with many children outgrowing the condition till they reach their 20s. Adults can be easily managed with medications.

Antibiotics and anti-pyretics are the main stay of treatment for pneumonia. Intravenous antibiotics are needed most often. Asthma can be managed with inhalers for immediate relief. Long term management is done using locally delivered steroid inhalers or oral steroids along with beta-2 agonists.

Take home pointers:

Pneumonia is an infection of the lung tissue called as alveoli. It can be due to a bacterial, viral or fungal infection. It leads to solidification of lung alveoli producing symptoms like high fever, shivering, cough with bloody phlegm, chest pain and body ache. Treatment is using antibiotics or anti-fungals based on the cause of pneumonia.
Asthma is a hypersensitivity of the lung air passages to environmental stimuli leading to a trio of sudden wheezing, cough and shortness of breath. There is a tendency to aggravation and remission. Treatment is using inhalers, steroids and nebulised medications.

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