Pneumonia Cough, Sputum and Other Signs and Symptoms

The typical symptom associated with infectious pneumonia, similar to other lower respiratory tract infections like bronchitis, is a productive and persistent cough. It is usually described as a deep cough that is nagging with sputum being expectorated into the throat or mouth.

However, in the early stages, a pneumonia cough may not present in this manner. Initially it is dry and non-productive with pain in the center of the chest. This is similar to the cough in tracheitis.

Coughing up blood or bloody sputum becomes evident as the condition progresses although this may not be present in every case of pneumonia. Typically the cough lasts for less than 3 weeks (acute) although a chronic dry cough associated with lung inflammation (evident on x-ray) is seen in interstitial pneumonia.

The color and nature of expectorated mucus may provide some indication of the type of infection :

  • Yellow mucus is seen in the early stages of a productive penumonia cough
  • Green mucus is seen in more chronic infectious pneumonia
  • Rusty red-colored mucus is seen in pneumococcal pneumonia (Streptococcus pneumoniae)
  • Deeper red-colored mucus may be seen in Klebsiella pneumoniae infection
  • Bad tasting and foul smelling mucus is seen in infectious pneumonia caused by anaerobic bacteria like S.pneumoniae, S.aureus and K.pneumoniae

Signs and Symptoms of Pneumonia

Apart from the cough mentioned above, the other symptoms of pneumonia may vary greatly depending on the cause and type of pneumonia.

  • Chest pain
    • Centrally located early in the disease and progresses to the affected side, although the unaffected side may experience some discomfort as well.
    • May be associated with pleuritis that is often associated with lung diseases like pneumonia.
    • Pain pronounced on coughing or breathing in deeply. Refer to lung chest pain for other causes of chest pain associated with respiratory diseases.
    • Pain may be referred to shoulder or upper abdomen.
    • Upper abdominal tenderness may be a sign of lower lobe pneumonia.
  • Shortness of breath (dyspnea)
    • Difficulty breathing (‘not getting enough air’) is reported in most cases to varying degrees.
    • In milder cases, shortness of breath may only be reported after activity, which is uncharacteristic for the patient’s usual exercise tolerance.
    • Rapid, shallow breathing may be present in severe cases (ARDS = acute respiratory distress syndrome) and may be accompanied by pallor (infrequent) or cyanosis (very rare).

The other signs and and symptoms of pneumonia are non-specific and may be seen in many infectious diseases, particularly respiratory tract infections.

  • Fever and chills
  • Sweating
  • Fatigue
  • Nausea and/or vomiting
  • Loss of appetite
  • Headache
  • Diarrhea (sometimes)

Related Articles

  1. What is Pneumonia?
  2. Pneumonia Types and Causes


  1. Bacterial Pneumonia. Emedicine

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  • Paul

    I used this article in my research work, thanx Doc.

  • Susan

    My 7 year old complains about her tummy hurting she says behind her belly button ..pain comes and goes and sometimes she will double over holding her gut … Should I take her to her regular doctor or the ER ? The last time I took her by the time the doctor came in to see her the pain was gone and she was playing so I’m not sure what’s going on or If it may be something serious that she may need tests done to find out what it is …

    • Hi Susan. This should be assessed by a pediatrician. Even if the pain has resolved by the time of the appointment, the doctor will consider investigations to identify any problem. Only consider the ER if there are acute episodes which are worsening, not easing or other symptoms arise. You may also want to read up on abdominal migraines which tends to affect children. The exact cause is unknown. Here is the link to our article on abdominal migraines