Can the Flu Turn Into Pneumonia? A Doctor Shares the Warning Signs to Watch For
Plus find out who's most at risk for this potentially serious complication
Wintertime unfortunately means cold and flu season. And for the estimated 40 million people who get the flu each year, it can sometimes spell trouble for your health. Why? Experts say the flu can turn into pneumonia, an infection that adults age 65 and older are more prone to developing. Here we explain who’s most at risk and key warning signs to watch for.
The difference between the flu and pneumonia
The flu and pneumonia are different conditions, but both are respiratory infections. The influenza virus causes the flu, whereas pneumonia can be caused by a virus, bacteria or fungi and primarily affects the lungs.
“While the flu can make you feel miserable, pneumonia is a more serious complication that can lead to hospitalization or worse,” cautions Po-Chang Hsu, MD, consultant at Alpas Wellness.
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Can the flu turn into pneumonia?
Influenza can become pneumonia when the flu virus weakens the immune system, making the lungs more vulnerable to infections, explains Dr. Hsu.
There are two main types of pneumonia:
- Viral pneumonia occurs when the flu virus leads to lung inflammation and difficulty breathing.
- Secondary bacterial pneumonia occurs more commonly when bacteria enter the weakened immune system and cause a lung infection.
Risk factors for the flu turning into pneumonia
Certain groups might be more prone to developing pneumonia after having the flu. Adults over 65 and young children under five are at higher risk because their immune systems are either aging or developing, says Dr. Hsu.
“People with chronic conditions like asthma, COPD, diabetes or heart disease also face an increased likelihood of flu complications, including pneumonia,” he adds. “Those with weakened immune systems due to conditions like cancer, HIV or medications that suppress immune function are also more susceptible. Pregnant women and residents of long-term care facilities are at greater risk as well, given their altered immune responses and exposure to others who may be sick.”
Signs the flu may be turning into pneumonia
If you have the flu and start feeling worse instead of better over time, it may be a sign that pneumonia is developing, Dr. Hsu says. While flu duration can vary and some symptoms can remain after the virus is gone, symptoms lasting more than 10 days may signal complications.
Other pneumonia warning signs to watch for:
- A cough that becomes more severe and produces yellow, green or bloody mucus
- A persistent or returning fever after initial improvement (this can indicate a bacterial infection taking hold)
- Shortness of breath, rapid breathing or tightness in the chest
- Severe fatigue that does not improve with rest
- Becoming confused (especially older adults)
- Bluish lips or fingertips (which could signal low oxygen levels)
“Anyone in a high-risk group—older adults, young children or those with chronic illnesses—should seek medical attention if they develop flu symptoms to prevent complications,” advises Dr. Hsu.
“The best way to protect yourself is by getting a flu shot yearly, washing your hands regularly, and staying home when sick to avoid spreading infections,” he adds. “If you are recovering from the flu and feel like you are getting worse instead of better, do not ignore it—talk to your doctor to ensure you are on the right path to recovery.”
What to do if you think you have pneumonia
If you suspect you have pneumonia, visit your doctor. He or she may perform imaging tests, a blood test, a sputum (spit) test and check your pulse oxygen levels. Pneumonia treatment depends on the cause and severity. It may include antibiotics, antifungals or antiviral medications, as well as oxygen or IV fluid therapy.
Other infections that may turn into pneumonia
The flu is not the only infection that can turn into pneumonia. Respiratory syncytial virus (RSV) can cause severe lung infections, Dr. Hsu says. COVID-19 has also been known to lead to pneumonia, particularly in vulnerable populations.
“Some bacterial infections, such as those caused by Streptococcus pneumoniae, Staphylococcus aureus or Haemophilus influenzae can trigger bacterial pneumonia,” he explains. “Additionally, certain fungal infections like histoplasmosis and coccidioidomycosis (dubbed Valley fever) can cause pneumonia, particularly in people with weakened immune systems or those exposed to environmental sources like contaminated soil.”
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