Confused lungs with question marks against a split background of flames and virus cells.

Is It a Lung Infection or Just a COPD Flare-up?

Last updated: June 2023

Because COPD weakens the lungs, people who have COPD are prone to respiratory, or lung, infections.1 But people who have COPD are also prone to episodes of more intense symptoms for other reasons, such as coming into contact with an irritant. These are called exacerbations, or flare-ups. Both infections and flare-ups cause COPD symptoms to worsen. So how do you tell the difference?

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How to tell the difference between an infection and a flare-up

This post will help answer that question. And it's an important question because the actions you take and the treatments you need for an infection are not the same as dealing with a flare-up. Not getting the care you need in a timely manner for an infection could lead to hospitalization or even death.

Why COPD increases the risk of lung infections

When you have COPD, it can be hard to completely clear your airways of dust, bacteria and viruses, and other pollutants.2 You don't have the breath power and you may not have the coughing power either. So, those things sit in your airways and lungs. In the case of bacteria and viruses, they may begin to multiply and can lead to infections.

What is a lung infection?

It's simply your body's response to the presence of a foreign body, such as bacteria, in your airways.3 Infections can be mild or severe, acute or chronic. In healthy people, the immune system mounts a defense against the infection. Sometimes this is enough to fight off the infection. Other times, medication, antibiotics or antivirals, are needed to assist your natural immune system defenses.

When you have a chronic illness such as COPD, your immune system may not be functioning at full power. Plus, your airways are already inflamed and irritated and may not be equipped to fight off the infection easily. While upper respiratory infections occur even in people with healthy lungs, lower respiratory infections do not. But in people with COPD, lower respiratory infections often become common.4 Both upper and lower respiratory infections can cause problems in people with COPD.

Types of respiratory infections

The two main types of lung infections you need to be on the lookout for are viral or bacterial in origin. Viral infections include:

  • Common colds
  • Influenza, the flu
  • Some types of pneumonia

The main bacterial infection of concern for people with COPD is pneumonia. Bacterial pneumonia can be more severe than viral pneumonia in healthy people. However, viral pneumonia can lead to bacterial pneumonia, especially in people with chronic lung conditions.5 And viral pneumonia often goes hand in hand with the flu. The combination can be life-threatening to people with COPD.6

COPD symptoms vs. lung infection symptoms

Because an infection can make your COPD worse, some of the symptoms are the same:7

When you have a COPD exacerbation, any or all of these symptoms may become worse, at least for a period of time. Rest might offer some relief, as might some of your medications or a nebulizer treatment. Oxygen, if it's been prescribed for you, can also help. If these symptoms do not lessen with rest or treatment or if they worsen further, then your exacerbation may require medical care.

One of the reasons this might happen is because you also have a respiratory or lung infection. In that case, you may notice not only a worsening of your usual COPD symptoms, but also:8

  • Coughing up more mucus than usual
  • Mucus that is thicker than usual and that is colored green, yellow or even blood-tinged
  • Fever or chills
  • Sore or scratchy throat
  • Sinus pain, headache or tenderness along your cheekbones
  • Achy joints

What you should do when COPD symptoms worsen

If you notice your COPD symptoms getting worse or that you have any of the symptoms of infection listed above, you need to take it seriously. Definitely keep following your COPD treatment plan to the letter. But also, it's time to give your doctor a call. For COPD flare-ups, the doctor may prescribe a change in treatment, add oxygen to your plan or just ask you to come in to the office for a visit.

But, if there is an infection causing the flare-up and other symptoms, then you may need to start taking an antibiotic (for bacterial infections) or an antiviral (for viral infections). Depending on how much your breathing has deteriorated, you may even need emergency care or to be admitted to the hospital.

It's important to note that although there are medicines to fight infection, it's much smarter to do all you can to avoid infection in the first place. This is why people with COPD should get a flu shot every year and a pneumonia shot every few years. Also, avoiding people who you know are sick and practicing thorough handwashing can help prevent being exposed to germs and infections.

The changes can be subtle

It's not always easy to tell if your COPD is just flaring up or if you also have a respiratory infection. The changes in your symptoms could be subtle sometimes. You might not actually feel sick. But it's so much better to err on the side of caution and consult with your doctor any time things feel a bit different or worse.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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