Is it possible to have pneumonia without a fever?

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Is it possible to have pneumonia without a fever?

Pneumonia is a respiratory infection that affects the lungs. It causes inflammation in the air sacs, or alveoli, of one or both lungs. Although a fever is a common symptom of pneumonia, it is possible for a person to have pneumonia without a fever.

A fever means that a person has a body temperature of 100.4ºF (38ºC) or above. It occurs as a response to an infection in the body. Although fever is a common symptom of pneumonia, it may not occur in some people.

This article will discuss who might not experience a fever alongside pneumonia. It will also look at the other symptoms of pneumonia and when to see a doctor.

Is it possible?

A woman holding a thermometer.

It is possible for a person to have pneumonia without experiencing a fever.

One 2018 article notes that the symptoms of pneumonia do not always occur at the same time. It also states that some groups of people may not experience all of the typical symptoms of pneumonia.

According to the National Heart, Lung, and Blood Institute, infants, older adults, and those who have a weakened immune system may experience atypical symptoms, such as a lower-than-normal temperature as opposed to a fever.

The American Lung Association (ALA) state that older adults and those with weakened immune systems may also present with fewer or milder symptoms. Older adults may also experience confusion.

Learn more about the symptoms of pneumonia in older adults here.

The symptoms of pneumonia in infants may include:

  • vomiting
  • coughing
  • appearing restless or tired
  • breathing difficulties, such as:
    • grunting
    • rapid breathing
    • a bluish tint to the lips and skin
    • widening of the nostrils when breathing
    • the muscles pulling inward between the ribs when breathing

Typical symptoms of pneumonia

According to the National Health Service (NHS), the most common symptoms of pneumonia usually include:

  • coughing
  • yellow or green mucus arising in the throat and mouth
  • difficulty breathing
  • chest pain, which can worsen when coughing
  • a rapid heartbeat
  • shivering or sweating
  • loss of appetite

Some less common symptoms include:

  • fatigue
  • nausea
  • headache
  • coughing up blood

Types of pneumonia and their symptoms

The symptoms and when they appear can vary depending on the type of pneumonia a person has.

The different types of pneumonia and their typical symptoms include:

Bacterial

This is a common cause of pneumonia in adults. In the United States, the most common cause of bacterial pneumonia is Streptococcus pneumoniae.

Bacterial pneumonia can develop on its own or after a person has a cold or the flu.

The ALA note that the symptoms can appear gradually or suddenly and typically include:

  • a fever of 105ºF (41ºC) or higher
  • profuse sweating
  • rapid breathing
  • a rapid heart rate
  • bluish nail beds and lips
  • a confused or delirious mental state

Some bacteria can cause bacterial pneumonia with atypical symptoms. This is called atypical pneumonia. One example of this includes “walking pneumonia,” which can cause milder symptoms.

Viral

Viral pneumonia typically occurs due to the common cold or the influenza virus.

The symptoms can appear over a period of several days. Early symptoms include:

  • a fever
  • dry cough
  • headache
  • muscle pain
  • increasing cough
  • shortness of breath

Fungal

This may occur after inhaling fungal spores. These may come from environmental materials such as soil or animal droppings.

According to the Centers for Disease Control and Prevention (CDC), people who have a weakened immune system may be more likely to develop fungal pneumonia.

Symptoms can appear over several days or weeks and typically include:

  • cough
  • difficulty breathing
  • a fever
  • chest pain
  • fatigue
  • chills

Hospital-acquired

Those staying in a hospital may develop a form of pneumonia that occurs when the breathing tubes that medical professionals use to support breathing cause damage in the lungs.

Symptoms include:

  • cough
  • mucus
  • chest pain
  • shortness of breath
  • a fever
  • rapid breathing
  • a crackling sound when breathing

Aspiration

Aspiration pneumonia can occur when a person inhales foreign objects, such as food, saliva, or vomit that contains germs.

Symptoms include:

  • shortness of breath that can appear suddenly
  • a fever
  • a crackling sound when breathing
  • difficulty swallowing
  • fatigue
  • wheezing
  • sweating
  • slightly blue skin

When to see a doctor

A person should seek medical help if they have any symptoms of pneumonia.

However, a person needs urgent medical help if they have any of the following symptoms:

  • a bluish tint to the lips or fingertips
  • chest pain
  • a high fever
  • a cough with mucus that becomes worse

Treatments

The treatment for pneumonia will depend on its cause. For example, the ALA note that antibiotics are available to treat bacterial pneumonia.

However, if the pneumonia is viral, a doctor may prescribe antiviral medications.

A person can also treat the symptoms of pneumonia at home by:

  • taking over-the-counter medications, such as aspirin, nonsteroidal anti-inflammatory drugs, or acetaminophen
  • drinking plenty of fluids
  • getting plenty of rest
  • drinking warm beverages
  • using a humidifier

It is important to note that aspirin is not suitable for children to take. This is due to its association with Reye’s syndrome, which can cause brain and liver damage.

Complications and risk factors

According to the ALA, some complications of pneumonia may include:

  • sepsis
  • respiratory failure
  • acute respiratory distress syndrome, which is a severe form of respiratory failure
  • lung abscesses, though these are infrequent

Groups who have a higher chance of developing complications due to pneumonia include:

  • older adults
  • younger children
  • those with weakened immune systems
  • those with other medical conditions, including diabetes

Prevention

There are two vaccinations available to help prevent pneumonia. These are the pneumococcal conjugate vaccine, or PCV13, and the pneumococcal polysaccharide vaccine, or PPSV23.

People should also be sure to:

  • wash their hands frequently
  • quit smoking, if they already smoke
  • avoid alcohol misuse

Summary

It is possible for a person to have pneumonia without a fever. However, this appears to be more likely in older adults, infants, and those with weakened immune systems.

Instead, these groups may experience a lower-than-normal body temperature.

Also, a person may not experience all of the symptoms of pneumonia at the same time, or they may not develop some of the typical symptoms at all.

Although a person can usually manage the symptoms of pneumonia at home, they should seek medical help to ensure that their symptoms do not worsen.

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