Understanding Double Pneumonia And How Serious It Is

Pneumonia is a chest infection that causes the air sacs (alveoli) in the lungs to become inflamed and filled with fluids or pus. This can make breathing difficult and cause other flu-like symptoms.

Pneumonia can affect one or both lungs. In either case, pneumonia is a severe illness that causes about 48,000 deaths each year in the United States, and it is a leading cause of death in children. Because of this, medical care and adequate treatment are essential.¹

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What is double pneumonia?

Double pneumonia, sometimes known as “bilateral pneumonia,” is the name given to any type of pneumonia that affects both lungs at the same time. 

Double pneumonia includes the most commonly known pneumonia that occurs in the alveoli of the lungs. 

Another subtype of pneumonia, called bronchopneumonia, occurs in the bronchi and airways of both lungs, so it can also be considered double pneumonia. The bronchi are air passages that extend from the windpipe to the lungs and split into smaller air tubes with alveoli.² 

Symptoms of double pneumonia

The symptoms of double pneumonia are similar to pneumonia that affects one lung. Symptoms of double pneumonia may include:

  • Chest pain when coughing or breathing

  • Fever

  • Shortness of breath 

  • Coughing up mucus or phlegm 

  • Chills 

  • Low blood oxygen levels

  • Headache

  • Weakness 

  • Muscle pain

  • Extreme tiredness 

  • Nausea and vomiting

  • Diarrhea 

  • Confusion or disorientation in older adults 

  • Fast heart rate

  • Fast breathing 

  • Low blood pressure 

  • A poor appetite 

Having double pneumonia doesn’t necessarily mean the symptoms will be twice as bad as pneumonia in one lung, but in many people, they are more severe. This is because symptoms such as chest pain may be felt on both sides rather than one. 

What causes double pneumonia?

Double pneumonia has the exact causes of pneumonia in one lung. Since the causes are the same, there isn’t any way of confirming whether someone will get single or double pneumonia without a chest x-ray or CT scan. It may just be due to chance. 

Pneumonia is sometimes also classified as either community-acquired, healthcare-acquired, or ventilator-acquired, depending on where a person developed pneumonia.

Double pneumonia can be caused by coming into contact with the following:

A virus

Viruses such as the common cold, influenza, or respiratory syncytial virus (RSV) can cause double pneumonia.


Some bacteria, such as streptococcus pneumonia and Group A streptococcus, can cause double pneumonia.³


Fungi are a much rarer cause of pneumonia. Fungal pneumonia usually occurs in people who are immunocompromised.


Pneumonia can also be caused by aspiration when foreign or harmful substances, including food, are swallowed incorrectly. 

The body has mechanisms that prevent bacteria, viruses, and fungi from getting into the lungs. If they make their way into the lungs and the alveoli, the body responds by sending immune cells to the alveoli in both lungs, causing inflammation and a buildup of fluid and pus. This leads to double pneumonia. 

Risk factors of double pneumonia 

While anyone can get double pneumonia, some people are more likely to develop severe pneumonia or have complications from the illness. 

These include people who:

  • Smoke

  • Drink alcohol heavily

  • Are immunocompromised

  • Are under the age of two

  • Are over the age of 65 

  • Have underlying conditions, such as cancer, heart or lung disease, autoimmune diseases, and diabetes 

  • Live in a crowded place 

  • Regularly breathing in air pollution or toxic fumes 

  • Are malnourished 

  • Take medications that weaken the immune system 

  • Are hospitalized and put on a ventilator 

  • Have recently had a viral or bacterial infection that affected the respiratory tract 

How serious is double pneumonia?

Double pneumonia may be more severe than pneumonia that affects one lung. However, it depends on a few factors, such as:

  • How many segments of the lungs are affected 

  • Whether a person has underlying risk factors 

If only one segment in each of the two lungs is affected, double pneumonia may be less severe than if multiple lung segments in one or two lungs are affected.

Double pneumonia, like single pneumonia, may lead to a person needing to be hospitalized to receive a higher level of care and breathing support. 

Most people, however, can fully recover from double pneumonia at home. Double pneumonia can lead to complications, such as the following:


Sepsis, sometimes known as “blood poisoning,” is when the lung infection spreads into the bloodstream. Sepsis is a life-threatening medical emergency that can lead to organ failure. 

Getting medical care for double pneumonia early on can help prevent sepsis.

Pleural effusions

Pleural effusions are sometimes called “water on the lungs.” This occurs when too much fluid exists in the narrow space between the lungs and chest wall. 

Lung abscesses

A lung abscess, usually caused by bacterial pneumonia, is when pockets of pus form inside or around the lungs. 


Pleurisy occurs when the lining between the lungs and chest wall becomes inflamed. Pleurisy can cause chest pain during a deep breath or cough and increase the risk of getting water in the lungs. 

Organ failure

Pneumonia can lead to the failure of organs to function correctly, such as:

  • Kidney failure

  • Respiratory failure 

When there are low levels of oxygen in the blood, this usually indicates that a person needs a ventilator to help them breathe. 


Some people die from pneumonia. This is more likely to happen to very young children or people 70 and older. 

How is double pneumonia diagnosed?

A doctor can diagnose pneumonia based on the symptoms the patient described. 

A chest x-ray or a CT scan can confirm that a person has double pneumonia. This is because it will show that there is inflammation from the infection in the two lungs. 

The levels of oxygen in the blood can be assessed with pulse oximetry. This involves placing a clip with a sensor on one of the fingers. Pulse oximetry may be essential when a patient is very unwell and can be carried out by medical professionals. 

A sputum sample may also be taken. Sputum consists of the saliva and mucus that is coughed up. The sputum can be analyzed to see the bacteria or fungi causing the infection. 

Blood tests can also indicate how much inflammation/infection there is, and blood gas might be performed in certain circumstances. An arterial blood gas (ABG) test usually measures oxygen and carbon dioxide levels in the blood, as well as the pH of the blood. 

It can also help health professionals shed light on the impact of certain respiratory (including severe pneumonia), circulatory, and metabolic conditions that affect essential body systems in the emergency setting. 

This can give an idea of the progression of double pneumonia and its current severity. 

Treatment of double pneumonia

It is essential to start treating double pneumonia quickly. When left untreated, double pneumonia can lead to permanent lung damage. 

Seeking medical care 

If you suspect you have pneumonia, the first step to treating the infection is seeing a doctor. They will be able to diagnose the type of pneumonia—viral or bacterial—so that your treatment can be tailored to give you the best possible outcome. 

If you have difficulty breathing, confusion, or severe chest pain, you should seek emergency medical care as soon as possible. 

Double pneumonia is treated in much the same way as single pneumonia. Make sure to follow the treatment regime as your doctor prescribes, but contact them if you struggle to do so for any reason. 

Double pneumonia can be treated with the following:

Pain relief

Over-the-counter medications such as paracetamol, aspirin, and ibuprofen can help manage some double pneumonia symptoms such as fever and muscle pain. 

Antiviral medications 

Antiviral medications may be used to treat double pneumonia caused by some types of viruses. 


Antibiotics can treat double pneumonia caused by bacteria but not viruses. Antibiotics start to work within a few days of treatment and usually continue for five to seven days. 


People with double pneumonia should avoid work and any physical exercise. Keeping fluids up is essential. 

Hospital care

Many people with pneumonia can recover at home, but others may need a higher level of care in a hospital. This may be because they have developed complications such as sepsis or pleurisy or if they are at greater risk of developing complications. 

In the hospital, people may be given oxygen or a ventilator to help them breathe or have medications and nutrition administered into their veins with an IV line if they’re too unwell to swallow them. 

Can you prevent double pneumonia?

While you may not be able to entirely prevent yourself from getting pneumonia, you may be able to reduce the risk by:

Practicing good hygiene

Tips for practicing good hygiene include:

  • Washing your hands with soap and warm water for 20 seconds

  • Avoiding sick people

  • Considering wearing a face mask in healthcare settings

  • Cleaning and disinfecting frequently-touched surfaces 

Lifestyle changes

Making other lifestyle changes, such as regularly exercising, avoiding excessive alcohol intake, quitting smoking, and eating healthy, could also help. 

Managing risk factors as much as possible, such as smoking, excessive alcohol use, and medical conditions such as diabetes. 


Getting the flu vaccine each year protects against the flu, reducing the risk of getting pneumonia as a secondary infection. 

The pneumonia vaccine protects against pneumonia. This vaccine is available for children under six, adults over 65, and other at-risk people. 

The lowdown 

Double pneumonia is a serious illness but isn’t always more severe than single pneumonia. 

Understanding the causes and risk factors can help you know when to seek help to ensure you have the best chance of making a full recovery. 

People also ask: 

What’s the difference between pneumonia and double pneumonia?

Pneumonia and double pneumonia are the same types of illness. They both have the exact causes, symptoms, and treatment options. Double pneumonia means that the infection is in both lungs. Due to this, it may be more severe. 

Is double pneumonia life-threatening? 

Double pneumonia can be life-threatening when left untreated or if a person has other risk factors, like underlying medical conditions. However, in some people, the disease is mild. In either case, with adequate medical care, most people fully recover. 

How long does it take to heal from double pneumonia?

Once treatment has started, people generally improve and recover within a few days to weeks. Some people take a few months to recover. The exact time can vary from person to person. 

Is double pneumonia contagious? 

Bacterial and viral double pneumonia, like single pneumonia, is contagious. Pneumonia can spread between people when someone coughs or sneezes out droplets containing the particles. This is why good hygiene, such as washing hands and wiping frequently-touched surfaces, is essential.

Fungal pneumonia and aspiration pneumonia aren’t contagious.

  1. Pneumonia | Centers for Disease Control and Prevention

  2. Bronchopneumonia (2022)

  3. Typical bacterial pneumonia (2022)

Other sources:

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