Is it actually possible for a person with pneumonia to have only one symptom: coughing?

“One of the hallmark symptoms of pneumonia is cough, but it is infrequently the only symptom,” says Angel Coz, MD, FCCP, board certified pulmonologist, Associate Professor of Medicine, University of Kentucky, Lexington Veterans Affairs Medical Center.

“Infrequently” is the key word here. It’s possible for coughing to be the only symptom of pneumonia—but this is very atypical.

It Happened to My Elderly Mother

My mother’s only symptom of her second bout of pneumonia was, indeed, just coughing.

  • She reported no feverish feeling.
  • She reported no decline in energy or increase in fatigue.
  • She “felt fine” and was up and about as she normally always was.
  • There were no aches or pains anywhere.
  • Her throat was not sore or scratchy.
  • All she had was a cough.

However, I did not like the sound of the cough, and it just seemed like a different animal than what would be caused by a typical common cold.

It didn’t sound like her usual cough from a cold or from acid reflux.

There was something about the way it sounded that made me highly suspicious that it was pneumonia, which was easily confirmed with an X-ray. The treatment was antibiotics.

Dr. Coz continues, “It is important to mention that pneumonia tends to be more common in patients with pre-existing lung disease like emphysema (COPD).

“Those patients typically have cough on a regular basis. However, any change in the intensity of the cough or in the characteristics of the phlegm (increased amount, change in color, etc.) should alert the patient that a different process is occurring and that medical attention should be sought immediately.”

When a person over age 65 is diagnosed in the ER with pneumonia, even when the only symptom is a cough (or at least the patient reports this), it’s not uncommon for the doctor to recommend an overnight stay in the ER observation wing just as an extra layer of medical security.

Dr. Coz is a pulmonary and critical care specialist at the Lexington Veterans Affairs Medical Center. He has a special interest in sepsis resuscitation and medical education. Sepsis.org/advisory/angel-o-coz-md-fccp
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.