The symptoms of a bacterial infection are very similar to symptoms of a viral infection, but each requires different treatments.
Knowing the difference between bacterial and viral infections can save you time and money.
Soma Mandal, Summit Medical Group internal medicine physician, decodes the important differences between these infections and when you need to see a doctor.
Selected Podcast
Is It a Virus or a Bacterium? How to Tell the Difference
Featured Speaker:
Before joining Summit Medical Group, Dr. Mandal was Medical Director and a physician for Take Care Health Services - Ethicon Employee Health Services in Somerville, New Jersey. She also has practiced privately in New York City. Dr. Mandal is Former Medical Director of the New York University Nursing Faculty Practice. She has been a hospitalist at New York University Medical Center, an attending physician at Maimonides Medical Center, and an attending physician with Gouveneur Healthcare Services, all located in New York.
Dr. Mandal says, "My father's experience with severe asthma inspired me to help him and other people living with health issues." She adds, "I believe clear communication is key to an effective patient / doctor relationship."
Dr. Mandal is a member of the New York University School of Medicine Board of Governors. She is a recipient of the Patient's Choice Award. She is featured in Consumer's Research Council of America "America's Top Physicians" listings.
When she is not working with her patients, Dr. Mandal enjoys spending time with her family, going to the beach, knitting, crocheting, playing tennis, and playing music. She is writing a children's book on diversity. Dr. Mandal is the author of articles for MomMD and the Washington Square News.
Soma Mandal, MD
Soma Mandal, MD, specializes in internal medicine, with focus on women's health, travel medicine, preventive medicine, sports medicine, evidence-based medicine, weight management, nutrition, mind-body medicine, and behavioral health.Before joining Summit Medical Group, Dr. Mandal was Medical Director and a physician for Take Care Health Services - Ethicon Employee Health Services in Somerville, New Jersey. She also has practiced privately in New York City. Dr. Mandal is Former Medical Director of the New York University Nursing Faculty Practice. She has been a hospitalist at New York University Medical Center, an attending physician at Maimonides Medical Center, and an attending physician with Gouveneur Healthcare Services, all located in New York.
Dr. Mandal says, "My father's experience with severe asthma inspired me to help him and other people living with health issues." She adds, "I believe clear communication is key to an effective patient / doctor relationship."
Dr. Mandal is a member of the New York University School of Medicine Board of Governors. She is a recipient of the Patient's Choice Award. She is featured in Consumer's Research Council of America "America's Top Physicians" listings.
When she is not working with her patients, Dr. Mandal enjoys spending time with her family, going to the beach, knitting, crocheting, playing tennis, and playing music. She is writing a children's book on diversity. Dr. Mandal is the author of articles for MomMD and the Washington Square News.
Transcription:
Is It a Virus or a Bacterium? How to Tell the Difference
Melanie Cole (Host): The symptoms of a bacterial infection are very similar to symptoms of a viral infection, but each requires different treatments. Knowing the difference between a bacterial and a viral infection can save you a lot of time and even money. My guest today is Dr. Soma Mandal. She’s a Summit Medical Group internal medicine physician. Welcome to the show, Dr. Mandal. Tell us a little bit about in this time of the year, we’re seeing the flu virus going rampant, but people are never quite sure whether they need an antibiotic. How do we tell the difference between a bacteria and a virus?
Dr. Soma Mandal (Guest): Hi, Melanie. In general, most colds and other respiratory infections are not serious for adults in good health. It’s just the hassle of dealing with a runny rose, coughing, sneezing, fever, headaches, aching muscles, and inability to sleep. Knowing whether your infection is caused by a virus or bacteria makes a difference in how it’s treated. Well, the first thing to know is what the difference between a bacterial and viral infection? Bacteria are one-celled organisms that multiply by simple divisions and they’re linked to such respiratory infections, like ear infections, throat infections, pneumonia, bronchitis, sinus infections, and whooping cough. Most respiratory infections, however, are caused by viruses, rather than by bacteria. Viruses are some of the tiniest entities known. Unlike bacteria, viruses don’t divide and they reproduce on their own. They’re like little parasites. They take over the cell’s machinery and they force the cell to reproduce the virus in many numbers. They can cause infections like the common colds, the flu, and certain pneumonias and bronchiolitis. It is difficult for most people to determine whether you have a viral or a bacterial infection. That’s where your doctor comes in, to distinguish between the two. If you have a cold and a cough, it’s usually viral, but you should suspect a secondary infection caused by a bacteria if a fever recurs after the first few days.
Melanie: Then what? People are often using antibiotics, Dr. Mandal. Maybe they have a cold, maybe they have the flu or virus and they ask for an antibiotic. What do you tell them?
Dr. Mandal: Well, it depends. Many respiratory infections, which are usually viral, usually lasts seven to ten days and don’t need to be treated by a healthcare professional. Common home remedies can be helpful for these types of things. But if your symptoms are lasting for more than that 10-day period, then medical care should be sought. People who are at higher risks for this type of bacterial respiratory infections should seek medical care early in the course of the infection. If I have a patient who comes in and they are having recurrent fevers well into the course of their upper respiratory infection, they can’t breathe, they’re having shortness of breath, they’re bringing up a lot of yellow or green phlegm or any blood in the phlegm. These are things that make me suspect that they have a bacterial infection, rather than a viral infection.
Melanie: If somebody comes, you might use a “watch and wait” with the virus, right? You will sometimes just tell them it’s a waiting game; you just have to let it take its course. If it’s a bacteria, do you ever play the waiting game or do you give an antibiotic right away? If it’s like strep throat or a urinary tract infection, is an antibiotic right [away] something you do or is there a “watch and wait” there, too?
Dr. Mandal: Sure. In most doctors’ offices, you are able to test for strep throat, so if I do see someone who has a fever, who has a headache, who has a very nasty-looking throat, these are all things that make me suspect that they have a strep throat and then I do a test called the Rapid Strep Test in the office which we confirm in the office with a throat culture as well. In most of those cases, those patients need an antibiotic. Most sore throats, however, are caused by a virus. To distinguish between the two can be sometimes difficult. If you have a fever or any bad headache associated with that, those are reasons to seek medical help.
Melanie: Then if it is a virus and it’s going on for a long time, can it turn in to bacteria? Like if you’ve got a respiratory infection of some sort that’s a virus, can it then become a bacterial infection that would need an antibiotic?
Dr. Mandal: Certainly. Sometimes, a viral infection can lead to a bacterial infection. How that happens is a virus can weaken your immune system and damage the tissues and that makes it easier for bacteria to grow and cause disease. Well into the course, like if by second week, you’re still having fever, if you are having difficulty bringing up phlegm, you’re having thick, what we call purulent sputum/phlegm, those are reasons to see the doctor and in a lot of those cases, I do prescribe antibiotics.
Melanie: Dr. Mandal, people cough or sneeze and it’s green. Right away, they say, “Oh, I’ve got bacteria.” Is that always the case? Is it always colored because it’s bacteria or can viruses also have green or yellow phlegm as well?
Dr. Mandal: That’s a very good question. It’s a question I get all the time almost every day. In general, mucus when you’re healthy is colorless and they’re produced by these cells called goblet cells, which line the epithelium. These, the mucus as well as the goblet cells, help protect your airways and they produce a protein called mucin and is basically when it attracts water, its job is to trap germs, dust, debris, so it sort of cleans your system. When you get an infection, whether it’s a viral or bacterial, the infection can damage the cells that line the airway. What happens is the viruses or the bacteria, in the course of killing the cells which are done by a certain type of white blood cell called the neutrophil, the neutrophils release certain enzymes called myeloperoxidase enzymes. That’s what gives the mucus that green color. I don’t get too concerned when someone doesn’t have a fever or isn’t having any difficulty breathing or is able to bring up their phlegm and they have green-colored phlegm. But if it’s accompanied by those other signs or symptoms, that makes me think, “Okay, they may need an antibiotic.” If I find that they don’t have those symptoms, I’m not inclined to prescribe an antibiotic right away.
Melanie: Bacteria can actually sometimes be beneficial, the ones that we have in our gut, the good bacteria. Viruses are almost never beneficial, correct?
Dr. Mandal: There are good bacteria that help with the digestion and give us protection as well. Most viruses are pathogens, I guess. When I say that, they cause things like the cold, the flu. They can cause sore throat. They can cause pneumonias and other respiratory illnesses as well. Viruses are not beneficial to us at all.
Melanie: Let’s speak a little bit about vaccines, Dr. Mandal. Vaccines, as they come out, are they generally for a bacterial infection? Are they for these viruses? The flu vaccine, maybe even ones that aren’t working as good as they should be working, what are vaccines doing for us for these viruses and/or bacteria?
Dr. Mandal: Well, what the vaccines do, such as the flu vaccine, is they take a part of that flu virus—it’s complicated so I won’t go into the whole science bit—and they make certain proteins and those are similar or the same as the virus itself. They’re injected into you and so your body is able to produce the antibodies against that particular virus. In this particular case where the flu shot is not covering a strain of that virus that is rampant in New Jersey, what has happened is that that virus has mutated, so the flu vaccine is not covering that particular strain. There are vaccines that are available for bacterial illnesses as well, such as the pneumococcal vaccine that’s a bacterial condition. There are vaccines available for that as well.
Melanie: In just the last few minutes, Dr. Mandal, give us your best advice on dealing with a bacteria or a virus, some good home remedy information, things that we can do at home to help treat it if we do have a really bad virus and why people should consider coming to Summit Medical Group for their care.
Dr. Mandal: Sure. It’s really a watch-and-wait game, so even though antibiotics don’t help you recover from a viral respiratory infection, there are ways that you can speed recovery and feel better. If you smoke, stop smoking. Stay away from people who smoke. If the air is dry at home, add a humidifier at home. You can use an over-the-counter nasal spray but no more than two to three days as it can cause things like rebound congestion, which can cause further issues. For fever, for any discomfort, you can use over-the-counter Tylenol or Motrin. Then don’t blow your nose too hard. Drink a lot of fluids. You can use warm towels for any kind of facial discomfort. Most important thing to avoid spreading germs to others is to wash your hands frequently, especially if you are in frequent contact with others, and this will help stop the spread of an infection.
Melanie: Thank you so much. It’s really great information. You’re listening to SMG Radio and for more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. Let’s all take care of ourselves and feel better. This is Melanie Cole. Thanks so much for listening.
Is It a Virus or a Bacterium? How to Tell the Difference
Melanie Cole (Host): The symptoms of a bacterial infection are very similar to symptoms of a viral infection, but each requires different treatments. Knowing the difference between a bacterial and a viral infection can save you a lot of time and even money. My guest today is Dr. Soma Mandal. She’s a Summit Medical Group internal medicine physician. Welcome to the show, Dr. Mandal. Tell us a little bit about in this time of the year, we’re seeing the flu virus going rampant, but people are never quite sure whether they need an antibiotic. How do we tell the difference between a bacteria and a virus?
Dr. Soma Mandal (Guest): Hi, Melanie. In general, most colds and other respiratory infections are not serious for adults in good health. It’s just the hassle of dealing with a runny rose, coughing, sneezing, fever, headaches, aching muscles, and inability to sleep. Knowing whether your infection is caused by a virus or bacteria makes a difference in how it’s treated. Well, the first thing to know is what the difference between a bacterial and viral infection? Bacteria are one-celled organisms that multiply by simple divisions and they’re linked to such respiratory infections, like ear infections, throat infections, pneumonia, bronchitis, sinus infections, and whooping cough. Most respiratory infections, however, are caused by viruses, rather than by bacteria. Viruses are some of the tiniest entities known. Unlike bacteria, viruses don’t divide and they reproduce on their own. They’re like little parasites. They take over the cell’s machinery and they force the cell to reproduce the virus in many numbers. They can cause infections like the common colds, the flu, and certain pneumonias and bronchiolitis. It is difficult for most people to determine whether you have a viral or a bacterial infection. That’s where your doctor comes in, to distinguish between the two. If you have a cold and a cough, it’s usually viral, but you should suspect a secondary infection caused by a bacteria if a fever recurs after the first few days.
Melanie: Then what? People are often using antibiotics, Dr. Mandal. Maybe they have a cold, maybe they have the flu or virus and they ask for an antibiotic. What do you tell them?
Dr. Mandal: Well, it depends. Many respiratory infections, which are usually viral, usually lasts seven to ten days and don’t need to be treated by a healthcare professional. Common home remedies can be helpful for these types of things. But if your symptoms are lasting for more than that 10-day period, then medical care should be sought. People who are at higher risks for this type of bacterial respiratory infections should seek medical care early in the course of the infection. If I have a patient who comes in and they are having recurrent fevers well into the course of their upper respiratory infection, they can’t breathe, they’re having shortness of breath, they’re bringing up a lot of yellow or green phlegm or any blood in the phlegm. These are things that make me suspect that they have a bacterial infection, rather than a viral infection.
Melanie: If somebody comes, you might use a “watch and wait” with the virus, right? You will sometimes just tell them it’s a waiting game; you just have to let it take its course. If it’s a bacteria, do you ever play the waiting game or do you give an antibiotic right away? If it’s like strep throat or a urinary tract infection, is an antibiotic right [away] something you do or is there a “watch and wait” there, too?
Dr. Mandal: Sure. In most doctors’ offices, you are able to test for strep throat, so if I do see someone who has a fever, who has a headache, who has a very nasty-looking throat, these are all things that make me suspect that they have a strep throat and then I do a test called the Rapid Strep Test in the office which we confirm in the office with a throat culture as well. In most of those cases, those patients need an antibiotic. Most sore throats, however, are caused by a virus. To distinguish between the two can be sometimes difficult. If you have a fever or any bad headache associated with that, those are reasons to seek medical help.
Melanie: Then if it is a virus and it’s going on for a long time, can it turn in to bacteria? Like if you’ve got a respiratory infection of some sort that’s a virus, can it then become a bacterial infection that would need an antibiotic?
Dr. Mandal: Certainly. Sometimes, a viral infection can lead to a bacterial infection. How that happens is a virus can weaken your immune system and damage the tissues and that makes it easier for bacteria to grow and cause disease. Well into the course, like if by second week, you’re still having fever, if you are having difficulty bringing up phlegm, you’re having thick, what we call purulent sputum/phlegm, those are reasons to see the doctor and in a lot of those cases, I do prescribe antibiotics.
Melanie: Dr. Mandal, people cough or sneeze and it’s green. Right away, they say, “Oh, I’ve got bacteria.” Is that always the case? Is it always colored because it’s bacteria or can viruses also have green or yellow phlegm as well?
Dr. Mandal: That’s a very good question. It’s a question I get all the time almost every day. In general, mucus when you’re healthy is colorless and they’re produced by these cells called goblet cells, which line the epithelium. These, the mucus as well as the goblet cells, help protect your airways and they produce a protein called mucin and is basically when it attracts water, its job is to trap germs, dust, debris, so it sort of cleans your system. When you get an infection, whether it’s a viral or bacterial, the infection can damage the cells that line the airway. What happens is the viruses or the bacteria, in the course of killing the cells which are done by a certain type of white blood cell called the neutrophil, the neutrophils release certain enzymes called myeloperoxidase enzymes. That’s what gives the mucus that green color. I don’t get too concerned when someone doesn’t have a fever or isn’t having any difficulty breathing or is able to bring up their phlegm and they have green-colored phlegm. But if it’s accompanied by those other signs or symptoms, that makes me think, “Okay, they may need an antibiotic.” If I find that they don’t have those symptoms, I’m not inclined to prescribe an antibiotic right away.
Melanie: Bacteria can actually sometimes be beneficial, the ones that we have in our gut, the good bacteria. Viruses are almost never beneficial, correct?
Dr. Mandal: There are good bacteria that help with the digestion and give us protection as well. Most viruses are pathogens, I guess. When I say that, they cause things like the cold, the flu. They can cause sore throat. They can cause pneumonias and other respiratory illnesses as well. Viruses are not beneficial to us at all.
Melanie: Let’s speak a little bit about vaccines, Dr. Mandal. Vaccines, as they come out, are they generally for a bacterial infection? Are they for these viruses? The flu vaccine, maybe even ones that aren’t working as good as they should be working, what are vaccines doing for us for these viruses and/or bacteria?
Dr. Mandal: Well, what the vaccines do, such as the flu vaccine, is they take a part of that flu virus—it’s complicated so I won’t go into the whole science bit—and they make certain proteins and those are similar or the same as the virus itself. They’re injected into you and so your body is able to produce the antibodies against that particular virus. In this particular case where the flu shot is not covering a strain of that virus that is rampant in New Jersey, what has happened is that that virus has mutated, so the flu vaccine is not covering that particular strain. There are vaccines that are available for bacterial illnesses as well, such as the pneumococcal vaccine that’s a bacterial condition. There are vaccines available for that as well.
Melanie: In just the last few minutes, Dr. Mandal, give us your best advice on dealing with a bacteria or a virus, some good home remedy information, things that we can do at home to help treat it if we do have a really bad virus and why people should consider coming to Summit Medical Group for their care.
Dr. Mandal: Sure. It’s really a watch-and-wait game, so even though antibiotics don’t help you recover from a viral respiratory infection, there are ways that you can speed recovery and feel better. If you smoke, stop smoking. Stay away from people who smoke. If the air is dry at home, add a humidifier at home. You can use an over-the-counter nasal spray but no more than two to three days as it can cause things like rebound congestion, which can cause further issues. For fever, for any discomfort, you can use over-the-counter Tylenol or Motrin. Then don’t blow your nose too hard. Drink a lot of fluids. You can use warm towels for any kind of facial discomfort. Most important thing to avoid spreading germs to others is to wash your hands frequently, especially if you are in frequent contact with others, and this will help stop the spread of an infection.
Melanie: Thank you so much. It’s really great information. You’re listening to SMG Radio and for more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. Let’s all take care of ourselves and feel better. This is Melanie Cole. Thanks so much for listening.