Pneumonia in Kids

Sick child

Pneumonia is the leading cause of hospitalizations among young children. It's a common childhood disease, so it is important to recognize the signs and symptoms to ensure proper care for your loved one.

What Is Pneumonia?

Pneumonia is an infection in the lungs most often caused by viruses or bacteria. Generally, pediatric cases of pneumonia develop after having an upper respiratory tract infection. Pneumonia caused by bacterial infections is spread from person-to-person by coughing or having contact with an infected person's saliva or mucus. Most cases of pneumonia infections happen during the fall, winter and in early spring when your child is mostly indoors and in close contact with others.

Symptoms

Signs and symptoms of pneumonia can be a little more subtle in infants and young children and can vary depending on the age of the child and the cause of the infection. Symptoms of this infection include:

  • Unusually high fever
  • Cough
  • Fast labored breathing
  • Breathing, grunting or wheezing sounds
  • Breathing difficulty using muscles below and between the ribs and above the collarbone
  • Chest pain, particularly with coughing or deep breathing
  • Chills
  • Change in appetite (poor feeding/no appetite)
  • Flaring of nostrils
  • Fatigue/ Less energetic
  • General discomfort
  • Bluish color of lips and nails

UptoDate a clinical decision tool notes that pneumonia may present differently in young infants. Infants may be restlessness or fussy or they may have a difficult time feeding. You may only notice a fever or a higher white blood cell count in younger school-aged children with pneumonia.

Walking Pneumonia

Walking pneumonia is more common in school-aged children and it is caused by the mycoplasma bacteria. This type of pneumonia occurs more frequently when living crowded spaces. Unlike viral pneumonia, walking pneumonia can occur almost any time of the year. Generally, this type of lung infection is less serious and your child may experience cold symptoms, a low-grade fever, a hacking cough, sore throat, headache and a rash in addition to the usual pneumonia symptoms. Often, children with this condition will not feel sick enough to stay at home.

Pneumonia Risk Factors

While most healthy children can fight off viral or bacterial infections, children with weakened immune systems are at higher risk for developing pneumonia. According to the World Health Organization (WHO), children experiencing malnutrition/undernourishment, or kids with weaker immune systems or lung conditions such as cystic fibrosis or cancer are more likely to develop pneumonia. There are also certain environmental conditions that can increase a child's chance of acquiring pneumonia including:

  • Parents that smoke in the home
  • Living in a crowded home
  • Indoor air pollution

Diagnosing Pneumonia

Most times your health care provider will diagnose pneumonia by examining your child for any symptoms. Your provider may also conduct the following test to confirm the diagnosis:

  • Blood tests including a complete blood count (CBC) and blood cultures
  • CT scan of the chest
  • Throat and nose swab tests to check for viruses
  • Sputum culture (to make sure there are no other causes of illness)
  • Measurement of the levels of oxygen and carbon dioxide in the blood

Pneumonia Treatment

The treatment plan will depend on a number of factors including your child's age, the seriousness of the condition, and whether the pneumonia is caused by bacteria or a virus.

Viral Pneumonia

When pneumonia is caused by a virus, there is no specific treatment but rest and supportive therapies are encouraged.

Supportive therapies may involve:

  • Corticosteroid medicines
  • Encouraging fluids to keep your child hydrated
  • Providing oxygen therapy
  • Using the humidifier to help moisten air and help your child breathe better
  • Encouraging rest

Viral pneumonia generally gets better after a few days, but your child's cough may last for a few weeks. Usually, medicine is not necessary to help your child get better.

Antibiotic Treatment

It is often difficult to determine if your child's pneumonia is caused by a virus or bacteria, so your health care provider may prescribe an antibiotic. Antibiotics may be given in pill or liquid form.

Usually, amoxicillin a high dose antibiotic is prescribed for uncomplicated pneumonia. Your health care provider may also use cephalosporins or azithromycin as alternatives. A combination of antibiotics (ampicillin and either gentamicin or cefotaxime) is normally used in the initial treatment of newborns and young infants.

It is important for your child to complete the prescribed course of antibiotics. You may be tempted to stop giving your child medicine after a few days because your child may be feeling better but it's important to finish all the medicine because some bacteria may still be present and the infection might come back unless all the medicine is finished.

When to See Physician

Mother with sick daughter

To ensure the best possible outcome, take your loved one to see a provider right away if you think they might have pneumonia. You should also follow-up with your provider if you think the infection is getting worse or if your child is experiencing any of the following symptoms:

  • Ongoing fever lasting more than a few days even when using antibiotics
  • Breathing difficulties
  • Signs of an infection somewhere else in the body such as redness, swollen joints, bone pain, neck stiffness, or vomiting

UptoDate notes that you should call for help right away if your child experiences any of the following conditions:

  • Stops breathing
  • Turns blue or very pale
  • Has trouble breathing
  • Starts grunting while breathing
  • Appears to be getting tired of having to work so hard to breathe

With most pediatric pneumonia cases, a child can be cared for at home. Some children may, however, become very sick and have to be cared for in the hospital.

Preventing Pneumonia

Most parents feel helpless when their child becomes ill. There are a number of steps you can take to keep your child healthy and active:

  • Keep your child away from anyone who may be sick.
  • Wash your hands and encourage everyone in the family to wash their hands often.
  • Use hand sanitizer when soap and water are not readily available.
  • Make sure your child's vaccines are up to date. The flu vaccine is recommended for children age 6 months and older and the pneumococcal vaccine (PCV-13) is recommended for children under the age of 4.
  • Don't let your loved one share cups, forks or other utensils with others.

Healthy and Happy

You cannot prevent your loved one from getting sick but taking active steps to prevent pneumonia will ensure that your child remains healthy and happy.

Pneumonia in Kids