Pneumonia in Children
What is pneumonia?
Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi. It can be a mild or serious infection. Pneumonia in children is generally more common in those younger than age 5.
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What are the different types of pneumonia?
The main types of pneumonia are:
Bacterial pneumonia. This is caused by various bacteria. The streptococcus pneumoniae is a common bacterium that causes bacterial pneumonia.Many other bacteria may cause bacterial pneumonia including:
Group B streptococcus
Group A streptococcus
Bacterial pneumonia may happen suddenly and the following symptoms may occur:
Pain in the chest
Vomiting or diarrhea
Decrease in appetite
Viral pneumonia. This is caused by various viruses, including the following:
Respiratory syncytial virus, or RSV (most commonly seen in children younger than age 5)
Early symptoms of viral pneumonia are the same as those of bacterial pneumonia. However, with viral pneumonia, the respiratory involvement happens slowly. Wheezing may occur and the cough may worsen.
Viral pneumonias may make a child more at risk for bacterial pneumonia.
Mycoplasma pneumonia. This type of pneumonia is more common during the school years, including the college years.
Symptoms may not be present at first or they may be mild. They may include:
Other less common pneumonias may be caused by fungi.
What are the symptoms of pneumonia?
Each child’s symptoms may vary. In addition to the symptoms listed above, your child may have the following symptoms:
Chest or stomach pain
Decrease in appetite
Breathing fast or hard
Not feeling well
The symptoms of pneumonia may look like other problems or health conditions. Always see your child's healthcare provider for a diagnosis.
How is pneumonia diagnosed?
Diagnosis is usually made based on the season and the extent of the illness. Based on these factors, your child’s healthcare provider may diagnose simply on a thorough health history and physical exam. The provider may include the following tests to confirm the diagnosis:
Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Blood tests. A blood count looks for evidence of infection. An arterial blood gas test analyzes the amount of carbon dioxide and oxygen in the blood.
Sputum culture. A diagnostic test done on the material (sputum) that is coughed up from the lungs and into the mouth. A sputum culture is often done to determine if an infection is present. This test is not routinely done because it is hard to get sputum samples from children.
Pulse oximetry. An oximeter is a small machine that measures the amount of oxygen in the blood. To get this measurement, a small sensor (like a bandage) is taped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.
Chest CT scan. A test that takes images of the structures in the chest, very rarely done.
Bronchoscopy. A procedure used to look inside the airways of the lungs, very rarely done.
Pleural fluid culture. A culture of fluid sample taken from the space between the lungs and chest wall (pleural space). Fluid may come to that area as an extension of the pneumonia. This fluid may be infected with the same bacteria as the lung or may just be caused by the inflammation in the lung.
Treatment for pneumonia
Treatment may include antibiotics for bacterial and mycoplasma pneumonia. There is no clearly effective treatment for most viral pneumonias. They usually resolve on their own. Flu-related pneumonia may be treated with an antiviral medicine.
Other treatment may include:
Increased fluid intake
Cool mist humidifier in the child's room
Acetaminophen (for fever and discomfort)
Medicine for cough
Some children may be treated in the hospital if they are having severe breathing problems. While in the hospital, treatment may include:
Antibiotics by IV (intravenous) or by mouth (oral) for bacterial infection
IV fluids, if your child is unable to drink well
Frequent suctioning of your child's nose and mouth (to help get rid of thick secretions)
Breathing treatments, as ordered by your child's health care provider