• Pneumonia—Child

    Definition

    Pneumonia is an infection of the lungs. It affects the small airways and air sacs of the lungs.
    Pneumonia can be described by where and how your child was infected. Types include:
    • Community-acquired—from the community, such as home, school or daycare
    • Nosocomial—in a hospital or healthcare setting
    • Aspiration—happens when foreign matter is inhaled into the lungs, such as food, liquid, saliva, or vomit

    Causes

    Viruses, bacteria, or other germs most often cause pneumonia. Cold or flu viruses are the most common cause of pneumonia in children. Rarely, pneumonia can be caused by food, liquid, or other items that are inhaled.
    The infection or inhaled substance causes irritation and swelling in the deeper areas of the lungs. Pus or other fluids can also build up in the area. The swelling and fluid make it difficult for oxygen to pass from the lungs to the blood.

    Risk Factors

    Pneumonia is more in children under the age of 5 years.
    Factors that may increase your child’s risk of pneumonia include:

    Symptoms

    Pneumonia may cause respiratory symptoms, such as:
    • Cough, which may or may not produce mucus
    • Wheezing—a hoarse whistling sound
    • Rapid breathing
    • Shortness of breath, may cause flaring of nose
    It may also cause nonrespiratory symptoms, such as:
    • Chest pain
    • Reduced activity levels
    • Irritability
    • Lack of appetite or difficulty feeding—may lead to dehydration
    • Fever
    • Vomiting
    • Abdominal pain
    • Bluish gray color around the nose, lips, or fingernails—in severe cases

    Diagnosis

    You will be asked about your child’s symptoms and medical history. A physical exam will be done. The exam will evaluate your child’s breathing and lung sounds. Diagnosis will often be based on these findings.
    The amount of oxygen may be measured with a small clip on your child’s finger. This will show how much the pneumonia is affecting the transfer of oxygen from the lungs to the blood.
    Other tests may be done to find the specific germ causing the pneumonia. Tests may include:
    • Blood tests
    • Sputum culture
    • Urine tests
    Imaging tests may also be done to see what areas of the lungs are affected. Tests may include:

    Treatment

    Treatment of pneumonia depends on:
    • What is causing the pneumonia
    • Severity of symptoms
    • Other factors, like the overall health of your child
    Treatment options may include:

    Medications

    Pneumonia caused by a bacterial infection can be treated with antibiotics. Antiviral medications may be used to help manage pneumonia caused by a virus.
    Other medications may be used to help manage symptoms and keep your child more comfortable.
    Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

    Hospitalization

    Hospitalization may be needed for children with severe pneumonia, or who are at high risk for severe pneumonia. Treatments in the hospital may include:
    • Oxygen therapy to increase levels of oxygen in the blood
    • Nutrition and fluids through IV for children who have trouble feeding or keeping food down
    • Medication delivered through IV
    Hospitalization may also be needed to monitor children with weakened immune systems or whose infection has spread to the blood.

    Prevention

    Certain vaccines can help prevent pneumonia. Talk to your child’s doctor about options for your child such as:
    • Flu vaccine—in all children aged six months and older
    • Pneumococcal vaccine:
      • PCV13 is recommended in all children, and routinely given to all children aged 2 months to 5 years
      • PCV23 in children aged 2 years and older who have a high risk of infection or a suppressed immune system
    • Hemophilus influenza type B vaccine, routinely given to all children aged 2 months to 5 years
    • Pertussis (whooping cough) vaccine, routinely given to all children aged 2 months to 5 years as part of the DTaP vaccine
    Some children may have a higher risk of pneumonia. Medication may be given to these children after a viral infection to help reduce their risk of pneumonia. Options include:
    • Antiviral—for infants who are at high risk of developing pneumonia from respiratory syncytial virus
    • Antibiotics—to prevent pneumonia in children with reduced immunity or certain underlying illnesses such as cystic fibrosis
    To decrease your child’s risk of any respiratory infection:
    • Do not expose your child to tobacco smoke. Smoke weakens the lungs' resistance to infection.
    • Have your child avoid close contact with people who have a cold or the flu.
    • Encourage your child to wash their hands often, especially after coming into contact with someone who is sick.

    RESOURCES

    FamilyDoctor.org - American Academy of Family Physicians http://familydoctor.org

    Healthy Children - American Academy of Pediatrics http://www.healthychildren.org

    CANADIAN RESOURCES

    Canadian Paediatric Society http://www.cps.ca

    The College of Family Physicians of Canada http://www.cfpc.ca

    References

    Dehydration. Nemours Kids Health website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/emergencies/dehydration.html. Updated July 2013. Accessed February 19, 2014.

    Pneumonia. Nemours Kids Health website. Available at: http://kidshealth.org/parent/infections/lung/pneumonia.html. Updated May 2011. Accessed February 19, 2014.

    Pneumonia in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 7, 2014. Accessed February 27, 2014.

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