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Definition

Pneumonia is an infection deep in the small airways and air sacs of the lungs. The infection will make the air sacs swell and fill with fluid or pus. This causes intense coughing and can make it difficult to breathe.

Types of pneumonia include:

  • Community-acquired —infection is picked up in the community, such as home, school, or daycare
  • Nosocomial—infection is picked up in a hospital or healthcare setting
  • Aspiration —happens when foreign matter is inhaled into the lungs, such as food, liquid, saliva, or vomit

This article will focus on community-acquired pneumonia.

Infection in the Air Sacs of the Lungs
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Causes

Pneumonia is caused by a germ in the air that you breathe. Germs that most often cause community-acquired pneumonia include:

  • Viruses—such as flu or cold viruses
  • Bacteria
  • Fungus—more likely to happen in people with other health issues or immune system problems

Risk Factors

Pneumonia is more common in children under the age of 5 years.

Factors that may increase your child’s chance of pneumonia include:

Symptoms

Pneumonia may cause:

  • Cough
  • Shortness of breath
  • Chest pain
  • Fever and chills
  • Wheezing—a hoarse whistling sound
  • Rapid breathing

Children may also have:

  • Lower activity levels
  • Irritability
  • Lack of appetite or difficulty feeding
  • Stomach pain or vomiting
  • Headache

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor may suspect pneumonia based on the exam.

Blood and coughed fluids may be tested, but are not always needed.

Sometimes images of the lungs may be needed. Tests may include:

Treatment

Treatment of pneumonia depends on:

Treatment will be based on what may have caused the pneumonia and your child's overall health. More support may be needed if there is a severe infection. A hospital stay may be needed if it becomes difficult to breathe.

Treatment options may include:

Medications

The doctor may recommend:

  • Antibiotics—for an infection caused by a bacteria
  • Antiviral medications—for an infection caused by viruses
  • Over-the-counter medications to reduce fever and discomfort

Oxygen may need to be given for severe infections. This will help to increase the level of oxygen that passes to the blood.

Hospitalization

A hospital stay may be needed if:

  • Child is not getting enough oxygen into their blood
  • Child is dehydrated because they are not able to eat or drink enough

Treatments in the hospital may include:

  • Oxygen therapy to increase levels of oxygen in the blood
  • Nutrition and fluids through IV
  • Medication delivered through IV

A hospital stay may also be needed for children with weaker immune systems.

Prevention

Vaccines may help to prevent certain pneumonia:

  • Flu vaccine—in all children aged 6 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
  • Pertussis (whooping cough) vaccine, routinely given to children 11 years or older as part of the Tdap vaccine

Some children may have a higher risk of pneumonia. Medication may be given to these children after a cold or the flu to help prevent pneumonia.

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.
  • Treat any chronic disease.

RESOURCES

Family Doctor—American Academy of Family Physicians  http://familydoctor.org 

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

CANADIAN RESOURCES

Caring for Kids—Canadian Paediatric Society  http://www.caringforkids.cps.ca 

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

References

Community-acquired pneumonia in children. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T113670/Community-acquired-pneumonia-in-children  . Updated August 15, 2017. Accessed August 23, 2017.

Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html. Updated February 7, 2017. Accessed August 23, 2017.

Pneumonia. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/infections/lung/pneumonia.html. Updated May 2011. Accessed August 23, 2017.

Pneumonia. WHO website. Available at: http://www.who.int/mediacentre/factsheets/fs331/en/. Updated September 2016. Accessed August 23, 2017.

Pneumonia in Children. Bostons Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/pneumonia. Accessed August 23, 2017.

Pneumonia in Children. Children's Hospital of Philadelphia website. Available at: http://www.chop.edu/conditions-diseases/pneumonia-children. Accessed August 23, 2017.

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