What is pneumonia?

Pneumonia (an infection in the lungs) is a major cause of illness in the United States. Each year in the United States, more than 1 million Americans visit the emergency room with pneumonia and about 50,000 die from the disease. Pneumonia occurs when viruses or bacteria infect one or both lungs. It often follows a bout of cold or flu. Pneumonia occurs in people of all ages and has a wide range of symptoms. Individuals with a compromised or immature immune system, such as young children under the age of 5, are at greatest risk for pneumonia and are more likely to develop severe symptoms. There are two main types of pneumonia—bacterial and viral. Bacterial pneumonia (the most serious type) can be treated with antibiotics but often requires hospitalization. Viral pneumonia (the less severe type) does not respond to antibiotics and must simply run its course.

How do children get pneumonia?

Respiratory viruses, such as respiratory syncytial virus (RSV), the flu virus, and the adenovirus are the most common causes of pneumonia in young children. Respiratory viruses (which spread easily from person-to-person) can lead to viral pneumonia, which, in turn, weakens the immune system and increases the risk for bacterial pneumonia.

Children (and adults) can get bacterial pneumonia without first having viral pneumonia. According to the Centers for Disease Control and Prevention (CDC), the most common cause of bacterial pneumonia in the U.S. is streptococcus pneumoniae (pneumococcus). Pneumococcal bacteria, like other bacteria, spread from person-to-person through close contact, typically through respiratory droplets from an infected person’s nose or mouth that are dispersed when they cough or sneeze. People, especially children, can carry the bacteria in their throats without feeling sick which means they may be contagious without knowing it.

What are the symptoms of pneumonia?

  • Sometimes a chest X-ray is necessary to determine whether the lungs are infected. However, in most cases, your child’s health care provider will rely upon your child’s symptoms in making a diagnosis. Pneumonia symptoms include:
  • Fever (chills, sweating) 
  • Loss of appetite 
  • Low energy 
  • Cough 
  • Difficulty breathing 
  • Flaring (widening) of the nostrils 
  • Chest pain, particularly when coughing or breathing deeply 
  • Wheezing 
  • Bluish tint to the lips or fingertips 
  • Persistent crying (in babies and toddlers) 
  • Pale skin and/or limp body movements (in babies and toddlers)

Viral pneumonia is the usual suspect when a child has chest congestion, a cough, runny nose, and low-grade fever. While high fever (104°F), fatigue, vomiting, and rapid breathing point toward bacterial pneumonia.

How is pneumonia treated?

Bacterial pneumonia is treated with antibiotics. Children with viral pneumonia, however, must rely on home remedies (rest and fluids) to stay comfortable while the body musters its defenses. Your child’s health care provider may suggest giving your child (6 months and older) acetaminophen or ibuprofen to relieve fever and discomfort. While many of the symptoms of pneumonia will subside within a few days, the cough associated with pneumonia may last for weeks. Children with viral pneumonia are often contagious for several days before they actually feel sick, which makes it nearly impossible to stop the spread of the virus. However, once your child is fever-free or has been taking antibiotics for 24 hours, she is no longer contagious and can safely return to school or child care.

Children should not take cough suppressants containing codeine or dextromethorphan because coughing helps clear the mucus resulting from the pneumonia. Also, unless otherwise recommended by the child’s health care provider, parents should never give cough and cold medicines to children under 4 years of age. 

How can pneumonia be prevented?

Though you’ve likely heard well-meaning parents tell children to ”button up” during winter months to avoid “catching pneumonia,” rest assured that your child’s chances of catching pneumonia have nothing to do with his attire. Here are some steps parents can take to reduce their child’s risk for pneumonia:

  • Make sure your child’s vaccinations are up to date. The pneumococcal conjugate vaccine protects children from infections caused by streptococcus pneumoniae, which is the most common cause of bacterial pneumonia. In addition, the Haemophilus influenza type b (Hib), Pertussis (whooping cough), Varicella (chickenpox), Measles, and seasonal influenza (flu) vaccines protect children from various infections that could lead to pneumonia. 
  • Don’t smoke. Children who are exposed to smoke are more susceptible to upper respiratory infections that can lead to pneumonia. 
  • Wash hands frequently, and teach your children the importance of handwashing, and the correct way to do it.

When should I call the doctor?

Because pneumonia can be serious, call your child’s health care provider right away if you think your child might be ill with this disease. The AAP also cautions parents to call their child’s health care provider again if after the initial exam their child develops any of the following symptoms: 

  • A persistent fever (despite taking antibiotics)
  • Difficulty breathing
  • Red, swollen joints
  • Bone pain
  • Neck stiffness
  • Vomiting 

All of these symptoms are signs that the illness is worsening. Seek immediate medical attention if your child has extreme difficulty breathing and/or if his face and lips have a blue tint signifying a lack of oxygen.

Last updated March 22, 2020

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