Pneumonia—Child

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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 hard to breathe.

This article will focus on community-acquired pneumonia. It is the type that is spread in community places such as home, school, or daycare.

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 like immune system problems

Risk Factors

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

Other things 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:

  • Be less active
  • Seem irritable
  • Have little or no interest in food or feeding
  • Have stomach pain or vomiting
  • Have a headache

Diagnosis

The doctor will ask about your child’s symptoms and past health. A physical exam will be done. The doctor may suspect pneumonia based on the exam. Blood and coughed fluids may be tested. These test are not always needed.

Images of the lungs may be taken with:

Treatment

Treatment will be based on what germ caused the infection and 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:

Medicine

  • 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 in 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
  • Medicine given through IV

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

Prevention

Vaccines may help to prevent certain pneumonia. Vaccine schedules for children include:

  • 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. Medicine may be given to these children after a cold or the flu to help prevent pneumonia.

To decrease your child’s risk of any airway infection:

  • Do not expose your child to tobacco smoke. Smoke weakens the lungs' resistance to infection.
  • Avoid close contact with people who have a cold or the flu.
  • Encourage your child to wash their hands often.
  • 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/ForPatients

References:

Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):e25-76.
Community-acquired pneumonia in children. EBSCO DynaMed website. Available at: https://www.dyname... . Accessed August 23, 2020.
Immunization schedules. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Accessed August 23, 2020.
Gereige RS, Laufer PM. Pneumonia. Pediatr Rev. 2013 Oct;34(10):438-56.
Haq IJ, Battersby AC, Eastham K, McKean M. Community acquired pneumonia in children. BMJ. 2017 Mar 2;356:j686.
Pneumonia. Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Accessed August 23, 2020.
Pneumonia. WHO website. Available at:
...(Click grey area to select URL)
Accessed August 23, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated: 8/7/2020

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