Pneumonia in Children
This serious inflammation of lung tissue is caused by either a bacterial or a viral infection. Newborns sometimes acquire pneumonia from bacteria in the maternal genital tract. More frequently, however, viruses are to blame for pneumonia in infants and children between the ages of two months and five years. One such organism, known as respiratory syncytial virus (RSV), is particularly common in winter and early-spring epidemics. Influenza viruses are also an important cause of pneumonia in children, especially older ones. These infections generally occur during outbreaks of flu during the winter.
Signs and Symptoms of Pneumonia
The signs and symptoms of pneumonia can vary a great deal, depending on its cause, the child’s age, and the immune system’s ability to fend off the infection. While it is not always possible to distinguish between viral and bacterial pneumonia, each possesses certain fairly typical characteristics.
Viral pneumonia in infants or young children often develops gradually following low-grade fever, runny nose and a diminished appetite for one or two days. These symptoms may then give way to increasing fretfulness, vomiting, cough and rapid breathing. The child also may develop a wheeze.
Infants between the ages of four weeks and three months may develop a syndrome of pneumonia without fever and a sharp “staccato” cough. This type of viral pneumonia also has a gradual onset but shows no preference for any given season.
Bacterial pneumonia typically begins more suddenly than the viral variety. The cough may bring up sputum, and there may be chest pain and high fever. In some cases, however, the only symptoms are fever and rapid breathing.
The doctor can determine whether pneumonia is a likely diagnosis by considering the child’s age, the season and the severity of symptoms. The physician recognizes pneumonia from symptoms and from the physical exam during which the pediatrician listens to the chest sounds with a stethoscope (auscultation) and by chest X rays. Tests of blood or sputum also may be ordered, in order to identify the causative organism underlying pneumonia.
Treatment of Pneumonia
Bacterial pneumonia is treated with antibiotics such as erythromycin and amoxicillin. In most cases, treatment of viral pneumonia consists mainly of supportive therapy, which is aimed at easing the discomfort brought on by the illness rather than attacking its cause.
Even though antibiotics are not effective against pneumonia caused by viruses, your child may be given an antibiotic while there is still uncertainty about what is causing the pneumonia. Such therapy does no harm to children with viral pneumonia. A child with chronic lung disease or congenital heart disease may be given specific antiviral agents for pneumonia caused by respiratory syncitial virus or influenza A.
Most older children with pneumonia can be treated successfully at home. A newborn with pneumonia generally needs to be hospitalized for observation and care if there are difficulties in breathing or eating, or if dehydration occurs. Once pneumonia has been resolved, a return visit to the doctor’s office for a repeat physical examination and chest X ray is usually necessary to make certain that the chest is clear.