How Do I Know if My Child has Pneumonia?

Reviewed on 1/8/2021

What is pneumonia in children?

The symptoms of pneumonia in kids may include cough with mucus, fever and chills, loss of appetite, tiredness, rapid breathing, shortness of breath, headache, and blue around lips or fingernails.
The symptoms of pneumonia in kids may include cough with mucus, fever and chills, loss of appetite, tiredness, rapid breathing, shortness of breath, headache, and blue around lips or fingernails.

Pneumonia is a type of infection that affects the lungs. It can affect one or both lungs. It causes the air sacs in the lungs, called alveoli, to fill with pus or other liquid. Pneumonia is caused by bacteria, viruses, fungi, or, more rarely, parasites.

While anyone can develop pneumonia, among children it is most common in those under age five. Pneumonia can be mild and not much worse than a bad cold. In other cases, it can be life-threatening.

Children under two are most at risk of developing severe pneumonia. It can also be very serious for children with underlying chronic health problems or a weakened immune system. Children under one are also at risk for developing pneumonia if they are around second-hand smoke.

Signs and symptoms of pneumonia

The symptoms of pneumonia in kids may include any combination of the following:

  • Cough that produces mucus
  • Fever and chills
  • Loss of appetite
  • Tiredness
  • Rapid breathing
  • Shortness of breath that is worse with activity
  • Headache
  • Fussiness
  • Blue tint around lips or fingernails

While the symptoms of viral and bacterial pneumonia are similar, breathing problems may develop more slowly with viral pneumonia. Children with viral pneumonia may also be at a greater risk of developing bacterial pneumonia as well.

Types of pneumonia

One way doctors classify pneumonia is based on where or how it was transmitted. Knowing this can help your child's doctor decide on a course of treatment.

Community-acquired pneumonia

This type of pneumonia occurs in a community setting, which is defined as somewhere other than a hospital, rehabilitation center, nursing home, or other types of healthcare facilities. If your child caught pneumonia at school, daycare, or an extracurricular activity, it was probably this type.

Hospital-acquired pneumonia

This type of pneumonia spreads in a hospital or another type of healthcare facility. Hospital-acquired pneumonia develops in people at least 48 hours after being admitted. It does not include people who develop pneumonia while they are on a ventilator since that is a separate type of pneumonia.

Ventilator-associated pneumonia

This occurs when people who are on a ventilator develop pneumonia. It occurs at least 48 hours after intubation, which is when the ventilator tube is placed in the airway so that a ventilator can assist with breathing.

Aspiration pneumonia

Aspiration pneumonia happens when food, liquid, or vomit is inhaled into the lungs. When this happens, a healthy respiratory system can usually clear it up on its own, but in some cases, an infection develops. Toddlers and young children are at a higher risk for this type of pneumonia.

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What is pneumonia? See Answer

Causes of pneumonia

Regardless of where it's acquired, pneumonia has three primary causes and a fourth, much rarer, cause:

Bacterial pneumonia

  • Most commonly caused by Streptococcus pneumoniae
  • Can also be caused by Mycoplasma pneumoniae, a bacterium that causes a milder form of pneumonia
  • Can also be caused by Chlamydophila pneumoniae, which also causes milder pneumonia
  • More rarely caused by Legionella pneumophila, also known as Legionnaires’ Disease, caused by exposure to contaminated water

Viral pneumonia

  • Not as serious as bacterial pneumonia, but can be severe in children with existing heart and lung disease
  • In children, viral pneumonia is usually caused by respiratory syncytial virus (RSV)
  • Children with viral pneumonia may be at increased risk for developing bacterial pneumonia

Fungal pneumonia

  • Most common in people with chronic health problems or weakened immune systems, such as occurs with HIV/AIDS
  • Also occurs in people who are exposed to large amounts of fungi in contaminated soil or bird droppings

Parasitic pneumonia

  • Rare cause of pneumonia, almost always occurs in people with compromised immune systems
  • Parasites get into the body by being swallowed or through the skin and travel to the lungs

When to see a doctor for pneumonia

You should call your child's pediatrician if they have any of the following symptoms:

  • Fever for more than three days
  • Trouble breathing
  • Not drinking enough
  • Swollen joints or stiff neck

Diagnosing pneumonia

Your child's doctor may be able to diagnose pneumonia by listening to their symptoms and doing a physical exam. Other tests may be done, including a chest x-ray, blood tests, which is testing the mucus your child coughs up, or pulse oximetry, which tests the oxygen level in blood.

Treatments for pneumonia

Treatment for pneumonia depends on the cause.

Bacterial pneumonia

Bacterial pneumonia is generally treated with antibiotics.

Viral pneumonia

Antibiotics are not effective against viral pneumonia, so they usually get better on their own. Sometimes doctors prescribe antivirals for viral pneumonia.

Fungal pneumonia

Fungal pneumonia is treated with an antifungal medication that is appropriate for the type of fungus causing pneumonia.

Parasitic pneumonia

Treatment for parasitic pneumonia will depend on the type of parasite involved and the underlying issues that weakened the immune system.

Symptomatic relief

Regardless of the cause or treatment of pneumonia, you can help your child get symptomatic relief with the following measures:

  • Give plenty of liquids, offer the breast or bottle more frequently to nursing children
  • Give acetaminophen or ibuprofen to control fever, but do not give ibuprofen to children under six months of age
  • Use a cool-mist humidifier.
  • Make sure your child gets lots of rest.
  • Don't give cough medicine without talking to your child's doctor. Coughing helps the body fight the infection.
  • Give honey for a cough or sore throat but don't give honey to children under the age of one.

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References
American Family Physician: "Community-Acquired Pneumonia in Adults: Diagnosis and Management."

American Lung Association: "Pneumonia."

Biomed Research International: "Parasitic Pneumonia and Lung Involvement."

Craig Hospital: "Hospital Acquired Pneumonia (HAP) Prevention."

Cedars Sinai: "Pneumonia in Children."

Centers for Disease Control and Prevention: "Causes of Pneumonia."

John Hopkins Medicine: "Pneumonia."

National Heart, Lung, and Blood Institute: "Pneumonia."

Northwestern Medicine: "What is Aspiration Pneumonia?"

Pediatrics in Review: "Pneumonia."

StatPearls: "Bacterial Pneumonia."

StatPearls: "Pediatric Pneumonia."

StatPearls: "Viral Pneumonia."

World Health Organization: "Pneumonia."

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