Pneumonia is a general term referring to an infection of the lungs that can be caused by a variety of micro-organisms, including viruses, bacteria, and parasites. Often pneumonia begins after an upper respiratory tract infection (an infection of the nose and throat). When this happens, symptoms of pneumonia begin after two or three days of a cold or sore throat.

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Symptoms of pneumonia vary, depending on the age of the child and the cause of the pneumonia. Some common symptoms include: fever; chills; cough; unusually rapid breathing; breathing that makes a "grunting" or wheezing sound; laboured breathing that makes a child's rib muscles retract (muscles between ribs draw inward with each breath); vomiting; chest pain; abdominal pain; decreased activity; loss of appetite (in older children) or poor feeding (in infants); and bluish or grey colour of the lips and fingernails. Sometimes a child's only symptoms are fever and rapid breathing. And sometimes, when the pneumonia is in the lower part of the lungs near the abdomen, there may be no breathing problems at all - only fever and abdominal pain.

When pneumonia is caused by bacteria, the infected child usually becomes sick relatively fast, with the sudden onset of high fever and unusually rapid breathing. When pneumonia is caused by viruses, symptoms tend to appear more gradually and are often less severe than in bacterial pneumonia. Wheezing may be more common in viral pneumonia.

Some types of pneumonia cause symptoms that give important clues about which germ is causing the illness. For example, in older children and adolescents, pneumonia due to MYCOPLASMA ("walking pneumonia") is notorious for causing sore throat and headache in addition to the usual symptoms of pneumonia. In infants, pneumonia due to CHLAMYDIA may cause conjunctivitis (redness of the eyes) with only mild illness and no fever. In pneumonia due to Pertussis (the whooping cough bacteria) the child may have long coughing spells, turn blue from lack of air, or make a classic "whoop" sound when trying to take a breath.

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Known Causes

Pneumonia is a lung infection that can be caused by different types of germs, including bacteria, viruses, fungi, and parasites. Although different types of pneumonia tend to affect children in different age groups, pneumonia is most commonly caused by viruses. Some viruses that cause pneumonia: influenza virus (flu), respiratory syncytial virus (RSV), parainfluenza virus, and adenovirus.

The term "double pneumonia" is an old-fashioned term meant to indicate that the pneumonia involved both lungs. This term, though impressive-sounding, has little clinical significance, since pneumonia commonly affect both lungs.

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Prevention

There are vaccines to prevent infections by viruses or bacteria that cause some types of pneumonia. For example, children usually receive routine immunisations against HAEMOPHILUS INFLUENZAE and Pertussis (whooping cough) beginning at age two months - the Pertussis immunisation is the "P" part of the routine DTP injection. Children with chronic illnesses, who are at special risk for other types of pneumonia, may receive additional vaccines or protective immune medication.

Doctors may give prophylactic (disease-preventing) antibiotics to prevent pneumonia in children who have been exposed to someone with certain types of pneumonia, such as Pertussis. Children with HIV infection may also receive prophylactic antibiotics to prevent pneumonia caused by PNEUMOCYSTIS CARINII. Antiviral medication is now available, too, and can be used to prevent some types of viral pneumonia, or to make symptoms less severe.

In general, since pneumonia is usually caused by bacteria or viruses that are contagious, it is best to keep children away from anyone who already has pneumonia or an upper respiratory tract infection that can lead to pneumonia. If someone in your home has a respiratory infection or throat infection, keep his or her drinking glass and eating utensils separate from those of other family members, and wash your hands frequently, especially if you are handling used tissues or dirty handkerchiefs.

Incubation: - The incubation period for pneumonia varies, depending on the type of virus or bacteria causing the infection. Some common incubation periods are: respiratory syncytial virus, 4-6 days; influenza, 18-72 hours.

Duration: - With treatment, most types of bacterial pneumonia can be cured within 1-2 weeks. Viral pneumonia may last longer. Mycoplasmal pneumonia may take 4-6 weeks to resolve completely.

Contagiousness: - The viruses and bacteria that cause pneumonia are contagious and are usually found in fluid from the mouth or nose of an infected person. Illness can spread by coughs and sneezes, by drinking glasses and eating utensils, and in used tissues or handkerchiefs.

Home Treatment: - If your doctor has prescribed antibiotics for your child's bacterial pneumonia, give the medicine on schedule for as long as your doctor directs. This will help your child recover faster and will decrease the chance that infection will spread to others in the household.

Use a cool-mist humidifier to increase moisture in the air. Encourage your child to drink fluids, especially if there is a fever. Ask your doctor before you use a medicine to treat your child's cough, since cough suppressants stop the lungs from clearing mucus, and this may not be helpful in all types of pneumonia.

If your child has chest pain, try a heating pad or warm compress on the chest area. Take your child's temperature at least once each morning and each evening, and call your doctor if it goes above 102F (38.9C). Check your child's lips and fingernails to make sure that they are rosy and pink, not bluish or grey - a sign that your child's lungs are not getting enough oxygen.

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Conventional treatments

Doctors usually make the diagnosis of pneumonia after a physical examination of your child, and possibly a chest x-ray, blood tests, and (sometimes) bacterial cultures of mucus produced by coughing. In most cases, pneumonia can be treated with antibiotics given to your child by mouth at home. The type of antibiotic used depends on the type of pneumonia.

Infants may be hospitalised for treatment if their pneumonia is caused by Pertussis (whooping cough bacteria) or other bacterial pneumonia, or if they have lung infections that may have spread into the bloodstream. Children may be hospitalised if they have chronic illnesses that affect the immune system; if they are vomiting so much that they cannot take medicine by mouth; if they are having trouble breathing; if they have recurrent episodes of pneumonia; or if their skin colour shows that they are not getting enough oxygen.

When To Call Your Paediatrician: - Call your doctor immediately if your child has any of the signs and symptoms of pneumonia, but especially if the child is having trouble breathing or is breathing abnormally fast, if there is a bluish or grey colour to the fingernails or lips, or if there is a fever of 102F (38.9C) or above.

Call your doctor immediately if an infant has any of the signs and symptoms of pneumonia.

Source: - The Nemours Foundation