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Pneumonia in children
Pneumonia in children can occur after a few days of a more common cold; the child gets worse instead of better after a few days of illness, and gets a high fever, cough and rapid breathing. Pneumonia can be caused by both viruses and bacteria.
What is pneumonia in children
A lung infection (pneumonia) is a lower respiratory infection that is most often caused by viruses or bacteria, but can also be caused by fungi and protozoa. Most pneumonia in young children that occurs outside hospital is the result of a viral infection. For example, a common cold that spreads to the lungs. With increasing age, an increasing proportion of pneumonia in children is caused by bacterial infections.
What causes children to get pneumonia?
It is common to divide pneumonia into pneumonia acquired outside hospital (community acquired, SEP) and pneumonia acquired in hospital (nosocomial pneumonia). Viral infections are more common than bacterial, and are usually also less serious than bacterial. A pneumonia caused by a viral infection will cause moderate illness, while bacterial pneumonia most often causes a rapidly-onset illness with high fever and rapid breathing. Pneumonia caused by fungi is less common in the general population.
Most cases of pneumonia in children come as a result of a common cold, which develops into an infection in the lower respiratory tract. Among the very youngest children, bacteria are the most frequent cause of pneumonia. From the age of three months and up to preschool age, viruses are the most frequent cause.
Whooping cough can lead to bacterial pneumonia if the child is not sufficiently vaccinated against Bordetella pertussis, the bacterium that causes whooping cough. In the past, the bacterium Streptococcus pneumonia was also a common cause of pneumonia. After vaccinating against this bacterium began, the incidence has become much lower. In older children and adults, bacterial pneumonia can be caused by mycoplasma or chlamydia bacteria.
Viral pneumonia occurs more often in autumn and winter, while bacterial pneumonia is equally common all year round.
What symptoms are common in children?
Since most pneumonia starts with a more innocent cold, the child will first have a normal course of a cold. In those cases where it develops further into pneumonia, the child will then become sicker, and not healthier, after a few days of a cold.
Typical symptoms of pneumonia are:
High fever
Cough (both dry cough and mucus cough can occur)
Heavy breathing (dyspnea)
Rapid breathing (tachypnea)
Pain in the chest when inhaling and coughing
Impaired general condition and lassitude
Nasal wing play (the child expands the nostrils in time with breathing, a sign of breathing difficulties)
Irritability
Crackling sounds in the chest may occur
Abdominal pain, vomiting, diarrhea and refusal to eat can also occur
It can be difficult to detect pneumonia in children, especially in young children. Sometimes the only obvious symptom is that the child is breathing rapidly. The WHO has defined values for breathing rate, and counting the number of times the child breathes per minute can be used as a test to see if there may be disease in the lungs.
According to the WHO, the following breathing rates are indicative, if the child breathes faster than these values, the child must be examined by a doctor. ">" means "more than".
· > 55 breaths/min in children under two months is abnormal
· > 50 breaths/min in children 2-12 months old is abnormal
· > 40 breaths/min in children one to five years old is abnormal
· > 30 breaths/min in children older than five years is abnormal
Although it is rare that children with pneumonia do not have breathing difficulties and a fever, pneumonia with more unusual symptoms can also occur. Symptoms such as pallor, passivity and abdominal pain can also be caused by pneumonia. Pneumonia must therefore always be ruled out as a cause of serious illness in children.
How should children with pneumonia be treated?
Pneumonia caused by viral infections should not be treated with antibiotics, as antibiotics only have an effect on bacteria. Nevertheless, antibiotics may be necessary in some cases, as a secondary bacterial infection may occur, which should be treated with antibiotics. It can often be difficult to distinguish viral pneumonia from bacterial, so it may be appropriate to take culture samples of saliva and mucus.
Bacterial infections must always be treated with antibiotics. Penicillin is the first choice in these cases, in case of lack of effect or samples that indicate particular types of bacteria, it may be appropriate to try other types of antibiotics. The very youngest children will most often be treated in hospital and given intravenous antibiotics. Older children can usually stay at home and be treated with potions or tablets that can be picked up from the pharmacy. A typical course of antibiotics for pneumonia will last 7-10 days. Ask the pharmacist if you need advice on how to give the medicine to the child.
When the child has pneumonia, he will often have a high fever. It is then important not to overheat the child with duvets and blankets, but rather to make sure that the child is able to get rid of the heat from the fever. It may be a good idea to lower the room temperature. Be aware that children with fever can have febrile convulsions, always contact a doctor if the child has febrile convulsions that last more than five minutes. Adequate fluid intake and nutrient intake are important. If the child is struggling to get nutrition, it may be a good idea to get help finding nutritional drinks at the pharmacy. Fever-reducing and pain-relieving medicines such as paracetamol should be used at a body temperature >39 °C, and can also be bought at the pharmacy.
