Pneumonia is the one of the most common childhood respiratory tract infections, affecting children of all ages, although the highest incidence of pneumonia is in children between 2 and 4 years of age. It is a common cause of hospitalization in children, accounting for about 20% of all pediatric hospital admissions. Early recognition of the symptoms of childhood pneumonia can prevent hospitalization.
Generalized Symptoms
Patients with pneumonia often have fever. Upper respiratory symptoms of a cold, like runny nose, usually precede the symptoms of pneumonia. Children with pneumonia can be tired, short of breath and lack energy. Patients with bacterial pneumonia usually become sick rather quickly, while children with viral and atypical pneumonia can have slowly progressive symptoms for days or weeks. Decreased oral intake can lead to dehydration and electrolyte disturbances. Dehydration can also affect the kidneys, causing acute renal failure.
Respiratory Symptoms
The main symptoms of pneumonia are respiratory symptoms. The inflammation in the lungs and the increased production of mucous and other byproducts of the immune system's response to the infection lead to increased cough. A productive, phlegm-containing cough usually accompanies bacterial pneumonia, while viral pneumonia tends to produce dry, raspy cough. As the pneumonia progresses and the inflammation in the lungs worsen, the child develops rapid breathing, taking shallow breaths to drag oxygen-rich air into the lungs. This can produce retractions, the pulling-in of the chest wall in an attempt to improve breathing.
Children with pneumonia have two distinctive respiratory sounds. The first is called wheezing, a high-pitched noise heard on inspiration, produced by the air flowing through narrowed, inflamed airways. The second is called crackles, which, as the name implies, sound like paper getting crumpled together. Crackles are the result of fluid in the small airways, resulting in their collapse.
Worsening Pneumonia
If the pneumonia worsens, children can have altered mental status, as the progressive decrease in oxygen tends to make them listless, tired and fatigued. If the lack of oxygen continues, children can have cyanosis, or blue tinge around lips and extremities, as a symptom of decreased presence of oxygen in the blood. Respiratory distress, with rapid breathing and retractions can lead to decreased breathing effort as the child becomes tired of working so hard to breath. This can lead to apnea, or lack of breathing effort.
