Pneumonia is an acute infection of the lungs. According to the World Health Organization, it is the leading cause of death in children worldwide, causing more fatalities than measles, AIDS and malaria combined. The symptoms of pneumonia in children include fever, cough, and respiratory distress with increased need for oxygen and rapid breathing.
Bacterial Pneumonia
The two most common bacteria that cause pneumonia in children are Streptococcus pneumoniae and Haemophilus influenzae type b (Hib). Another microbe, Mycoplasma pneumoniae, usually causes milder symptoms, a condition commonly referred to as “walking pneumonia.” According to the Children’s Hospital of Boston, children with bacterial pneumonia usually have a quick onset of symptoms, with cough that produces phlegm, pain in the chest from repeated episodes of coughing and form the inflammation of the lungs, vomiting, decreased appetite and fatigue. Physical exam findings of bacterial pneumonia include decreased breath sounds over the affected segment of the lung, rapid breathing with retractions--or pulling in of chest muscles--and crackles--or a rattling, popping sound heard in the part of the lungs affected by the pneumonia. X-rays can also help with the diagnosis of bacterial pneumonia. In children with bacterial pneumonia, the X-ray reveals a consolidation or opacification of the segment of the lung affected by the bacteria. The treatment for bacterial pneumonia involves intravenous or oral antibiotics, oxygen and intravenous fluids, if needed.
Viral Pneumonia
Viral pneumonia presents in similar ways to bacterial pneumonia, except that the symptoms are not as severe. The most common viruses that cause pneumonia in children are respiratory syncytial virus, or RSV--especially in children under 2; parainfluenza virus; influenza virus; and adenovirus. Children with viral pneumonia may have other symptoms, like a rash, redness of the whites of the eyes, muscle aches and copious runny nose that may help distinguish them from children that have bacterial pneumonia. X-rays usually reveal generalized inflammation of the lungs. The treatment of viral pneumonia is supportive, with fluids, fever control with acetaminophen or ibuprofen, and monitoring the respiratory status of the child. Younger children and infants may need hospitalization with supplemental oxygen and intravenous fluids until the symptoms improve.
Aspiration Pneumonia
Aspiration pneumonia is a frequent cause hospitalization, especially in children who are neurologically impaired; for example, children with severe cerebral palsy. Aspiration pneumonia occurs when secretions from the mouth, the upper airway or the stomach go into the lungs. Neurologically impaired children often lack the protective mechanisms that prevent this from happening in otherwise normal children. As a result of the aspiration, bacteria from the mouth and the upper airway can colonize the lungs and cause infection there. Children with aspiration pneumonia can have severe respiratory distress and need for supplemental oxygen. The treatment for aspiration pneumonia involves oxygen, intravenous fluids for dehydration, protective measures to prevent further aspiration--like feeding tubes that bypass the mouth swallowing processes--and intravenous antibiotics.
