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Pneumonia-Child

Definition

Pneumonia is an infection of the lungs. It affects the small airways and air sacs.

Pneumonia can be described by where and how your child was infected. Types include:

  • Community-acquired—from the community, such as home, school, or daycare
  • Nosocomial—in a hospital or healthcare setting
  • Aspiration—happens when foreign matter is inhaled into the lungs, such as food, liquid, saliva, or vomit
Infection in the Air Sacs of the Lungs
IMAGE
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Causes

Viruses, bacteria, or other germs most often cause pneumonia. Cold or flu viruses are the most common cause of pneumonia in children. Rarely, pneumonia can be caused by food, liquid, or other items that are inhaled.

The infection or inhaled substance causes irritation and swelling in the deeper areas of the lungs. Pus or other fluids can also build up in the area. The swelling and fluid make it difficult for oxygen to pass from the lungs to the blood.

Risk Factors

Pneumonia is more common in children under the age of 5 years.

Factors that may increase your child’s chance of pneumonia include:

Symptoms

Pneumonia may cause respiratory symptoms, such as:

  • Cough, which may or may not produce mucus
  • Wheezing—a hoarse whistling sound
  • Rapid breathing
  • Shortness of breath, may cause nasal flaring

It may also cause nonrespiratory symptoms, such as:

  • Chest pain
  • Reduced activity levels
  • Irritability
  • Lack of appetite or difficulty feeding—may lead to dehydration
  • Fever
  • Vomiting
  • Abdominal pain
  • Bluish gray color around the nose, lips, or fingernails—severe cases

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. The exam will evaluate your child’s breathing and lung sounds. Diagnosis will often be based on these findings.

The amount of oxygen may be measured with a small clip on your child’s finger (pulse oximetry). This will show how much the pneumonia is affecting the transfer of oxygen from the lungs to the blood.

Other tests may be done to find the specific germ causing the pneumonia. Tests may include:

  • Blood tests
  • Sputum culture
  • Urine tests

Imaging tests may also be done to see what areas of the lungs are affected. Tests may include:

Treatment

Treatment of pneumonia depends on:

  • What is causing the pneumonia
  • Severity of symptoms
  • Other factors, like the overall health of your child

Treatment options may include:

Medications

Pneumonia caused by a bacterial infection can be treated with antibiotics. Antiviral medications may be used to help manage pneumonia caused by a virus.

Other medications may be used to help manage symptoms and keep your child more comfortable.

Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye syndrome. Ask your doctor which medications are safe for your child.

Hospitalization

Hospitalization may be needed for children with severe pneumonia, or who are at high risk for severe pneumonia. Treatments in the hospital may include:

  • Oxygen therapy to increase levels of oxygen in the blood
  • Nutrition and fluids through IV for children who have trouble feeding or keeping food down
  • Medication delivered through IV

Hospitalization may also be needed to monitor children with weakened immune systems or whose infection has spread to the blood.

Prevention

Certain vaccines can help prevent pneumonia. Talk to your child’s doctor about options for your child such as:

  • Flu vaccine—in all children aged 6 months and older
  • Pneumococcal vaccine:
    • PCV13 is recommended in all children, and routinely given to all children aged 2 months to 5 years
    • PCV23 in children aged 2 years and older who have a high risk of infection or a suppressed immune system
  • Hemophilus influenza type B vaccine, routinely given to all children aged 2 months to 5 years
  • Pertussis (whooping cough) vaccine, routinely given to all children aged 2 months to 5 years as part of the DTaP vaccine
  • Pertussis (whooping cough) vaccine, routinely given to children 11 years or older as part of the Tdap vaccine

Some children may have a higher risk of pneumonia. Medication may be given to these children after a viral infection to help reduce their risk of pneumonia. For example, antibiotics may be given to prevent pneumonia in children with reduced immunity or certain underlying illnesses such as cystic fibrosis.

To decrease your child’s risk of any respiratory infection:

  • Do not expose your child to tobacco smoke. Smoke weakens the lungs' resistance to infection.
  • Have your child avoid close contact with people who have a cold or the flu.
  • Encourage your child to wash their hands often, especially after coming into contact with someone who is sick.

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://familydoctor.org

  • Healthy Children—American Academy of Pediatrics

    http://www.healthychildren.org

  • Caring for Kids—Canadian Paediatric Society

    http://www.caringforkids.cps.ca

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Community-acquired pneumonia in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113670/Community-acquired-pneumonia-in-children. Updated May 17, 2016. Accessed October 3, 2016.

  • Dehydration. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/emergencies/dehydration.html. Updated July 2013. Accessed February 19, 2014.

  • Pneumonia. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/infections/lung/pneumonia.html. Updated May 2011. Accessed February 19, 2014.

  • 2/3/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113670/Community-acquired-pneumonia-in-children: Rantala A, Jaakkola JJ, et al. Respiratory infections in adults with atopic disease and IgE antibodies to common aeroallergens. PLoS One. 2013;8(7):e68582.