What is Pneumonia?
Pneumonia is an infection of the lungs (lower respiratory tract) that can be caused by viruses, bacteria, fungi, and parasites. It is usually an extension of a viral or bacterial infection of the throat or upper respiratory tract.
Often pneumonia begins after a cold, with symptoms beginning after 2 or 3 days of a cold or sore throat.
The length of time between exposure and feeling sick from pneumonia, called the incubation time, varies depending on the type of virus or bacteria causing the infection. For instance, if a child develops pneumonia from a cold caused by a Respiratory Syncytial Virus (RSV), it takes 4 to 6 days for symptoms to appear; for the flu virus, symptoms start after 18 to 72 hours.
Pneumonia caused by bacterial infections can last 1 to 2 weeks with appropriate antibiotics. In general, symptoms should improve about a week after starting antibiotics. Because there are no medications to treat viral infections, symptoms from viral pneumonia may last longer.
Signs and symptoms of pneumonia which needs urgent medical attention if your child:
- Is having trouble in breathing or is breathing abnormally fast
- Has a bluish or gray colour to the fingernails or lips
- Has a fever of 102ºF (38.9ºC), or above 100.4ºF (38ºC) in infants under 6 months of age
What causes pneumonia?
Most cases of pneumonia are caused by common viruses that cause cold, flu, and other respiratory infections such as Adenovirus, Rhinovirus, Influenza (flu), Respiratory Syncytial Virus (RSV), and Parainfluenza virus.
The viruses and bacteria that cause pneumonia are contagious and are spread by sneezing or coughing, or contact with contaminated surfaces like shared drinking glasses or utensils, or used tissues, or coming in contact with secretions of the infected person. However, a person who becomes infected by someone with pneumonia will not necessarily develop pneumonia themselves.
Who gets pneumonia?
Anyone can get pneumonia, but some kids are at higher risk than others. Children who are more likely to get pneumonia include:
- Children with chronic illnesses, such as heart or lung disorders
- Children with asthma
- Infants born prematurely
- Children with a compromised immune system, such as those who are HIV positive
What are the signs and symptoms of pneumonia?
Symptoms vary depending on the age of the child and the cause, but common ones include:
- Cough
- Fever
- Rapid breathing (in some cases, this is the only symptom)
- Breathing with grunting or wheezing sounds
- Laboured breathing that causes nasal flaring and makes the rib muscles draw in (muscles under the ribcage or between ribs suck inward with each breath)
- Chest pain
- Abdominal pain
- Vomiting
- Decreased activity
- Loss of appetite in older kids or poor feeding in infants, which may lead to dehydration
- In extreme cases, bluish or gray colour of the lips and fingernails
Someone with pneumonia in the lower part of the lungs near the abdomen might have a fever and abdominal pain or vomiting but little or no breathing problems.
What tests are used to diagnose pneumonia?
Doctors usually make a pneumonia diagnosis after examining the child and asking about the child’s symptoms. The doctor also might order a chest X-ray, blood tests, tests for viruses in nasal secretions or bacterial cultures of mucus produced by coughing in some cases.
How is pneumonia treated?
In most cases, children with bacterial pneumonia are given oral antibiotics and are able to stay home to rest and recover. The type of antibiotic used depends on the type of pneumonia. In some cases, other members of the family might be treated with medication to prevent illness.
Pneumonia due to flu virus can be treated with anti-viral medications within the first 2 or 3 days of symptoms. For other viruses that cause pneumonia, there are no medications. In these cases, supportive measures like keeping your child hydrated, controlling any fever, and treating wheezing or oxygen needed are used until the body can overcome the infection by itself.
Dr. Ambreen Pandrowala, Junior Consultant – Infectious Diseases & Dr. Nehal Shah, Associate Consultant – Paediatrics | SRCC Children’s Hospital, Mumbai