Cold and flu season can be a scary time for a parent. Deciding when your child needs to see their doctor can always be a tough decision. As a parent, you always wonder if this illness is just a head cold or the dreaded pneumonia.
Pneumonia is defined as an infection of the air sac of the lungs. Pneumonia can produce a variety of symptoms, mostly depending on what caused the infection and how severe it is. Often pneumonia starts as a cough with fever or chills, and more severe cases can lead to breathing issues and admission to the hospital. Some people can even have chest pain that occurs when they cough or take a deep breath.
You should contact your child’s pediatrician if the following symptoms appear:
Cough with fever for more than 3-5 days if older than 1 year
Lack of appetite
Trouble breathing or fast breathing
Diagnosing pneumonia involves a physical exam, checking oxygen levels, and looking at the patient’s medical history. Sometimes a chest x-ray and blood work is needed. Treatment is determined by how severe the pneumonia is and what is thought to be causing it. In order to confirm the exact cause of the pneumonia, a sample must be taken from deep inside of the lungs. Because that is so difficult, many physicians treat patients based on their history and how sick they appear.
Bacterial pneumonia is caused by bacteria deep in the lungs leading to inflammation and accumulation of debris in the air sacs. Many bacterial pneumonias can be prevented by the pneumococcal vaccine, given as a part of childhood immunizations. If your child is receiving vaccines according to the American Academy of Pediatrics guidelines, they would be protected from these bacteria by 12 months of age. Bacterial pneumonias do need to be treated with antibiotics.
Viral pneumonia is irritation of the lung from a viral illness. Influenza, respiratory syncytial virus (RSV) and now COVID-19 are all causes of viral pneumonia. There are no antibiotics that treat viral pneumonias, but there are some medications that sometimes can be given to help your body fight off the virus. Often treatment for viral pneumonia consists of just giving your child’s body time to fight off the virus. Some patients start with a viral pneumonia, then somewhat get better, and then develop a bacterial pneumonia. Therefore, if your child has a viral infection with runny nose, cough and congestion and then spikes a fever after having these symptoms for a bit, or if gets better and then becomes worse, your child should see their pediatrician. Antibiotics could be needed.
Many children only have pneumonia a few times in their life. If your child has multiple pneumonias over the course of a short time, sometimes there can be an underlying cause in their body that predisposes them to infection. There is a wide variety of reasons for this to occur including lung abnormalities when they were a newborn or an abnormal immune system that has difficulty fighting off infections, among others. Often if your child is having multiple pneumonias, they will be referred to a pulmonologist or other specialists to consider these other causes.
Swaroop Juliana Pinto, MD, is a member of the Section of Pediatric Pulmonary Medicine at Nationwide Children's and an assistant professor of Pediatrics at The Ohio State University College of Medicine. Her clinical interests include sleep disordered breathing in children and adolescents. Her research interests include pathophysiology of obstructive sleep apnea and cardiovascular morbidity of obstructive sleep apnea in children with sickle cell disease.
Bailey Young, DO
Pediatric Pulmonary Fellowship
Bailey Young, DO, is a pediatric pulmonary fellow at Nationwide Children's Hospital. Dr. Young attended medical school at Edward Via College of Osteopathic Medicine - Virginia and completed her pediatric residency at Geisinger Medical Center.
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