Autor NN Team Data: 20.08.2009

Pneumonia is an inflammatory condition of the lungs, caused by bacteria, viruses, fungi or parasites. This might affect the healthy child's too, but the risks are higher at children with a weakened immunity or with chronic diseases.  

Many pneumonia are actually complications of less serious diseases, for example cold or flu. The severity of pneumonia may differ a lot. Generally it is easily treated with antibiotics (the bacterial pneumonia) but doctors deal more and more with pneumonia which are resistant to antibiotics. 

How does it occur? 
The child's and the adult's organism is permanently attacked by germs, including the one which can cause pneumonia. But the respiratory system has an efficient defense mechanism which eliminates the germ through cough or specific flora. In some conditions, when the immunity is weak or deals with another disease also, the organism cannot fight the germs. They reach the lungs and start the antibodies "fight". The white cells in the blood start attacking them, and this inflammated the air bags in the lungs which get filled with liquid, making the breathing more difficult. 

How is it transmitted? 
The transmission way mostly depends on the type of germs. Some are transmitted through air, others through direct contact with respiratory mucosa (from dirty hands). The child can take it from communities, meaning school or kindergarten. Usually, the Streptococcus pneumonia is the guilty bacteria. 
Sometimes, the germ is the Mycoplasma pneumonia, a microorganism which causes a milder form of pneumonia. It is more severe when the pneumonia occur after hospitalization or surgery. The nosocomial infections (taken from the hospital) are more difficult to be treating because the germs are resistant to antibiotics. 
Special cases are children with a weak immunity. This may be caused by medication (after a transplant), by chronic diseases (asthma) or illnesses such as HIV/AIDS. The germs (facultative pathogens) are dangerous too for these children, while they would cause a simple rhynopharyngitis at a healthy child. 
A special type is the aspiration pneumonia, which occurs after the inhalation of a foreign substance. This might be food, or drinks, when the child chokes, and stomach substances most often. Fortunately, such events are rare and happen only when the child loses the conscience or suffers seizures. 

Which are the pneumonia types? 
There are more possible classifications: depending on the causes (the ones above), on the pathogen or on the distribution. Depending on the pathogen which causes the infection pneumonia may be viral, bacterial, with Streptococcus and with Mycoplasma. It's important to determine the type of pneumonia, in order to establish the right treatment. 

Depending on the area pneumonia may be lobar (an entire lobe of the lung is affected) multilobar (or bronchopneumonia, the lobules are affected, the infection occurs as small spots) or interstitial (the areas in between the alveoli are infected). 

What are the symptoms? 
At children without chronic diseases, the pneumonia is often a cold complication. It's hard to determine the moment when the pneumonia turned into a cold, and that's why many pneumonia are diagnosed late. More than that, the pneumonia symptoms differ very much in severity from a child to another, depending on the type of disease and on the general health. 

Generally, pneumonia manifests through:
  • fever and shaking chills cough 
  • difficult breathing 
  • sweat 
  • chest pain, which depend on the breathing 
  • headaches 
  • muscles pains 
  • fatigue, apathy 
It's not necessary for these symptoms to occur at the same time. A few of them are enough to take the child to the doctor, especially if he is little or suffers from a chronic disease. 

How is the diagnosis established? 

In order to confirm or not, the parents guesses, the doctor will use the stethoscope to listen to the child's lungs. If there are more specific sounds, the diagnosis must be confirmed through chest X-ray which will determine de distribution and spreading of infection. In order to identify the pathogen and to establish a treatment, the doctor will take a sputum sample from the child's throat. 

How do you treat it? 

The treatment depends on the pathogen, as we mentioned before. The bacterial pneumonia is treated with antibiotics. In a few days, your child wil feel better. However, the treatment must be followed for as long as the doctor mentioned. Otherwise, the disease may come back and create bacteria strains which are resistant to the antibiotics. 

Viral pneumonia might be treated with antivirals, but usually the diseases disappear just like that and the only recommended treatment is the rest and a healthy diet, with a large quantity of liquids. 

Pneumonia with mycoplasma is treated with antibiotics. But the recovery might take longer and the child will feel tired even for a long time after the disappearance of infection. As the symptoms are mild, this type of pneumonia passes unnoticed, being confused with a cold. 

Besides these, a symptomatic treatment might be used because it reduces the symptoms severity. The pain and fever can be reduced with ibuprofen and paracetamol. The aspirin is prohibited, especially if the pneumonia is viral, because there is a risk of Reye syndrome occurrence. If the little one cannot sleep because of cough, ask for a treatment, keeping in mind that the cough shouldn't be completely stopped, as it helps the lungs to clear. 

If the disease is considered serious or if it's about a little child, the hospitalization might be necessary for at least three-four days. The children will receive intravenous treatment and he will be helped to breathe if necessary. Although the hospitalization is not necessary, you must see the doctor at the end of the treatment and ask for a new chest X- ray to make sure that the infection is gone completely. Don't omit this control although the child feels good and seems completely recovered. 

Meanwhile, make sure that the child takes enough rest (although he has no pain) and that he drinks much water, which will help the dilution of the lungs sputum. Feed him healthy to maintain his body strong, and don't forget about the treatment the doctor prescribed, although the symptoms disappear with time. 

Of course it's easier to prevent than to treat. Therefore, teach your child to wash his hands well before eating and not to put the dirty hand into the mouth or nose. If it's not always possible for him to wash his hands, put a bottle of hand cleanser in his school bag, this is based on alcohol (you find it at the supermarket), and teach him to use it whenever needed. The child should avoid the sick people (coughing, sneezing) as much as possible. 

When you deal with a child's cold or flu, make sure he receives the proper care: much rest, healthy diet, and a mucoregulator medicine (Bromhexim, Mucosolvan), to help eliminate the mucus which contains bacteria and viruses. T 

Some types of pneumonia may be prevented through vaccines. The simple flu vaccine may reduce the risk of pneumonia, as this disease is often a complication of a flu. Regarding the pneumococcal vaccination, ask for the pediatrician advice. 

Read the English version of this article: Pneumonia