Pneumonia In Children: Symptoms, Diagnosis And Treatment

Pneumonia symptoms overlap with several other illnesses, and diagnosis is often essential.

Medically reviewed by Dr. Dur Afshar Agha, MS Dr. Dur Afshar Agha Dr. Dur Afshar AghaMS facebook_iconinsta_icon Specialty: Masters of Tropical PediatricsExperience: 26 years
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Pneumonia in children occurs when the air sacs in the lungs get inflamed due to the accumulation of pus and other liquids (1). The condition may be caused by a viral, bacterial, or fungal infection that starts in the child’s nose or throat and gradually travels to the lungs.

Children are more prone to developing pneumonia than adults because of their smaller airways and immature immune systems. However, the condition is curable with timely intervention.

Read on to know more about the different types, causes, symptoms, risks, diagnosis, and management of pneumonia in children.

Causes And Types Of Pneumonia

Pneumonia is caused by bacteria, viruses, or fungi and spreads via direct contact with a person already infected or a contaminated surface (2). The following are the main subtypes of pneumonia in children (3).

1. Bacterial pneumonia

Streptococcus pneumoniae is the most common bacterium that causes bacterial pneumonia. Other bacteria that may cause bacterial pneumonia include

  • Group B streptococcus
  • Staphylococcus aureus
  • Group A streptococcus

2. Viral pneumonia

The following viruses may cause viral pneumonia.

  • Respiratory syncytial virus (RSV)
  • Parainfluenza virus
  • Influenza virus
  • Adenovirus

3. Mycoplasma pneumonia

Also called “walking pneumonia,” this type of pneumonia presents different mild symptoms and physical signs than other forms of pneumonia. Although it affects people of all age groups, it is more commonly seen in older children.

Besides these, pneumonia can also be caused by fungi and the inhaling of food, liquid, gases, or dust.

Signs And Symptoms Of Pneumonia

The signs and symptoms may vary in each child. However, the common signs and symptoms of pneumonia in children include (2) (4).

  • Cough with mucus
  • Fever
  • Fast breathing
  • Grunting or wheezing sound while breathing
  • Flaring nostrils or retraction of muscles under the ribs while breathing
  • Chest pain
  • Abdominal pain
  • Vomiting
  • Fatigue
  • Chills
  • Headache
  • Fussiness
  • Diarrhea
  • Decreased activity
  • Loss of appetite
  • Dehydration
  • Discoloration of the lips or nails

Risk Factors And Complications Of Pneumonia In Children

The following factors can put a child at a higher risk of developing pneumonia (4).

  • Weak immune system due to HIV or cancer
  • Conditions such as asthma or cystic fibrosis
  • Chronic illnesses such as heart or lung disorders
  • Problems with the airways
  • Exposure to second-hand smoke

Pneumonia is a life-threatening condition. If left untreated, it may lead to the following complications (4) (5).

  • Severe problems with breathing
  • Bacteria entering the blood
  • Collection of pus between the lungs and the inner surface of the chest wall (empyema)
  • Pleural effusion
  • Lung abscess
  • Necrotizing pneumonia
  • Sepsis
  • Arthritis
  • Meningitis

Diagnosis Of Pneumonia

Your child’s doctor will review their medical history and do a physical examination to diagnose pneumonia. The following tests and investigations help in confirming the diagnosis of pneumonia in children (2).

  • Chest X-ray

It helps create images of the internal tissues, bones, and organs and shows inflammation in the lungs.

  • Blood tests

Blood tests monitor blood cell counts to look for signs of infection and the concentration of gases such as oxygen and carbon dioxide in the circulating blood.

  • Sputum culture

The mucus or spit coughed up into the mouth from the lungs is examined to look for signs of infection. However, it may be challenging to get a sputum sample from children.

  • Pulse oximetry

A pulse oximeter is a small sensor taped on the finger or a toe to measure oxygen concentration in the circulating blood.

  • Chest CT scan

CT scan of the chest is done to check the internal structures of the chest from all angles.

  • Bronchoscopy

It helps check the inside of the airways. However, it is rarely done in children.

  • Pleural fluid culture

This test is done on the fluid collected from the pleural space (the space between the lungs and the chest wall) to look for signs of infection.

Treatment Of Pneumonia In Children

The following interventional steps may help in faster recovery of children with pneumonia (2) (6).

  • Taking ample rest
  • Drinking plenty of fluids
  • Using cool mist humidifiers
  • Administering acetaminophen for fever and discomfort
  • Taking cough medications

For children with breathing problems and severe symptoms, the following treatments might be suggested in a hospital setting.

  • Oral or IV antibiotics for bacterial infection
  • IV fluids if the child is unable to keep the fluids down
  • Oxygen therapy
  • Suctioning the child’s nose and mouth to get rid of thick mucus
  • Nebulizers or inhalers for wheezing
  • Breathing treatment according to the pediatrician’s recommendations

Pneumonia due to flu may be treated with antiviral medications. Do not administer OTC drugs without consulting a doctor, and ensure the child takes the full prescribed antibiotic course and at the specific dosage suggested by the doctor.

Prevention Of Pneumonia In Children

Some types of pneumonia can be prevented through vaccines. According to the American Academy of Pediatrics, all infants should be given routine vaccines against Streptococcus pneumoniae and Haemophilus influenzae as they are the most common bacteria responsible for pneumonia in children (6).

Pneumonia can also occur after episodes of flu and whooping cough. Therefore, children should be given vaccinations for pertussis and receive their yearly flu shots (1).

Good hygiene practices such as covering the nose and the mouth while coughing and sneezing and frequent hand washing can help prevent pneumonia and other infections (2).

Recovery In Children With Pneumonia

For children with bacterial pneumonia, the symptoms improve within one or two days after starting appropriate treatment. Children with viral pneumonia might recover a little slower. The child’s cough might last for weeks, even after the fever subsides. If the child does well on other parameters, cough is usually not a cause for concern (7).

When Should You Call The Doctor?

Contact your child’s healthcare provider if you notice any of these symptoms.

  • Fever lasting for more than a few days
  • Problems with breathing
  • Any new symptoms such as stiffness of the neck or swelling of the joints
  • Inability to drink or retain fluids

Frequently Asked Questions

1. How long does a child stay in hospital with pneumonia?

Depending on the child’s recovery rate and the hospital rules, a child with pneumonia may need to stay in the hospital for about three to four days (10).

2. Can a child with pneumonia attend school?

A child with pneumonia may go to school once (11):

  • They have had no fever for 24 hours
  • They can eat and drink well
  • They have regained their energy to carry out daily routines

If your child has pneumonia, ensure they are not exposed to first-hand or second-hand smoke. Avoid giving cough medicines to children with pneumonia as they do not help. If you suspect your child has pneumonia, do not hesitate to talk to the healthcare provider. Timely medical intervention can help prevent serious complications in children with pneumonia.

Key Pointers

  • Pathogens, such as bacteria, viruses, and fungi, can cause pneumonia in children.
  • Fever, cough with mucus, fast breathing, vomiting, diarrhea, chills, and headaches are common signs and symptoms.
  • A weakened immune system, chronic illnesses such as lung disorders, and conditions such as asthma raise a child’s risk of pneumonia.
  • If left untreated, pneumonia can cause complications, such as severe breathing problems, bacteriemia, lung abscesses, sepsis, and meningitis.
  • Maintaining good hygiene and keeping a child’s vaccination up-to-date can help prevent pneumonia.


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Dr. Dur Afshar Agha is a consultant pediatrician with around 26 years of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association.

Read full bio of Dr. Dur Afshar Agha
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