Signs of pneumonia in children to watch out for
Young children are more susceptible to pneumonia, which commonly affects children in Singapore. Look out for these signs of pneumonia in children and find out how help your child feel better.
Persistent coughing, fever and breathing difficulties in children are symptoms that raise alarm bells for parents, and these may actually point to signs of pneumonia in children.
Young children are more susceptible to contracting pneumonia and this can be a potentially life-threatening illness if left untreated.
Hence, it is crucial for parents to be aware of the simple ways it can be prevented and to look out for signs of pneumonia in children to avoid any complications it can bring.
Pneumonia is an infection in the lungs, specifically in one or both air sacs. The sacs may become filled with pus which causes the following signs of pneumonia in children: fever, labored breathing and chills.
- Difficulty breathing
- Low fever of 38.5 C or lower
- General feeling of discomfort
- Flu- or cold-like symptoms such as sore throat, chills, headache
- Coughing that is dry and frequent
- Rapid breathing with wheezing sounds
- Stomach pain
- Chest pain
- Shaking and chills
- Mucus tinged with blood or has a green or rust color
- Poor feeding (in infants) and decreased appetite (in older kids)
Signs of pneumonia in children vary depending on what part of the lungs are infected. A middle or top infection may cause labored breathing; an infection on the lower part may cause vomiting, nausea or an upset stomach.
Any of the following can cause pneumonia: bacteria, a fungus, viruses or parasites.
For bacteria, the organisms that are responsible for pneumonia are: streptococcus and mycoplasma (mild form of pneumonia referred to as “walking pneumonia”).
As for viruses, influenza and respiratory syncytial virus (RSV) are the culprits.
For those with compromised immune systems, pneumonia can be caused by organisms such as pneumocystis jiroveci. This is responsible for frequent pneumonia bouts in those who have HIV. Hence, a doctor may recommend an HIV test.
A child may develop pneumonia by:
- Breathing pneumonia-infected air or certain bacteria*
- Having a viral upper respiratory infection such as the cold or flu*
- Experiencing complications with other diseases such as chicken pox or measles
- Breathing gastric juices from the stomach and large amounts of food into the lungs; or vomiting into the lungs. This usually occurs in a seizure or stroke
*Note: The nose, even one of a healthy person’s, usually houses pneumonia-causing viruses or bacteria. When these spread to the lungs, pneumonia can develop. This occurs more during or after episodes of a cold or chronic diseases like chronic obstructive pulmonary disease.
Pneumonia can either be community-associated pneumonia (spread at school or work, for example) or healthcare-associated pneumonia (spread through hospitals). Treatment options for both vary; for this article, we focus on treatments for community-associated pneumonia since kids will most likely get the disease from school instead of a healthcare facility.
- Weakened immune system. Those with HIV or AIDS who are receiving chemotherapy, long-term steroids and those who have recently undergone an organ transplant
- Chronic illnesses such heart disease, asthma, chronic obstructive pulmonary disease
- Age. Pneumonia can be more severe for infants, young children and those 65 year and above. These groups are the ones with compromised immune systems or existing health issues
- Hospitalisation. Those who are in the intensive care unit, especially if on a ventilator
- Difficulty breathing. Severe cases of pneumonia may lead to insufficient intake of oxygen. In which case, hospitalisation is required where the child may be given a ventilator to assist with breathing
- Lung abscess is when pus is present in the lung cavity. This is removed either through antibiotics; or draining or surgery using a long tube or needle
- Having bacteremia, which is when bacteria is present in the bloodstream. Bacteria in the blood can spread to the lungs, and in some cases causes organ failure
- Pleural effusion is when fluid accumulates around the lungs. This must be drained immediately to avoid further infection
One of the signs of pneumonia in children to monitor is fever. Log the child’s temperature every morning and evening. If the fever goes above 38.9 C (for infants six months and older, and children) or 38 C (young infants) then call a doctor.
Pneumonia can be diagnosed through a physical examination performed by a doctor, who will listen to a child’s breathing and a crackling sound (one of the definite signs of pneumonia in children).
Other tests to confirm pneumonia are chest X-ray; blood tests; sputum test (when a sample of lung fluid, or sputum, is analyzed); and pulse oximetry (to measure the oxygen level in the blood).
Additional tests that are usually done on older patients or those who have serious health conditions are: chest CT scan and pleural fluid culture (this helps determine the type of infection).
Medication administered to treat pneumonia depends on the bacteria or virus that causes the infection.
If the pneumonia is caused by bacteria, antibiotics are usually given to tackle the condition.
If the pneumonia is caused by a virus, antibiotics will not be provided since it would be ineffective. Viral pneumonias may be treated using anti-viral medication. In addition to antibiotics and anti-viral medication, supportive medication is usually offered to provide relief for cough, fever, chest pains and body aches, depending on the patient’s symptoms.
Antibiotics must be taken on schedule, as prescribed by the doctor, to help kill the bacteria which is causing your child to be unwell. The treatment lasts from seven to 10 days. Note that the course of antibiotics should be completed as advised by the doctor. Incomplete intake of antibiotics affects how long it takes for the child to recover, thus prolonging the child’s discomfort and affecting his daily activities.
Other medicines prescribed to help ease the symptoms and signs of pneumonia in children are:
- Cough medicine to help loosen lung fluids, and relief throat inflammation, phlegm or pain
- Anti-pyretics or fever-reducing medicines such as ibuprofen and acetaminophen. Avoid giving aspirin to kids since it may cause Reye’s syndrome
In the event of mild viral pneumonia, bed rest, balanced diets and plenty of fluids may help improve the condition. Avoid exercise or activities (both indoor and outdoor) including sports or social play to minimise contact with other children too.
With regards to severe cases of pneumonia, hospitalisation may be required upon the doctor’s advice. The patient may require intravenous antibiotics and be put on oxygen to cope with breathing difficulties or discomfort that the child may experience.
Up to $400 per year per Medisave account can be used for Pneumococcal vaccinations for persons with higher risk of developing influenza-related complications and severe pneumococcal disease respectively. Do find out from your doctor or specialist about the procedures on this.
In mild cases when the signs of pneumonia in children are not that severe, some kids may feel well enough to go to school. However, it is highly recommended for an unwell child to stay home and rest, to facilitate the body to recover from this bout of illness.
Here are things that can be done at home:
- Offer your child plenty of fluids, including soup dishes such as bee hoon soup, mee sua soup or porridge, to hydrate the child and help purge the body of toxins.
- Use a warm compress on the chest area if your child experiences chest pains or discomfort.
- Ensure that the child sticks to the prescribed medication to ensure that the bacteria is completely eradicated.
- If your child is running a temperature, offer him a cool fever patch to help bring down the temperatures, and wiping him down with room temperature water (not iced cold water) to help provide some comfort and relief.
- Your child may be lethargic and disinterested in eating, so do be patient and offer him comfort by being there. Offer fruit or juices to help with getting your child hydrated too.
Once on antibiotics a child with pneumonia has a smaller chance of passing on the bacteria to anyone else at home. Nevertheless, be sure that everyone at home:
- Washes hands frequently and correctly (following the 20 second rule)
- Must avoid using the same cups, plates or utensils with the sick child
- Must have up to date immunizations to prevent other infections
- Boost a child’s immune system by allowing him to get enough sleep, adequate exercise and have a health diet
- Sneeze or cough into a tissue and wash your hands thereafter
- Wear a surgical mask when you are down with the common cold or cough
Pneumonia should not be taken lightly, and parents should ensure that they look out for signs of pneumonia in children especially when they have been unwell for a persistent period.
Parents, do you look out for signs of pneumonia in children when they experience severe and persistent cough, fever or breathing difficulties?