Pulmonology

PNEUMONIA IN CHILDREN : Causes, Symptoms and Treatment

Pneumonia is infection or inflammation in one or both lungs. It is sometimes referred to as a chest infection.

Small sacs called alveoli make up the lungs. In a healthy individual these sacs fill with air when the person breathes. When a person has pneumonia, these sacs become filled with pus and fluid and this makes breathing painful and oxygen intake is limited.

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According to the World Health Organization (WHO), pneumonia is the single largest infectious cause of death in children worldwide. It accounts for 16% of all deaths of children under the age of five years. It affects children everywhere but is most prevalent in South Asia and sub-Saharan Africa.

Most healthy children would be able to fight the infection with their immune system however, those whose immune systems are compromised are at a higher risk of developing pneumonia.

 

WHAT CAUSES PNEUMONIA? 

Pneumonia can be caused by viruses, bacteria or fungi. Common causes are as follows:

1. Bacterial pneumonia

  • Streptococcus pneumoniae – This is the most common cause of bacterial pneumonia in children.
  • Haemophilus influenza type B (Hib) – This is the second most common cause of bacterial pneumonia.
  • Streptococcus pyogenes
  • Staphylococcus aureus

Bacterial pneumonia may have a quick onset.

2. Viral pneumonia

  • Respiratory syncytial virus (RSV) – This is the most common viral cause of pneumonia and seen mostly in children under 5 years old.
  • Parainfluenza virus
  • Influenza virus
  • Adenovirus

In viral infections, the respiratory involvement happens slowly. With viral pneumonia, a child is susceptible to bacterial pneumonia.

3. Mycoplasma pneumonia

This tends to occur in epidemics. Symptoms and physical signs from this type of pneumonia are somewhat different than other types of pneumonia. It causes a mild, widespread pneumonia that affects all age groups.

4. Children with HIV

In children with HIV, Pneumocystis jiroveci is a common cause of pneumonia and is responsible for one quarter of all pneumonia related deaths in HIV-infected infants.

5. Other cuses

Other less common causes of pneumonia are due to inhalation of food, liquid or gases.

 

TRANSMISSION OF PNEUMONIA 

The transmission of pneumonia is important for treatment and prevention. Pneumonia can be spread through air-borne droplets from a cough or sneeze. It can also be spread through blood, especially during and shortly after birth.

However, more research is being done on the different pathogens causing pneumonia and the ways they are transmitted.

 

SYMPTOMS OF PNEUMONIA 

A few of the symptoms a child with pneumonia would present with are listed below:

  • Cough
  • Difficulty breathing
  • Fever
  • Poor feeding
  • Wheezing – particularly in viral pneumonia
  • Mucus production
  • Chills
  • Chest pain
  • Stomach pain
  • Vomiting
  • Convulsions

 

DIAGNOSIS OF PNEUMONIA 

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Any child who is suspected to have pneumonia should be taken to see a doctor where a number of investigations would be done. Diagnosis is based on history and a thorough physical examination. A few of the investigations are as follows:

  • Full Blood Count
  • Chest X-ray
  • Sputum culture
  • Blood culture and sensitivity
  • Pulse oximetry

 

TREATMENT OF PNEUMONIA 

Treatment is aimed at treating the infection and to prevent complications. Patients with severe cases of pneumonia would be hospitalized for management.

Generally pneumonia is treated with antibiotics for the infection. Antibiotics may be given orally or intravenously depending on the severity of the infection.

Oxygen therapy is given for severe cases.

Adequate oral hydration is required.

Analgesics like acetaminophen is given for fever and pain.

Cough medication may be prescribed.

There may also be the need for a cool mist humidifier in the child’s room.

An appropriate diet is also necessary.

 

HOW TO PREVENT PNEUMONIA 

Pneumonia can be prevented by:

  1. Immunization – Vaccines against Haemophilus influenza type B (Hib), pneumococcus, measles and whooping cough are one of the most effective ways of preventing pneumonia.
  2. Adequate nutrition improves a child’s immune system. Exclusive breastfeeding for the first 6 months of a child’s life is necessary to help improve their natural defenses.
  3. Environmental factors like encouraging good hygiene especially in crowded homes and preventing indoor air pollution are other ways of preventing pneumonia.
  4. In children with HIV infection, cotrimoxazole which is an antibiotic is given daily to decrease the risk of contracting pneumonia.

 

Categories: Pulmonology