The United Nations Children’s Fund (UNICEF) estimates that pediatric pneumonia kills 3 million children worldwide each year. These deaths occur almost exclusively in children with underlying conditions, such as chronic lung disease of prematurity, congenital heart disease, and immunosuppression. Although most fatalities occur in developing countries, pneumonia remains a significant cause of morbidity in industrialized nations.
The term ‘pneumonia’ refers to an infection in the lungs. Most cases of pneumonia follow a viral upper respiratory infection, but it can also be caused by bacterial infections. Coughing or direct contact with an infected person’s mucus can give you the virus/bacteria that may cause disease in you. This is why pneumonia is more common in winter/fall, because this is the time children spend indoors, and are in close contact with other individuals.
SIGNS AND SYMPTOMS
Cough is the most common presenting symptom in pneumonia after the first month of life.
Other signs and symptoms of pneumonia include the following:
Fever – mainly present in bacterial pneumonia. Viral infections usually present with low-grade or no fever.
sweating, chills and shaking
general sense of unwellness
loss of appetite and/or dehydration
rapid heart rate
Newborns with pneumonia will have a lower-than-normal body temperature rather than raised, along with poor feeding and irritability.
A history of TB exposure to possible sources should be obtained in every patient who presents with signs and symptoms of pneumonia (e.g, immigrants from Africa, certain parts of Asia, and Eastern Europe; contacts with persons in the penal system; close contact with known individuals with TB). Children with TB usually do not present with symptoms until 1-6 months after primary infection. These may include fever, night sweats, chills, cough (which may include hemoptysis), and weight loss.
Pneumonia is mainly a clinical diagnosis, following a detailed history and thorough physical exam.
Identifying the causative organism is the most valuable step in managing pneumonia, as it will be indicative of the treatment options. Diagnosis can be made with the help of the following tests:
- complete blood count
- blood and sputum culture (special test where causative organism is identified in the lab)
- chest X ray
Treatment decisions in children with pneumonia are dictated based on the infectious organism and the age and clinical status of the patient. Antibiotic administration must be targeted to the likely organism, bearing in mind the age of the patient, the history of exposure, the possibility of resistance and other pertinent history.
After initiating therapy, patients should be watched for resolution of the infiltrate (patch) on the X ray. Symptoms clear up much faster than infitrates. Repeat X rays should be ordered to monitor the resolution. Most childhood pneumonias have complete resolution and will leave no patch.
Avoiding sick contacts is of foremost importance in avoiding pneumonia.
Along with that, Hib vaccine (which vaccinates against the bacteria Hemophilus Influenza) also protects against pneumonia. This vaccine is routinely administered to infants and young children in most countries as part of the routine vaccine schedule. Pneumococcal vaccine and flu vaccine also decrease chances of contracting pneumonia.