It’s difficult to diagnose even relatively common illnesses in children for a few different reasons.
One is because children may not be available to verbalize their symptoms. There are also a lot of symptoms that are shared among illnesses.
Unfortunately, when it comes to a failure to diagnose an illness or a misdiagnosis, it can be deadly for a child.
Pneumonia is one of the most frequently missed diagnoses or misdiagnoses in children.
The following are some things parents should know about pneumonia in children.
What Is Pneumonia?
Pneumonia is an infection in a child’s lungs. The alveoli are sacs in the lungs, and when a child has pneumonia, these fill with fluid and pus. That, in turn, makes it more difficult for oxygen to reach the blood.
Symptoms of pneumonia can include:
- Very rapid breathing, which is often the only symptom
- Wheezing or grunting sounds when breathing
- Labored breathing, which might mean belly breathing or nostril-flaring
- Chest or belly pain
- Loss of appetite
- Poor feeding in infants
- In very extreme situations, blue or gray tinted lips and fingernails
Causes of Pneumonia
Pneumonia can be caused by a variety of different types of germs which include bacteria and viruses. Most cases in children are caused by viruses, including the flu virus, rhinovirus, and adenoviruses.
What will often happen is that a child will first have an upper respiratory tract infection, which is a throat and nose infection. Then symptoms of pneumonia might begin anywhere from 2 to 3 days after that.
The infection moves to the lungs, and fluid starts to gather in the lung air spaces and block the passage of air, creating a challenge in how the lungs function.
With bacteria-caused pneumonia, a child might start to get pretty sick fast, with a fever and fast breathing. It can take longer for viral pneumonia to begin, and the symptoms may be less severe.
Getting the proper diagnosis of pneumonia is important in children but can be challenging for health care providers.
A doctor might do some of the following tests if pneumonia is suspected in a child:
- Chest X-ray: this might be done to see what the internal bones, tissues, and organs look like.
- Blood tests: Checking the blood can be done to see how much oxygen and carbon dioxide are in the blood.
- Sputum culture: This is a test that is done on the material your child might cough up. It can help determine whether or not there’s an infection.
- Pulse oximetry: A small finger can be used on the finger or toe to figure out how much oxygen is in the blood.
- Chest CT scans
- Plural fluid culture: Pleural fluid is taken from the space between the lungs and chest wall to see if there are bacteria causing the illness.
How Is Pneumonia Treated?
A child’s doctor will look at their overall health, the extent and cause of the illness, and any other relevant information to decide how to treat pneumonia.
For example, treatment could include antibiotics, but this wouldn’t work for viral pneumonia. There isn’t a specific treatment for viral pneumonia, and it just has to get better on its own usually.
Other adjunctive treatments might include cough medicine, increasing fluid intake, and pain relievers. Nebulizer treatments can also be used.
For a child with severe breathing problems, hospitalization may be required. During hospitalization for pneumonia, treatments could include intravenous fluids, oxygen therapy, and suctioning the nose and mouth to get rid of thick fluid secretions.
What About Walking Pneumonia?
Walking pneumonia is a milder form of the illness that is seen in both children and adults, and it typically doesn’t lead to hospitalization.
Symptoms of walking pneumonia are more like the common cold, and children may not even act sick at all.
Walking pneumonia is often caused by Mycoplasma pneumoniae, which is an infection common in children.
You might need to see a doctor if your child starts to exhibit changes in appetite or behavior, has trouble breathing, or seems to be very low energy.
While walking pneumonia tends to be less severe than other types, it can become dangerous, especially in young children.
If you notice any changes in your child’s behavior, or they have symptoms that you think could be linked to pneumonia, it’s important to note those symptoms and talk with your pediatrician. It can become a very serious illness quickly, and medical treatment is important in these cases.