Pneumonia: in children

Sophie Matzik is a freelance writer for the NetDoktor medical editorial team.

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical professionals.

The Pneumonia in children is the most common respiratory disease in childhood. It is usually triggered by bacteria or viruses. Pneumonia in children is sometimes difficult to detect because the symptoms can be very non-specific. Severe pneumonia in children can lead to death, which is why timely treatment is important. Read everything important about pneumonia in children here.

Pneumonia in children – description

Pneumonia in children means that the lung tissue and airways in the chest become inflamed. Infection with pathogens such as bacteria, viruses or fungi is usually responsible for the disease. The symptoms of pneumonia in young children are similar to those in adults. Sufferers suffer from fever and cough and feel weak and tired. Children often experience symptoms such as chills or body aches, which are rare in adults.

Children are particularly at risk for pneumonia. Since toddlers in particular do not yet have their own hygiene awareness, pathogens such as bacteria or viruses are quickly transferred from one child to another. This usually happens through coughing or sneezing (droplet infection). In common facilities such as schools, kindergartens or homes, mutual infection quickly occurs. In addition, children’s immune systems often don’t work as effectively as adults. As a result, children generally have more infections and are therefore more at risk from serious illnesses such as pneumonia.

Pneumonia in toddlers and children is the most common respiratory illness in childhood. It is even one of the most common causes of death in childhood worldwide. Around 1.8 million children die of pneumonia worldwide every year. In Germany, the number of deaths is comparatively low, which is due on the one hand to the good medical care and on the other hand to the possibility of vaccination against the most common pathogens.

Causes of pneumonia in children

Pneumonia in children can occur as a result of another respiratory illness (such as asthma) or be a complication of other illnesses (e.g. cystic fibrosis). Pneumonia in children without previous illnesses or risk factors is less common. Bacteria or other pathogens (viruses, fungi) are often the cause of pneumonia in children. Other causes such as respiratory irritation gases or disorders of the immune system are rarely the cause of pneumonia in children.

Bacterial pneumonia in children

As with adults, bacteria are mostly responsible for pneumonia in children. Babies and toddlers are also susceptible to rarer pathogens that older children and adults would not fall ill with. Typical germs of pneumonia in children are pneumococcus, streptococcus agalactiae, hemophilus influenzae, and Escherichia coli. The causative agents of so-called atypical pneumonia, for example chlamydia or mycoplasmas, are more common in school-age children.

As a rule, symptoms such as shortness of breath, fever and cough are more pronounced in children with bacterial pneumonia than in those with viral pneumonia. Bacterial pneumonia often occurs after pneumonia caused by viruses. Doctors then speak of a so-called superinfection.

Viral pneumonia in children

Viral pneumonia in young children is caused, for example, by the respiratory syncytial virus (RS virus), the adenovirus or the influenza virus (flu virus). Infants in particular can develop severe RS virus pneumonia.

Picture gallery: Pneumonia – it is really that dangerous

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health issues since 2001. In addition to her work for NetDoktor, Christiane Fux also works in prose. Her first crime novel appeared in 2012, and she also writes, designs and publishes her own crime games.

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Contagion in a sick child

If pathogens such as bacteria or viruses are responsible for pneumonia in children, pneumonia is potentially contagious to others. The pathogens can be transmitted to other people when coughing or sneezing (droplet infection). Sufficient hygiene must therefore be ensured, especially for children: Always carry a clean handkerchief with you and make sure that your child sneezes or coughs at you and no other person. Do not leave your baby or toddler alone for a longer period of time during the period of illness, so that they may quickly notice a deterioration in their health.

Pneumonia in children: recognize symptoms

Recognizing pneumonia in children and toddlers is not always easy. Especially in babies and very young children who can not speak yet, you need to pay particular attention to the following signs that distinguish pneumonia from a normal cold:

Reluctance to drink and refusal to eat
Cough, often with greenish or yellowish sputum
Bloated stomach
Fast and shallow breathing (tachypnea)
Raised nostrils when inhaling (nostril breathing)
High fever
Strikingly high heart rate (children generally have a higher heart rate than adults)
Apathetic behavior

In children who can already speak, it is usually easier to identify pneumonia and better estimate the severity of the disease. The children then, like adults, complain of a bad general condition, a strong feeling of illness and, in addition to the symptoms just mentioned:

Headache and body aches
chills
Chest pain when coughing, which sometimes radiates into the (right) lower abdomen

Diagnosis and treatment of pneumonia in children

The diagnosis of pneumonia in toddlers and children is essentially the same as that in adults. First, the Medical history (medical history) raised by the doctor, usually the parents provide precise information. For example, targeted questions that may provide additional information to the doctor about suspected pneumonia in children could include:

Your child has been suffering from cough and fever for a long time?
Does your child cough a lot and cough up phlegm??
Your child has been feeling weak and tired for a long time?
Your child has been eating less lately?
Does your child behave differently than usual (e.g. change of character)?

This is followed by one physical examination on. The doctor listens to the lungs at various points on the back and chest with a stethoscope. The inflamed lung tissue and mucus that can collect between the alveoli cause typical breathing noises (sounding, fine-bubble rattling noises).

Further investigations

To be able to assess the extent of the inflammation, a X-ray of the lungs prepared. Taking a single x-ray in children is harmless with regard to radiation exposure. Excessive radiation exposure and corresponding consequential damage would only be expected if a large number of X-ray examinations were carried out in a very short time. The X-ray examination is the most important examination if pneumonia is suspected.

A laboratory analysis is necessary to prove which pathogens caused the pneumonia. For this purpose, sputum is cultivated. This means that an attempt is made in the laboratory to multiply bacteria from the sputum. From this, the bacterium responsible for pneumonia can be identified. A laboratory analysis is useful because different pathogens react differently to antibiotics. This can also be tested on the basis of pathogen cultivation from the sputum.

It is important that the sputum sample is obtained before the start of therapy, as it is otherwise contaminated by the active ingredient and no longer allows any precise conclusions to be drawn. However, a sputum test is not always necessary. It is usually only taken if the doctor is unable to make a clear diagnosis based on the symptoms at hand. In complicated cases, for example if therapy does not work, it may be necessary to take a mucosal sample (biopsy).

With a blood test the suspicion of pneumonia in children can be confirmed. If there is inflammation in the body, the C-reactive protein (CRP) is typically in the blood and the number of white blood cells (Leukocytes) increased.

Treatment of pneumonia in children

The treatment of children depends on the age of the child and the severity of pneumonia. Babies up to the age of six months and children with comorbidities or a very pronounced course of the disease should be treated in the hospital. Older children without accompanying illnesses can be treated at home. However, you must maintain bed rest and parents should strictly ensure that the therapy prescribed by the doctor is followed.

antibiotics

Bacterial pneumonia in children is treated with antibiotics. Treatment lasts for at least seven days, but can also extend over a longer period depending on the pathogen. Which antibiotic is used in an individual case depends on the type of bacteria. Babies and infants up to six months old are given the antibiotic by infusion. Oral intake is still very difficult at this age. In order to ensure a continuous level of active substances in the blood and not to risk that the disease worsens, intravenous administration is chosen from the beginning at this age.

Antipyretic

If the fever is high, the doctor prescribes antipyretic medication. Taking the dosage prescribed by the doctor is generally safe for smaller children as well. The stores are especially for children suitable Fever juices available with the active ingredients ibuprofen or paracetamol. Children should never be given aspirin, because it can develop life-threatening Reye syndrome.

Expectorant medication

With pneumonia, a lot of mucus accumulates in the tissue between the alveoli (interstitium). This mucus is carried out by coughing. To make expectoration easier, expectorant medication can be administered. Cough suppressants should not be given during the day as they suppress the urge to cough and the child can no longer cough up the mucus in the lungs and they must never be taken with expectorant medication at the same time. At night, however, the use of antitussive agents is recommended, as children can sleep through it better.

Further measures

Coughing up mucus can also be made easier by inhalation therapy and a vibration massage. With inhalation therapy, a solution of table salt and expectorant additives is inhaled. As a rule, the children rely on the help of their parents. A so-called vibration therapy is carried out by a physiotherapist. For this purpose, a vibrating device is placed on the back, which releases the mucus through the vibrations and thus also supports coughing up. Accompanying the therapy, it is important that children drink a lot to compensate for the loss of fluid due to cough and fever and that they are physically gentle.

Pneumonia in children – prognosis

There is no uniform prognosis for pneumonia in children. The individual course of healing and the duration of the disease depend on the type of pathogen and the general health of the child. If the child has no other diseases, the prognosis is usually good and the pneumonia usually heals within seven to ten days. After pneumonia is over, children are sometimes prone to respiratory infections for weeks. Therefore, you should spare yourself at least one month after getting rid of pneumonia.

Pneumonia in children – complications

Complications are rare in children with pneumonia. They often develop when the antibiotic therapy prescribed by the doctor is not followed. This can prolong the duration of the disease of pneumonia or spread the pathogens to the rest of the body. If the pathogen gets from the lungs to other organ systems, the following complications are possible:

Pleurisy
Fluid accumulation in the pleura (pleural effusion)
Blood poisoning when the bacteria enter the bloodstream (sepsis)
Meningitis (inflammation of the meninges)
Collection of pus in the lungs (abscess)

Go to the doctor immediately if the symptoms worsen or after three days – despite antibiotic therapy – there is no significant improvement in the state of health.

Differentiation between pneumonia and bronchitis

Differentiating inflammation of the bronchi (bronchitis) and pneumonia in children is often very difficult, even for doctors. Pneumonia can also develop from bronchitis. If your child becomes ill, the bronchitis should be completely cured with medical treatment and physical protection. Although bronchitis is often caused by viruses, preventive antibiotic therapy is useful in many cases to prevent an additional bacterial infection (superinfection) and thus reduce the risk of pneumonia in children.

Prevent pneumonia in children

You cannot generally prevent pneumonia in children. However, certain measures can reduce the risk of pneumonia in children. There are four main ones vaccinations. Vaccination, which generally protects against pneumonia in children, does not exist due to the large number of possible pathogens. At least against some of the most common triggers of pneumonia, there are vaccinations that are also recommended by the Standing Vaccination Committee (StiKo) for all children. The following vaccinations can prevent pneumonia:

Vaccination against measles
Vaccination against Haemophilus influenza type b
Pneumococcal vaccination
Vaccination against chickenpox (varicella)

The best preventive measure against pneumonia in children is a healthy lifestyle. Make sure that your child has a balanced diet and moves regularly. In children with other diseases or a weakened immune system, you need to take extra care that your child does not play with sick friends, as in such cases pneumonia can be life-threatening. A Pneumonia in children is a serious illness that must be cured completely before the children go back to kindergarten or school.