What you need to know about pneumonia in children

Pneumonia is relatively uncommon in children, accounting for 10-15% of respiratory infections in the winter. But this year there has been an increase in pediatric pneumonia infections which is a bit concerning since we are only in the fall months. The good news is that in the United States, most children recover from pneumonia with proper treatment. A small number may require hospitalization for oxygen support and IV antibiotics. Those with underlying health conditions are at greatest risk of hospitalization and death from pneumonia.

What is pneumonia?

Pneumonia is an infection of the lungs, causing inflammation as well as fluid build up in the air sacs. This causes patients to cough and can cause trouble breathing. Pneumonia is a condition that can be caused by viruses or bacteria.

What causes pneumonia?

The most common cause of pneumonia is a viral infection. This is especially true in babies and young children who are more susceptible to respiratory syncytial virus (RSV). Other viral causes of pneumonia include influenza, parainfluenza, and adenovirus.

Bacterial pneumonia is typically caused by pneumococcus (streptococcus pneumoniae). Children with this type of pneumonia tend to have a rapid onset of illness and feel very sick. They may have a productive cough as well.

Mycoplasma pneumonia historically causes a less severe form of pneumonia we call “walking pneumonia”. However, this year we are seeing a big increase in the number of mycoplasma infections and these infections are more severe that in years past. This can be due to the typical cycle in which we see more mycoplasma every 3-5 years. It can also be due to the specific strain that is going around.

What are the symptoms of pneumonia?

At first, most children have typical upper respiratory infection symptoms (common cold). However, sometimes pneumonia is their primary illness and can come on suddenly. Signs your child developed pneumonia, aside from a cough, include:

  • prolonged fever (3-5 days is typical for a cold)
  • fast breathing
  • trouble catching their breath
  • fatigue
  • abdominal pain and/or vomiting
  • decreased appetite.

How is pneumonia diagnosed?

Your child’s pediatrician can diagnose pneumonia after taking a careful history, reviewing your child’s vital signs and performing a physical exam. Sometimes a chest x-ray is needed to make the diagnosis. A blood test or nasal swab may be needed to help determine the cause of your child’s pneumonia. However, your doctor may not need to do any of these to make the diagnosis or determine a treatment plan.Your doctor will determine the best treatment for your child’s pneumonia based several factors including your child’s age, symptoms, and physical exam.

How is pneumonia treated?

Once your doctor determines what they believe is the cause of your child’s pneumonia, they will make a treatment plan with you. Both bacterial pneumonia and mycoplasma are treated with antibiotics. However, they are treated with different antibiotics so sometimes your doctor will recommend both. Viral pneumonia does not require antibiotics so your doctor will discuss ways to keep your child comfortable while they recover. (For more information on treating a cough, click here.)

Can pneumonia be prevented?

The best way to prevent pneumonia is to keep your child up to date on their vaccines. This includes seasonal flu and covid vaccines, as well as the RSV monoclonal antibody for babies. Do your best to avoid exposure to others who are sick or have your child wear a mask in crowded spaces. Teach them to wash their hands properly and to always cough or sneeze into their elbow. Finally, keep your children away from second hand smoke.

If you have any concerns about your child’s breathing or their illness in general, contact their pediatrician or call 911.