Pneumonia - children - community acquired


Definition

Pneumonia is a lung infection caused by bacteria, viruses, or fungi.

This article covers community-acquired pneumonia (CAP) in children. This type of pneumonia occurs in healthy children who have not recently been in the hospital or another health care facility.

Pneumonia that affects people in health care facilities, such as hospitals, is often caused by germs that are harder to treat.

Alternative Names

Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children

Causes

This EM Should be displayed at the top of the article section "Causes"

Viruses are the most common cause of pneumonia in infants and children.

Ways your child can get CAP include:

Risk factors that increase a child's chance of getting CAP include:

Symptoms

Common symptoms of pneumonia in children include:

Symptoms common in children with more severe infections include:

Exams and Tests

The health care provider will listen to your child's chest with a stethoscope. The provider will listen for crackles or abnormal breath sounds. Tapping on the chest wall (percussion) helps the provider listen and feel for abnormal sounds.

If pneumonia is suspected, the provider will likely order a chest x-ray.

Other tests may include:

Treatment

The provider must first decide whether your child needs to be in the hospital.

If treated in the hospital, your child will receive:

Your child is more likely to be admitted to the hospital if he:

If your child has CAP caused by bacteria, he will be given antibiotics. Antibiotics are not given for pneumonia caused by a virus. This is because antibiotics do not kill viruses. Other medicines, such as antivirals, may be given if your child has the flu.

Many children can be treated at home. If so, your child may need to take medicines such as antibiotics or antivirals.

When giving antibiotics to your child:

Breathing warm, moist (wet) air helps loosen the sticky mucus that may make your child feel like she is choking. These steps may help:

Make sure your child drinks plenty of liquids, as long as the provider says it is OK.

Make sure your child gets plenty of rest when she goes home. Have her take naps, if needed.

Outlook (Prognosis)

Most children improve in 7 to 10 days with treatment. Children who have severe pneumonia with complications may need treatment for 2 to 3 weeks. Children at risk for severe pneumonia include:

Possible Complications

In some cases, more serious problems may develop, including:

The provider may order another x-ray. This is to make sure that your child's lungs are clear. It may take many weeks for the x-ray to clear up. Your child may feel better for awhile before the x-rays are clear.

When to Contact a Medical Professional

Call the provider if your child has the following symptoms:

Prevention

Teach older children to wash their hands often:

Vaccines may help prevent some types of pneumonia. Be sure to get your child vaccinated with:

When infants are too young to be immunized, parents or caregivers can get themselves immunized against vaccine-preventable pneumonia.

References

Bradley JS, Byington CL, Shah SS, et al. Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. cid.oxfordjournals.org/content/53/7/617.full.pdf+html.

Byington CL, Bradley JS. Pediatric community-acquired pneumonia. In: Cherry JD, Harrison GJ, Kaplan SL, Steinback WJ, and Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 22.

Kelly MS, Sandora TJ. Community-acquired pneumonia. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 400.

Kronman MP, Shah SS. Pneumonia and respiratory infections. In: Florin TA, Ludwig S, eds. Netter's Pediatrics. Philadelphia, PA: Elsevier Saunders; 2011:chap 91.

Stocker DM. Pediatric respiratory emergencies: disease of the lungs. In: Marx JA, Hockberger RS, and Walls RM, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 170.

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