Pneumonia

Dr. Parang Mehta, MD.

Pneumonia, diarrhea, and measles -- this is the unholy trinity that kills millions of children all around the world each year.  Much of this mortality results from delayed diagnosis and improper treatment.  Though pneumonia is a serious disease, it is often not recognised early.

Even with the availability of modern treatment, pneumonia is a dangerous disease. The mortality is significant

Pneumonia is an infection of the lungs.  When an infection invades the lungs, the body's defensive cells pour into the lung, and fight the infection.  A lot of fluid, debris from killed lung cells, defensive cells, and infecting agents, and other material fill up the air spaces in the lungs.  Because of this, that part of the lung is unable to fulfil its function of bringing oxygen into the body, and supplying it to the bloodstream for distribution.

What Causes Pneumonia?

There are many causes of pneumonia.

 

The most important is pneumonia caused by bacterial infection.  Such pneumonia can progress rapidly, the child can be seriously ill in a matter of hours, and death can occur if effective treatment is not started quickly.

Viral pneumonia is usually not very serious, and most children recover in a few days.  Fungal pneumonias are slow illnesses, but are difficult to cure.  Swallowed foreign bodies like nuts, small toys, etc can cause repeated pneumonia in a particular part of the lung.

Most cases of pneumonia are caused by infections.  The two most common causes are bacteria and viruses.  Pneumonia can be contagious, and is spread by germs released into the air by coughing and sneezing by a person with pneumonia or other respiratory infection.  Sharing towels, pillows, glasses and eating utensils is also a risk factor.

Recognising Pneumonia

Children with pneumonia usually have fever and cough.  Since children with sore throats, colds, tonsillitis, laryngitis,and other diseases also have fever and cough, telling them apart may be difficult.

The important sign of pneumonia is fast breathing.  Since parts of the lungs have become non-functional, the body tries to meet its oxygen requirement by increasing the respiration rate.  If a child below one year of age has a breathing rate of more than 50 a minute, or an older child breathes more than 40 times in one minute, pneumonia is likely.

A doctor can usually diagnose pneumonia by examining the child, and laboratory tests are not always necessary.  In doubtful cases, some blood tests and X-rays can be a great help.  More specialised tests like a CT scan or MRI scan are only needed in children with repeated or difficult to treat pneumonia.

Bacteria That Cause Pneumonia

Treatment of Pneumonia in Children

It is not possible to reliably differentiate bacterial from viral pneumonia (these two are the most common).  Since bacterial pneumonia can become severe, and often causes death, all cases of pneumonia must be treated with antibiotics as soon as diagnosed.

Most cases of pneumonia can be treated at home with oral antibiotics.  Children who have significant difficulty in breathing, unable to eat and drink, vomiting a lot, not getting better on oral treatment at home, or who otherwise are very ill, should be admitted to hospital and treated with injectable antibiotics.  very young children with pneumonia (less than 6 months old) should also be treated in hospital.

Apart from antibiotics, medicine for fever, pain, vomiting, and cough may be needed.  These supportive medicines do not help the treatment of the pneumonia, but may increase the child's comfort.  Very ill children may also need intravenous fluids, oxygen, nutrition, etc.

 

Last Revision: May 22, 2020