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Pneumonia Symptoms 7

Pneumonia is a general term that refers to an infection of the lungs,which can be caused by a variety of microorganisms, includingviruses, bacteria, fungi, and parasites.

Often pneumonia begins after an upper respiratory tract infection (aninfection of the nose and throat). When this happens, symptoms ofpneumonia begin after 2 or 3 days of a cold or sore throat.

Signs and Symptoms

Symptoms of pneumonia vary, depending on the age of the child andthe cause of the pneumonia. Some common symptoms include:

fever

chills cough

unusually rapid breathing

breathing with grunting or wheezing sounds

labored breathing that makes a child's rib muscles retract(when muscles under the rib cage or between ribs drawinward with each breath)

vomiting

chest pain

abdominal pain

decreased activity

loss of appetite (in older children) or poor feeding (in infants)

in extreme cases, bluish or gray color of the lips andfingernails

Sometimes a child's only symptom is rapid breathing. Sometimeswhen the pneumonia is in the lower part of the lungs near theabdomen, there may be no breathing problems at all, but there maybe fever and abdominal pain or vomiting.When pneumonia is caused by bacteria, an infected child usuallybecomes sick relatively quickly and experiences the sudden onset ofhigh fever and unusually rapid breathing. When pneumonia is

caused by viruses, symptoms tend to appear more gradually and areoften less severe than in bacterial pneumonia. Wheezing may bemore common in viral pneumonia.Some types of pneumonia cause symptoms that give important cluesabout which germ is causing the illness. For example, in older

children and adolescents, pneumonia due to Mycoplasma (alsocalled walking pneumonia) is notorious for causing a sore throat andheadache in addition to the usual symptoms of pneumonia.In infants, pneumonia due to chlamydia may cause conjunctivitis(pinkeye) with only mild illness and no fever. When pneumonia isdue to whooping cough (pertussis), the child may have longcoughing spells, turn blue from lack of air, or make a classic "whoop"sound when trying to take a breath.

Description

Pneumonia is a lung infection that can be caused by different types

of germs, including bacteria, viruses, fungi, and parasites. Althoughdifferent types of pneumonia tend to affect children in different agegroups, pneumonia is most commonly caused by viruses. Someviruses that cause pneumonia are adenoviruses, rhinovirus,influenza virus (flu), respiratory syncytial virus (RSV), andparainfluenza virus (the virus that causes croup).

Incubation

The incubation period for pneumonia varies, depending on the typeof virus or bacteria causing the infection. Some common incubationperiods are: respiratory syncytial virus, 4 to 6 days; influenza, 18 to72 hours.

Duration

With treatment, most types of bacterial pneumonia can be curedwithin 1 to 2 weeks. Viral pneumonia may last longer. Mycoplasmalpneumonia may take 4 to 6 weeks to resolve completely.

Contagiousness

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The viruses and bacteria that cause pneumonia are contagious andare usually found in fluid from the mouth or nose of an infectedperson. Illness can spread when an infected person coughs orsneezes on a person, by sharing drinking glasses and eatingutensils, and when a person touches the used tissues or

handkerchiefs of an infected person.

Prevention

There are vaccines to prevent infections by viruses or bacteria thatcause some types of pneumonia.Children usually receive routine immunizations against Haemophilusinfluenzae and pertussis (whooping cough) beginning at 2 months ofage. (The pertussis immunization is the "P" part of the routine DTaPinjection.) Vaccines are now also given against the pneumococcusorganism (PCV), a common cause of bacterial pneumonia.Children with chronic illnesses, who are at special risk for other types

of pneumonia, may receive additional vaccines or protective immunemedication. The flu vaccine is strongly recommended for childrenwith chronic illnesses such as chronic heart or lung disorders orasthma, as well as otherwise healthy children.Because they are at higher risk for serious complications, infantswho were born prematurely may be given treatments that temporarilyprotect against RSV, which can lead to pneumonia in youngerchildren.Doctors may give prophylactic (disease-preventing) antibiotics toprevent pneumonia in children who have been exposed to someonewith certain types of pneumonia, such as pertussis. Children withHIV infection may also receive prophylactic antibiotics to prevent

pneumonia caused by Pneumocystis carinii.Antiviral medication is now available, too, and can be used toprevent some types of viral pneumonia or to make symptoms lesssevere.In addition, regular tuberculosis screening is performed yearly insome high-risk areas because early detection will prevent activetuberculosis infection including pneumonia.In general, pneumonia is not contagious, but the upper respiratoryviruses that lead to it are, so it is best to keep your child away fromanyone who has an upper respiratory tract infection. If someone inyour home has a respiratory infection or throat infection, keep his or

her drinking glass and eating utensils separate from those of otherfamily members, and wash your hands frequently, especially if youare handling used tissues or dirty handkerchiefs.

When to Call Your Child's Doctor

Call your child's doctor immediately if your child has any of the signsand symptoms of pneumonia, but especially if your child:

is having trouble breathing or is breathing abnormally fast

has a bluish or gray color to the fingernails or lips

has a fever of 102 degrees Fahrenheit (38.9 degreesCelsius), or above 100.4 degrees Fahrenheit (38 degreesCelsius) in infants under 6 months of age

Professional Treatment

Doctors usually make the diagnosis of pneumonia after a physicalexamination. The doctor may possibly use a chest X-ray, blood tests,and (sometimes) bacterial cultures of mucus produced by coughingwhen making a diagnosis.In most cases, pneumonia can be treated with oral antibiotics givento your child at home. The type of antibiotic used depends on thetype of pneumonia.Children may be hospitalized for treatment if they have pneumoniacaused by pertussis or other bacterial pneumonia that causes highfevers and respiratory distress. They may also be hospitalized ifsupplemental oxygen is needed, if they have lung infections that may

have spread into the bloodstream, if they have chronic illnesses thataffect the immune system, if they are vomiting so much that theycannot take medicine by mouth, or if they have recurrent episodes ofpneumonia.

Pneumonia - Exams and Tests

Your doctor will usually diagnose pneumonia by using yourmedicalhistory, a physical exam, and a chest X-ray. Based on the medical

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history and physical exam, your doctor may start your treatment rightaway without doing other tests. The need for more tests oftendepends on how severe your symptoms are, your age, and youroverall health. In general, the sicker you are, the more tests you willhave. This is especially true for older adults and infants.

A chest X-ray is almost always done to check for changes in thelungs that may mean pneumonia and to look for other causes of yoursymptoms. But an X-ray does not always show whether you havepneumonia, especially if the X-ray is done when you first get sick.

In some cases, the X-ray results may:

Suggest the type of organism (bacterial, viral, or fungal)causing pneumonia.

Show complications of pneumonia.

Show conditions that may occur with pneumonia, such asfluid in the chest cavity or a collapsed lung.

Reveal another condition, such as heart failure, lung cancer,oracute bronchitis.

If you are very ill, have severe shortness of breath, or have acondition that increases your risk (such as asthma orchronicobstructive pulmonary disease

), your doctor may examine yourmucus.

In a Gram stain, you cough up a sample of mucus (sputum)that is then treated with a special dye (Gram stain) and

looked at under a microscope. This test may show what typeof organism (bacterium or fungus) is causing the pneumonia.This test can help your doctor choose the best treatment foryour infection.

In a sputum culture and sensitivity, a sample of mucus isplaced in a container with substances that will make bacteriaor fungi grow. If bacteria or fungi grow, your doctor canidentify them and choose the correct treatment.Unfortunately, getting lung mucus that has not beencontaminated with throat or mouth mucus is difficult. So, theresults are not always helpful in identifying the cause of

pneumonia. This test may be less useful if you have alreadystarted using antibiotics.

If you have severe pneumonia, you may need other tests, includingtests to check for complications and to find out how well your

immune system is working.

A urine test is available that may identify within 15 minutes whetheryou are infected with Streptococcus pneumoniae, one of the maincauses of bacterial pneumonia, orLegionella pneumophila, thebacterium that causes Legionnaires' disease and sometimes cancause pneumonia.

Although experts consider the test to be useful for the identificationofLegionella pneumophila, doctors generally do not use it to identifyStreptococcus pneumoniae.4 But it may be useful in adults withsevere pneumonia and when a Gram stain has not identified the

bacteria.5

In people with impaired immune systems, pneumonia may becaused by other organisms, including some forms of fungi, such asPneumocystis jiroveci(formally called Pneumocystis carinii). Thisfungus often causes pneumonia in people who have AIDS. Somedoctors may suggest an HIV test if they think that Pneumocystisjiroveciis causing the pneumonia.

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