Pneumonia

What is pneumonia?

Pneumonia is an infection in your lungs caused by bacteria, viruses, or fungus. You can become infected if you come in contact with someone who is sick. You can get pneumonia if you recently had surgery or needed a ventilator to help you breathe. Pneumonia can also be caused by accidentally inhaling saliva or small pieces of food. Pneumonia may cause mild symptoms, or it can be severe and life-threatening.

What increases my risk for pneumonia?

• A cold or the flu
• Health conditions, such as heart or lung disease
• A weakened immune system caused by HIV, cancer, or steroid use
• Recent hospitalization
• Smoking
• Excess alcohol use
• Older age

How can I prevent pneumonia?

• Avoid the spread of germs. Wash your hands often with soap and water. Use gel hand cleanser when there is no soap and water available. Do not touch your eyes, nose, or mouth unless you have washed your hands first. Cover your mouth when you cough. Cough into a tissue or your shirtsleeve so you do not spread germs from your hands. If you are sick, stay away from others as much as possible.
• Limit alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
• Ask about vaccines. You may need a vaccine to help prevent pneumonia. Get an influenza (flu) vaccine every year as soon as it becomes available.

What may increase my child’s risk for pneumonia?

• Premature birth
• Breathing secondhand smoke
• Asthma or certain genetic disorders, such as sickle-cell anemia
• Heart defects, such as ventricular septal defect (VSD), atrial septal defect (ASD), or patent ductus arteriosus (PDA)
• Poor nutrition
• A weak immune system
• Spending time in a crowded place, such as a daycare center

How can my child’s pneumonia be prevented?

• Your child may be able to take antibiotics to prevent pneumonia if he has been exposed to it. He may also be able to take antibiotics if he has a weak immune system. Ask your child’s healthcare provider for more information.
• Do not let anyone smoke around your child. Smoke can make your child’s coughing or breathing worse.
• Get your child vaccinated against viruses or bacteria that cause infections such as the flu, pertussis, and pneumonia.
• Keep your child away from people with symptoms of a respiratory infection such as sore throat or cough.
• Wash your hands and your child’s hands often with soap to prevent the spread of germs.
• Do not let your child share food, drinks, or utensils with others.

What are the signs and symptoms of pneumonia?

• Fever or chills
• Cough
• Shortness of breath or rapid breathing
• Chest pain when you cough or breathe deeply
• Headache
• Vomiting
• Fatigue or confusion

How is pneumonia diagnosed?

Your healthcare provider will listen to your lungs. Tell him if you have other health conditions. Give him a complete list of all medicines you have taken recently. You may need any of the following:

• Pulse oximetry measures the amount of oxygen in your blood.
• Blood and urine tests may show signs of an infection or the bacteria causing your pneumonia. Blood tests can also show how much oxygen is in your blood.
• A chest x-ray or CT scan may show signs of infection in your lungs.
• A mucus sample is collected and tested for the germ that is causing your illness. It can help your healthcare provider choose the best medicine to treat the infection.

How is pneumonia treated?

• Medicines are given to treat a bacterial infection. Your healthcare provider may also recommend acetaminophen. It decreases pain and fever and is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
• Airway clearance techniques are exercises to help remove mucus so you can breathe more easily. Your healthcare provider will show you how to do the exercises. These exercises may be used along with machines or devices to help decrease your symptoms.
• Respiratory support is given to help you breathe. You may receive oxygen to increase the level of oxygen in your blood. You may also need a machine to help you breathe.

What are the signs and symptoms of child pneumonia?

The signs and symptoms depend on what caused the pneumonia and the age of the child. The signs and symptoms of bacterial pneumonia usually begin more quickly than they do with viral pneumonia. Your child may have any of the following:

• Fever
• Shortness of breath or trouble breathing
• Abdominal pain near your child’s ribs
• Poor appetite
• Cough
• Crying more than usual, or more irritable or fussy than normal
• Pale or bluish lips, fingernails, or toenails

How do I know if my child is having trouble breathing?

• Your child’s nostrils open wider when he breathes in.
• Your child’s skin between his ribs and around his neck pulls in with each breath.
• Your child is wheezing, which means you hear a high-pitched noise when he breathes out.
• Your child is breathing fast:
  • More than 60 breaths in one minute for newborn babies up to 2 months old
  • More than 50 breaths in one minute for a baby 2 months to 12 months old
  • More than 40 breaths in one minute for a child older than 1 year

How is pneumonia diagnosed?

Your child’s healthcare provider may be able to diagnose pneumonia by his exam. He will test your child’s oxygen levels using a pulse oximeter. If your child has low oxygen levels, his healthcare provider may do any of the following:

• A chest x-ray is a picture of your child’s lungs and heart. Healthcare providers may use this to look for signs of infection such as pneumonia, or other problems.
• Blood tests or a nasal swab may be done to show the virus, bacteria, or fungus that caused your child’s pneumonia.

How is pneumonia treated?

Many children can be treated at a doctor’s office and at home. If the pneumonia is severe, the healthcare provider may want your child to stay in the hospital for treatment. Trouble breathing, dehydration, high fever, and the need for oxygen or medicines are reasons to stay in the hospital.

• Antibiotics may be given if your child has bacterial pneumonia. Viral pneumonia will usually go away without antibiotics.
• Your child may need extra oxygen if his blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his nose and mouth or through small tubes placed in his nostrils. Ask your child’s healthcare provider before you take off the mask or oxygen tubing.

How can I manage my pneumonia symptoms?

• Rest as needed. Rest often throughout the day. Alternate times of activity with times of rest.
• Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Liquids help thin your mucus, which may make it easier for you to cough it up.
• Do not smoke. Smoking increases your risk for pneumonia. Smoking also makes it harder for you to get better after you have had pneumonia. Ask your healthcare provider for information if you need help to quit smoking.

When should I seek immediate care?

• You cough up blood.
• Your heart beats more than 100 beats in 1 minute.
• You are very tired, confused, and cannot think clearly.
• You have chest pain or trouble breathing.
• Your lips or fingernails turn gray or blue.

When should I contact my healthcare provider?

• Your symptoms are the same or get worse 48 hours after starting antibiotics.
• Your fever is not below 99°F (37.2°C) 48 hours after starting antibiotics.
• You have a fever higher than 101°F (38.3°C).
• You cannot eat or have loss of appetite, nausea, or vomiting.
• You have questions or concerns about your condition or care.

When should I seek immediate care?

• Your child is under 3 months old and has a fever.
• Your child is struggling to breathe or wheezing.
• Your child’s lips or nails are bluish or gray.
• Your child’s skin between the ribs and around the neck pulls in with each breath.
• Your child has any of the following signs of dehydration:
  • Crying without tears
  • Dizziness
  • Dry mouth or cracked lip
  • More irritable or fussy than normal
  • More sleepy than usual
  • Urinating less than usual or not at all
  • Sunken soft spot on the top of the head if your child is less than 1 year old

When should I contact my child’s healthcare provider?

• Your child has a fever of 102° F (38.9° C), or above 100.4° F (38° C) if your child is younger than 6 months.
• Your child cannot stop coughing.
• Your child is vomiting.
• You have questions or concerns about your child’s condition or care.