paediatrics / EDUCATION
Pneumonia
in children According to the World Health Organisation (WHO), pneumonia accounts for 15% of all deaths of children under 5 years old
P
neumonia is a form of acute lower respiratory
also spread via airborne droplets from a cough or sneeze.
tract infection that occurs when viruses, bacteria,
Early onset pneumonia can be acquired from the mother
or other micro-organisms cause inflammation of
during labour or delivery, with respiratory distress beginning
SIGNS AND SYMPTOMS
the lungs. When a patient has pneumonia, pus
at, or soon after birth. Because signs of pneumonia are
Children with
and fluid fill the alveoli in one or both lungs, which interferes
non-specific in neonates, any newborn infant with sudden
pneumonia may have
with oxygen absorption, making it difficult to breath.
onset respiratory distress or other signs of illness should be
a range of symptoms
assessed for pneumonia and sepsis.
depending on their
TYPES OF PNEUMONIA
age and the cause
WHY ARE CHILDREN VULNERABLE?
(bacterial or viral) of
The most common is streptococcus pneumoniae which
A healthy child has many natural defences that protect its
the infection.
occurs when the body is weakened in some way, such
lungs from the invading pathogens that cause pneumonia.
as illness, poor nutrition, or impaired immunity, and the
However, children and infants with compromised
bacteria can work their way into the lungs.
immune systems have weakened immune defences.
• Bacterial pneumonia is caused by various bacteria.
• Viral pneumonia is caused by different viruses including
Undernourished children, particularly those not exclusively
influenza (flu) and is responsible for about one-third of all
breastfed or with inadequate zinc intake are at a higher risk
pneumonia cases.
of developing pneumonia. Similarly, children and infants
• Mycoplasma pneumonia has somewhat different
suffering from other illnesses, such as AIDS or measles, are
symptoms and physical signs to other types of
more likely to develop pneumonia. Environmental factors,
pneumonia and is sometimes referred to as “walking
such as living in crowded homes and exposure to parental
pneumonia” since symptoms tend to be milder than
smoking or indoor air pollution, may also have a role to play
pneumonia caused by other germs. Caused by the
in increasing children’s susceptibility to pneumonia and its
bacterium mycoplasma pneumoniae, it generally causes
severe consequences.
DIAGNOSIS Pneumonia can be diagnosed in several different ways.
CAUSES
Healthcare providers can diagnose pneumonia by
Most cases of pneumonia follow a viral respiratory tract
the symptoms (in resource-poor settings), a physical
infection. Pneumonia is typically caused by a virus or
examination or by ordering diagnostics. Laboratory
bacteria. Infection can be passed between people from
tests can include chest X-rays and cell cultures to
direct contact (usually the hands) or inhaling droplets in the
look for pathogenic bacteria in the infected part of the
air from coughing or sneezing.
body. Usually, there should be a combination of clinical,
If a viral infection has weakened a child’s immune
• Rapid or difficulty breathing • Cough • Fever • Chills • Headache • Loss of appetite • Wheezing
a mild, widespread pneumonia that affects all age groups.
Common symptoms of pneumonia in children and infants include:
radiological, and laboratory findings to increase the
system, bacteria may begin to grow in the lungs, adding
likelihood of correct diagnosis. Healthcare providers can
a second infection to the original one. Certain children
diagnose many cases by using a stethoscope or observe a
whose immune defences or lungs are weakened by other
child’s respiratory rate and any breathing problems.
illnesses – such as cystic fibrosis, abnormalities in the
Children under five with severe cases of pneumonia may struggle to breathe, with their chests moving in or retracting during inhalation (known as ‘lower chest wall indrawing’). Infants may suffer convulsions, unconsciousness, hypothermia, lethargy,
immune system, or cancer – may be more likely to develop
COMPLICATIONS
pneumonia.
Most children affected by pneumonia recover without any
and feeding problems.
long-term difficulties.
TRANSMISSION
However, there are several potential complications
Pneumonia can be spread in several ways. The viruses
including:
and bacteria that are commonly found in a child’s nose or
• Septicaemia is the most common pneumonia
throat, can infect the lungs if they are inhaled. They may
complication and occurs when the bacteria causing
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Pharmacy Magazine APRIL 2020 |
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