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Quick reference medical handouts used by Pediatric offices

Don't Panic if your Child gets Pneumonia

Having their child diagnosed with pneumonia scares most parents. While some pneumonias are quite serious - particularly in newborns and in an older child with a vulnerable immune system - most pneumonias in children and adolescents are mild and easily treated.

Pneumonia simply means inflammation in the lung. Healthy lungs are an intricate weave of more than three hundred million tiny air sacs. When a child has pneumonia, these sacs fill with pus. This illness can be caused by bacteria, viruses, chemical irritants, or foreign bodies. The phrase "walking pneumonia" refers to a group of pneumonia's that even if untreated would not hospitalize a child or even confine them to bed. The illness can, however, make a youngster feel miserable with a hacking cough, chills, headache, fatigue, muscle aches and fever.

Most "walking pneumonia's" are caused by a microorganism called Mycoplasma pneumoniae. Illnesses caused by this germ are most commonly encountered between the ages of five and fifteen. The infection is spread mostly through droplets in the air, expelled when an infected child or adult blows their nose, sneezes, coughs or talks. Children can also become infected by shaking an infected child's hand or touching contaminated objects, such as toys or clothing, and then touching their eyes, nose or mouth. Mycoplasma pneumoniae infections are not highly contagious and transmission requires prolonged close contact with an infected person. Since the cough from this illness is worse at night, people sleeping in the same room with an infected child are more susceptible to getting infected. In healthy adults, multiple cases of walking pneumonia are commonly found in the work place.

A youngster with a Mycoplasma pneumonia infection usually becomes sick one to three weeks after exposure. The onset of symptoms is often gradual: a decrease in the youngster's energy may be the earliest sign, followed by symptoms suggesting a cold: headache, runny nose, sore throat, and fever. Unlike the typical cold, however, the child will gradually become worse over the next two weeks with a moist cough, worse at night. Infections of the middle ear ("otitis media") also can occur. Cigarette smoking by the parents or day care provider will increase the youngster's susceptibility to pneumonia. Without treatment, the illness could last six to eight weeks.

Mycoplasma infection is usually diagnosed based on the previously described symptoms. Chest x-rays are sometimes obtained when the diagnosis is in doubt. A blood test ("cold agglutinins") is available but is not always positive and therefore is not rountinely obtained. Mycoplasma infections are best treated with erythromycin, clarithromycin (Biaxin), azithromycin (Zithromax), and tetracyclines (only used over age 12). Even after treatment, many children will have a dry cough that lasts six weeks or more since it often takes that long for the damaged cells of the respiratory tract to completely heal. It is best to avoid cough suppressants since the cough keeps the infection from settling deeper in the lungs. Most physician use cough medications only when the cough disturbs the youngster's sleep at night. Since dry air makes the cough worse, a cold mist vaporizer or humidifier will help loosen the secretions. Tobacco smoke makes the cough worse so do not let anyone smoke in the house when a child has pneumonia. This should be the rule even when the child is well. The cough will last longer in teenagers who have already started smoking.

The child's physician should be called for the following symptoms:

* Ongoing respiratory problems (for example, asthma)

* A cough that triggers a bad headache

* Breathing becomes labored and difficult

* The child is not drinking enough fluids

* A high fever lasting over 48 hours

* Cough that lasts over three weeks.

At this time there are no vaccines to prevent Mycoplasma infections. As with any respiratory disease, children should be encouraged to cover their face when coughing or sneezing, and wash their hands frequently.


As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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