Posted by Dr Joe on December 16, 2019 · Leave a Comment
Pneumonia in kids is probably more common than we all realize. It represents an infection of the lung tissue which can be caused by viral illnesses, bacterial illnesses or a type of organism that is somewhere between a virus and bacteria called mycoplasma. The most common cause of pneumonia is usually viral, but viral illnesses can predispose lung tissue to become infected with bacteria. Other ways of acquiring pneumonia are by inhalation (this is unusual but certain illnesses such as
tuberculosis and anthrax may be acquired in this manner).
The best way to diagnose kids with pneumonia is through a thorough history and physical exam that your doctor will perform on your child. Another way that can be used to diagnose pneumonia is through the use of a chest X-ray, but small areas of pneumonia or early pneumonia might not show up on X-ray. Your Doctor will be able to diagnose this early on by piecing together what you tell him and his observation and examination of your child.
One thinks of pneumonia as an illness with high fever and severe productive cough but this is not always the case and sometimes all that is seen are the symptoms created by the body to help compensate for the changes occurring in the lungs. If a large amount of lung tissue is involved and it becomes difficult for the gas exchange (oxygen in and carbon dioxide out) to take place then a signal is sent to the brain to increase the rate of breathing so that more air is forced in and more oxygen can be extracted. When it is even more difficult to breathe the child may use muscles not ordinarily used to help with breathing such as abdominal muscles and neck muscles and one can observe this. With further progression of the disease less oxygen will reach the body and mild blueness or cyanosis will be seen in the skin.
OK we’ve talked about the more severe problems with pneumonia but let’s get back to the beginning and restate that most pneumonia is mild and might very well be a natural progression of a cold. In a considerable amount of children with mild pneumonia the diagnosis might never be made because it is not severe. And because most of these are viral in nature, they will clear up as the cold clears without the use of an antibiotic, and the child never exhibits the signs and symptoms mentioned in the previous paragraph.
If your Doctor pieces together the parts of the history and physical exam and decides your child might have pneumonia, and if your child appears sick or ill, he might very well begin an antibiotic because the exact nature of the pneumonia might be difficult to determine. Most of the time pneumonia can be adequately treated at home without the need for hospitalization and he/she will recover fully without any subsequent problems.
Bronchitis is a wastebasket term describing what is thought to be inflammation and mucous collection in the tubes that lead from your nose and mouth down into your lungs due to many causes- again usually viral. Any cold with a significant loose cough probably represents some degree of bronchitis or tracheitis (higher up). Generally, it also does not necessarily need an antibiotic to “cure” it because bronchitis, like mild pneumonia, will also go away as the cold resolves. There are instances, again, when your child’s doctor might very well decide to use an antibiotic for your child and those would include when your child looks sick or ill (because significant bronchitis and pneumonia can look exactly the same) or if your child has any sort of chronic lung condition such as asthma or cystic fibrosis where the chance of bacterial infection is increased.
So, especially during the winter months, if your child is diagnosed with pneumonia or bronchitis, you needn’t panic or assume the worst. Just follow your child’s doctor’s advice and he/she will be just fine.
