Pneumonia facts for kids
Quick facts for kids Pneumonia |
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| Synonyms | Pneumonitis |
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| Chest X-ray of a pneumonia caused by influenza and Haemophilus influenzae, with patchy consolidations, mainly in the right upper lobe (arrow) | |
| Pronunciation | |
| Symptoms | Cough, shortness of breath, chest pain, fever |
| Duration | Few weeks |
| Causes | Bacteria, virus, aspiration |
| Risk factors | Cystic fibrosis, COPD, sickle cell disease, asthma, diabetes, heart failure, history of smoking, very young age, older age |
| Diagnostic method | Based on symptoms, chest X-ray |
| Similar conditions | COPD, asthma, pulmonary edema, pulmonary embolism |
| Prevention | Vaccines, handwashing, not smoking |
| Medication | Antibiotics, antivirals, oxygen therapy |
| Frequency | 450 million (7%) per year |
| Deaths | Four million per year |
Pneumonia is a common illness that makes your lungs swell up. It mainly affects tiny air sacs in your lungs called alveoli. When you have pneumonia, you might cough a lot, feel pain in your chest, have a fever, and find it hard to breathe. This sickness can be mild or very serious.
Most often, pneumonia is caused by tiny germs like viruses or bacteria. Sometimes, other small living things can cause it too. Doctors usually figure out if you have pneumonia by checking your symptoms and doing a physical examination. They might also use Chest X-rays or blood tests to be sure.
Things that can make you more likely to get pneumonia include conditions like asthma or diabetes. Being very young or very old can also increase the risk. Good news! There are Vaccines that can help prevent some types of pneumonia. Washing your hands often and not smoking are also great ways to stay safe.
If bacteria cause pneumonia, doctors treat it with antibiotics. If someone is very sick, they might need to stay in the hospital. Sometimes, extra oxygen therapy is given to help with breathing. Pneumonia affects millions of people every year around the world. Thanks to modern medicine, many more people survive it now than in the past.
What are the Signs and Symptoms of Pneumonia?
When someone has pneumonia, they often have a cough that brings up mucus. They might also have a fever with shaking chills, feel short of breath, and have sharp chest pain when they take deep breaths. Their breathing might also be faster than usual.
For very young children (under five), common signs are fever, a cough, and breathing quickly or with difficulty. Sometimes, a fever might not be present, especially in babies or older people. In babies younger than two months, a cough might not even happen.
More serious signs in children can include skin that looks a bit blue, not wanting to drink, or being very sleepy.
Both bacterial and viral pneumonia usually cause similar symptoms. However, some specific types of pneumonia can have unique signs. For example, pneumonia caused by Legionella might also cause stomach pain or confusion. The table below shows how often different symptoms appear.
| How Often Symptoms Appear | |
|---|---|
| Symptom | Frequency |
| Cough | 79–91% |
| Tiredness | 90% |
| Fever | 71–75% |
| Shortness of breath | 67–75% |
| Mucus (Sputum) | 60–65% |
| Chest pain | 39–49% |
What Causes Pneumonia?
Pneumonia is mainly caused by infections from tiny living things called bacteria or viruses. Less often, fungi and parasites can also cause it. Even though many different germs can cause pneumonia, only a few are responsible for most cases. Sometimes, a person can have both a viral and bacterial infection at the same time.
It can be hard to find the exact germ causing pneumonia. In many cases, doctors cannot identify the specific pathogen, even with careful tests.
Some things make it easier to get pneumonia. These include smoking, having a weak immune system, or other health problems like asthma. For children, not being breastfed, breathing in cigarette smoke, or poor nutrition can also increase the risk.
Bacteria that Cause Pneumonia
Bacteria are a very common cause of pneumonia, especially the kind you catch outside of a hospital. One common bacterium is Streptococcus pneumoniae. Other bacteria that can cause pneumonia include Haemophilus influenzae and Mycoplasma pneumoniae.
Sometimes, these bacteria can become resistant to medicines, making them harder to treat. Things like smoking can make it easier for certain bacteria to cause pneumonia.
Viruses that Cause Pneumonia
Viruses cause a lot of pneumonia cases, especially in adults and children. Common viruses include rhinoviruses (which cause the common cold), influenza virus (flu), and respiratory syncytial virus (RSV).
Sometimes, a person with a viral infection can also get a bacterial infection. This means they have both types of pneumonia at once. Different viruses are more common at different times of the year. For example, during flu season, influenza viruses cause many cases. The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can also lead to pneumonia.
Fungi that Cause Pneumonia
Fungal pneumonia is not very common. It mostly affects people with weakened immune systems. This can happen due to conditions like AIDS or certain medicines.
Some common fungi that cause pneumonia include Histoplasma capsulatum and Pneumocystis jiroveci. These infections have become more common over time.
Parasites that Cause Pneumonia
Various parasites can affect the lungs. These include Toxoplasma gondii and Ascaris lumbricoides. These tiny organisms usually enter the body through skin contact, by eating contaminated food, or through insect bites.
Most parasites do not just affect the lungs. They usually involve other parts of the body first. In developed countries, these infections are more common in people who have traveled or are immigrants. Around the world, parasitic pneumonia is most common in people with weak immune systems.
Non-Infectious Causes of Pneumonia
Sometimes, pneumonia is not caused by an infection. This is called non-infectious pneumonia or pneumonitis. It happens when the lungs become inflamed for other reasons.
Examples include conditions like diffuse alveolar damage or lipoid pneumonia. Lipoid pneumonia is rare and happens when fats or oils get into the lungs. These can be inhaled or spread from other parts of the body.
How Pneumonia Affects Your Lungs
Pneumonia often starts as a cold or flu in your upper airways. Then, it moves down into your lungs. Your body has natural defenses to protect your lungs. These include reflexes like coughing and special cells that fight germs.
However, if germs get into your lower airways, they can cause an infection. How severe the pneumonia becomes depends on the strength of the germ. It also depends on how many germs enter your body and how well your immune system fights them off.
How Bacteria Affect the Lungs
Most bacteria enter your lungs when you breathe in tiny droplets from your throat or nose. Many people breathe in small amounts of these germs while they sleep. Once in the lungs, bacteria can spread between cells and air sacs.
Your body's defense cells, like macrophages and neutrophils, try to destroy the bacteria. These cells also release chemicals that activate your immune system. This causes symptoms like fever, chills, and tiredness. The air sacs in your lungs then fill with these defense cells, bacteria, and fluid. This is what doctors see on a chest X-ray.
How Viruses Affect the Lungs
Viruses can reach your lungs in different ways. Some viruses spread when you touch contaminated objects and then touch your eyes or nose. Others are inhaled through the air. Once in your upper airways, viruses can travel to your lungs. There, they invade and damage the cells lining your airways and air sacs.
Your immune system responds to the infection, which can cause even more lung damage. This inflammation is mainly caused by white blood cells. Besides harming the lungs, many viruses can also affect other body parts. Viruses can also make your body more likely to get bacterial infections. This is why you can sometimes have both viral and bacterial pneumonia at the same time.
How Doctors Diagnose Pneumonia
Doctors usually diagnose pneumonia based on your symptoms and a physical exam. They might also use a chest X-ray. In recent years, lung ultrasound has also become very helpful. It can sometimes be even more accurate than an X-ray.
If you have mild symptoms and a normal lung exam, it is unlikely to be pneumonia. However, it can be hard to tell if the pneumonia is caused by bacteria or a virus.
Diagnosing Pneumonia in Children
The World Health Organization (WHO) has guidelines for diagnosing pneumonia in children. They look for a cough or difficulty breathing, along with fast breathing, chest indrawing (when the skin pulls in around the ribs), or being less alert.
Fast breathing means more than 60 breaths per minute for babies under two months. For children aged two months to one year, it's over 50 breaths per minute. For children aged one to five years, it's over 40 breaths per minute.
Low oxygen levels and chest indrawing are important signs in children. Grunting sounds and flaring nostrils can also be helpful signs in young children.
Diagnosing Pneumonia in Adults
For adults with mild pneumonia, special tests are often not needed. If all your vital signs (like heart rate and breathing) are normal, pneumonia is unlikely. A blood test for C-reactive protein (CRP) can help. If your CRP is low and there are no clear signs of pneumonia, antibiotics are usually not needed.
Another blood test, called procalcitonin, can help doctors decide if antibiotics are needed. If you need to go to the hospital, doctors will usually recommend a pulse oximetry (to check oxygen levels), a chest radiography (X-ray), and blood tests.
Physical Exam for Pneumonia
During a physical exam, doctors might notice low blood pressure, a fast heart rate, or low oxygen levels. Your breathing rate might be faster than normal, sometimes even before other signs appear.
When listening to your chest with a stethoscope, doctors might hear harsh breathing sounds or crackles. They might also tap on your chest. A dull sound can mean there is fluid in your lungs.
Imaging Tests for Pneumonia
A chest radiograph (X-ray) is often used to diagnose pneumonia. For people with mild illness, an X-ray is only needed if symptoms do not improve or the cause is unclear. If someone is sick enough to be hospitalized, an X-ray is recommended.
X-ray findings do not always show how severe the illness is. They also do not reliably tell the difference between bacterial and viral infections. Sometimes, X-rays might look normal in the early stages of the disease. Complications like fluid around the lung (pleural effusion) can also be seen on X-rays.
A CT scan can give more detailed information if an X-ray is unclear. It can also help rule out other problems or find lung abscesses. However, CT scans are more expensive and use more radiation.
Lung ultrasound can also be helpful. It does not use radiation and can be done at the bedside. However, it requires special training to perform and interpret.
Classifying Pneumonia
Pneumonia is often classified by where or how it was caught. This helps doctors decide on the best treatment.
Community-Acquired Pneumonia
This type of pneumonia is caught in everyday places, like your home or school. It is less likely to involve bacteria that are resistant to many medicines. However, if someone has recently been in a healthcare setting, they might be at higher risk for these resistant bacteria.
Healthcare-Associated Pneumonia
This type of pneumonia is linked to recent contact with the healthcare system. This includes hospitals, clinics, or nursing homes. People in hospitals often have other health problems. These can make them more likely to get infections from germs found in hospitals.
Ventilator-associated pneumonia happens in people who are using a breathing machine (ventilator). It is specifically defined as pneumonia that starts more than 48 to 72 hours after a breathing tube is inserted.
Preventing Pneumonia
Preventing pneumonia involves vaccination, keeping your environment clean, and treating other health problems. Experts believe that if everyone took proper preventive steps, many lives could be saved, especially among children.
Vaccinations for Pneumonia
Vaccines can prevent certain bacterial and viral pneumonias in both children and adults. Influenza vaccines (flu shots) are helpful in preventing flu symptoms. The Centers for Disease Control and Prevention (CDC) recommends a yearly flu shot for everyone aged six months and older.
Vaccines against Haemophilus influenzae and Streptococcus pneumoniae are very effective. The pneumococcal conjugate vaccine is recommended for children under two years old. Vaccinating children has also helped reduce these infections in adults.
The CDC recommends that young children and adults aged 50 or older get the pneumococcal vaccine. This is because the risk of infection increases significantly around age 50. Other vaccines that help protect against pneumonia include those for whooping cough, chickenpox, and measles.
Medications for Prevention
During flu outbreaks, medicines like baloxavir or oseltamivir can help prevent the flu. These medicines work against current flu strains. They are most helpful if started soon after exposure to the virus.
Other Ways to Prevent Pneumonia
Stopping smoking and reducing indoor air pollution are important. Smoking is a major risk factor for pneumonia in healthy adults. Washing your hands often and coughing into your sleeve can also help prevent the spread of germs. Wearing surgical masks when sick can also protect others.
Treating other health problems like HIV/AIDS or diabetes mellitus can lower the risk of pneumonia. For babies under six months, exclusive breastfeeding reduces both the risk and severity of the disease. Zinc supplementation in children aged two months to five years also appears to reduce pneumonia rates.
For people with low vitamin C levels, supplements might be suggested. However, there is not strong evidence that vitamin C prevents or treats pneumonia in the general population.
Treating Pneumonia
| CURB-65 Score | ||
|---|---|---|
| Symptom | Points | |
| Confusion | 1 | |
| Urea>7 mmol/L | 1 | (a waste product in blood) |
| Respiratory rate>30 | 1 | (breaths per minute) |
| SBP<90mmHg, DBP<60mmHg | 1 | (low blood pressure) |
| Age>=65 | 1 | |
For most cases of bacterial pneumonia, antibiotics by mouth, rest, pain relievers, and fluids are enough for recovery. However, people with other health conditions, the elderly, or those with severe breathing problems might need more advanced care.
If symptoms get worse or complications happen, hospitalization might be needed. The CURB-65 score helps doctors decide if an adult needs to be admitted to the hospital. For children, if they have breathing difficulties or low oxygen levels, they should be hospitalized.
Over-the-counter cough medicine has not been found to be very effective for pneumonia. There is also not enough evidence to recommend mucolytics (medicines that thin mucus) or vitamin A supplements for children with pneumonia.
Pneumonia can cause serious illness. If organs are not working well, a person might need to go to the intensive care unit. If breathing problems are severe, a breathing machine might be needed.
Treating Bacterial Pneumonia
Antibiotics help people with bacterial pneumonia get better. The first dose of antibiotics should be given as soon as possible. However, using too many antibiotics can lead to bacteria becoming resistant to medicines.
The choice of antibiotic depends on the person's age, health, and where they caught the infection. In many places, amoxicillin is a common first choice for pneumonia caught outside the hospital. For children with mild or moderate symptoms, amoxicillin taken by mouth is also the first choice.
For those who need to be hospitalized, a combination of antibiotics is often used. The treatment usually lasts for a few days. Shorter courses of antibiotics (3-5 days) can be effective for some types of pneumonia.
Sometimes, corticosteroids are added to antibiotic treatment for severe cases. This can help reduce serious problems and even death. However, their general use is still debated by doctors.
Treating Viral Pneumonia
For viral pneumonia caused by the flu, medicines called neuraminidase inhibitors can be used. These include baloxavir or oseltamivir. They work best if started within 48 hours of symptoms appearing.
For other types of viral pneumonia, there are no specific antiviral medicines recommended. Doctors sometimes give antibiotics for viral pneumonia. This is because it can be hard to rule out a bacterial infection at the same time. The use of corticosteroids for viral pneumonia is also a topic of discussion among medical experts.
Treating Aspiration Pneumonia
Aspiration pneumonitis happens when you breathe in food, liquid, or vomit into your lungs. This is usually treated with supportive care. Antibiotics are only given if there is also an infection. The type of antibiotic depends on the suspected germs.
Follow-up Care
Doctors might recommend a follow-up chest X-ray for people with ongoing symptoms, smokers, and those over 50. This helps ensure the lungs have fully recovered.
What to Expect After Pneumonia
With treatment, most bacterial pneumonias get better in 3–6 days. It often takes a few weeks for all symptoms to go away. X-ray findings usually clear up within four weeks. The risk of death is low (less than 1%) for most people.
For older people or those with other lung problems, recovery might take more than 12 weeks. If someone needs to be hospitalized, the risk of death can be higher. Pneumonia is the most common infection caught in hospitals that leads to death.
Complications can happen, especially in older people or those with other health issues. These can include fluid buildup around the lung (empyema), lung abscesses (pockets of infected fluid), or severe breathing problems.
Predicting Outcomes
Doctors use tools like the CURB-65 score to help predict how severe pneumonia might be. This helps them decide if a person needs to be hospitalized.
Fluid Around the Lung and Abscesses
Sometimes, fluid can build up in the space around the lung. If germs infect this fluid, it is called an empyema. Doctors might use a needle to collect and test this fluid. If it is an empyema, the fluid needs to be drained, often with a special tube.
In rare cases, bacteria can form a pocket of infected fluid in the lung called a lung abscess. These can usually be seen on an X-ray or CT scan. Long-term antibiotics are often enough to treat an abscess. Sometimes, a surgeon or radiologist might need to drain it.
Breathing and Circulation Problems
Pneumonia can cause severe breathing problems. The lungs can fill with fluid and become stiff. This can make it very hard to get enough oxygen. In such cases, a breathing machine might be needed.
Pneumonia can also lead to sepsis, which is a serious body-wide response to infection. This usually happens in people with weak immune systems.
How Common is Pneumonia?
Pneumonia is a very common illness. It affects about 450 million people each year around the world. It is a major cause of death for all age groups, leading to about 4 million deaths yearly. Rates are highest in children under five and adults over 75. It is about five times more common in developing countries.
Pneumonia in Children
In 2008, about 156 million children got pneumonia. Most of these cases were in developing countries. In 2010, pneumonia caused 1.3 million deaths in children under five. This was 18% of all deaths in this age group.
Pneumonia is the leading cause of death among children in low-income countries. Many of these deaths happen in newborn babies. The World Health Organization estimates that one in three newborn deaths is due to pneumonia. About half of these deaths could be prevented with effective vaccines.
A Brief History of Pneumonia
Pneumonia has been around for a very long time. The word "pneumonia" comes from the Greek word "pneúmōn," meaning "lung." Ancient Greek doctors like Hippocrates (around 460–370 BC) described its symptoms. He also wrote about draining fluid from the lungs.
In the 1800s, scientists started to understand the cause of pneumonia better. Edwin Klebs first saw bacteria in the airways of people who died from pneumonia in 1875. Later, Carl Friedländer and Albert Fraenkel identified the two most common bacteria that cause pneumonia. Friedländer also developed the Gram stain, a test still used today to identify bacteria.
Sir William Osler, a famous doctor, called pneumonia the "captain of the men of death" in 1918. This was because it was a leading cause of death at the time. He also called it "the old man's friend" because it often brought a quick and painless end to suffering.
Viral pneumonia was first described in 1938 by Hobart Reimann. He noticed the difference between viral and bacterial types of pneumonia.
Many things in the 1900s helped improve how pneumonia was treated. With the discovery of penicillin and other antibiotics, along with better medical care, the number of deaths from pneumonia dropped a lot. Vaccines for children against Haemophilus influenzae began in 1988. Vaccines against Streptococcus pneumoniae for adults started in 1977 and for children in 2000. These vaccines led to a big decrease in pneumonia cases.
Pneumonia in Society
Raising Awareness
Because many people do not know much about pneumonia, November 12th was declared World Pneumonia Day in 2009. This day encourages people and leaders to take action against the disease.
The Cost of Pneumonia
Pneumonia costs a lot of money around the world. The global cost of pneumonia caught outside of hospitals is estimated to be billions of dollars each year. In the United States, the total cost of treating pneumonia was about $20 billion in 2012. A single hospital stay for pneumonia can cost over $15,000.
See also
In Spanish: Neumonía para niños
