Signs, Symptoms and Treatment of Pneumonia



The weather is cold and the runny noses and coughing have started. When I worked in primary care pediatrics, I cared for many children who had a runny noses, coughing, congestion and fever. Most of the time, children that had viral illnesses in the upper respiratory tract and they got better quickly with supportive care. What about an infection in the lower respiratory tract? This is called pneumonia, which is when fluid and pus fill the lungs. The condition can be more serious than a regular cold.

What is Pneumonia?

Pneumonia is an infection in either one or both lungs. It can be caused most commonly by viruses or bacteria, but can also be caused by fungi or parasites. It is usually diagnosed with a combination of a physical exam and a chest x-ray. Pneumonia often causes “crackly” and other abnormal chest sounds when you listen to the lungs with a stethoscope. Your child’s pediatrician may also order a sputum (mucous) culture or blood tests.

Signs, Symptoms and Treatment of PneumoniaYou may have heard the term, “walking pneumonia?” This is a specific type of pneumonia generally caused by the “mycoplasma” bacteria. This form of pneumonia is a lesser severe form and children tend to feel well enough to attend school or play despite having a lung infection. If you think your child may have “walking pneumonia” they should still be evaluated by their doctor and stay home from school.

One of the symptoms of pneumonia is low-grade or high fever.

Signs and Symptoms of Pneumonia 

Pneumonia usually starts as an upper respiratory tract infection (in the nose and throat) and a few days later, develops into a lower respiratory tract infection in the lungs. Symptoms depend on the age of the child and the agent causing the pneumonia (virus vs. bacteria). Bacterial pneumonia has a quick onset with a high fever and viral pneumonia develops more gradually and usually looks less serious. Symptoms of pneumonia commonly include a combination of the following:

  • Abdominal pain or vomiting
  • Chest pain
  • Congestion with a lot of mucous
  • Coughing
  • Difficulty breathing
  • Headache
  • Loss of appetite
  • Low-grade or high fevers (maybe with chills or body aches)
  • Rapid breathing
  • Runny nose
  • Wheezing or other type of “funny” sounding breathing

Treating Pneumonia

If your child gets bacterial pneumonia, they’ll be prescribed antibiotics to be taken for one to two weeks. If your child has viral pneumonia, antibiotics will not be prescribed because they don’t work on viruses and antiviral medications are infrequently used in children. Most of the time viral infections need to “run their own course” or go away on their own with supportive therapies alone (controlling fever or pain, giving fluids, keeping the child comfortable). It is sometimes difficult to determine viral from bacterial pneumonia so doctors may opt to treat with antibiotics. Your child’s pediatrician may recommend other therapies such as, 

  • Acetaminophen or Ibuprofen
  • Breathing treatments such as nebulized breathing, oral steroids or inhalers

Some children require hospitalization with more severe forms of pneumonia. Hospitalized children with pneumonia may require supplemental oxygen, IV antibiotics and medication and frequent breathing treatments. 

During the flu season it’s important to recognize whether your child has pneumonia and other illness like the flu. This blog post will help. I encourage you to share it with other parents and caregivers. My next RN Remedies blog post will cover pneumonia prevention and how to care for a child with pneumonia. Keep an eye out for it!