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JAMA Patient Page
August 1, 2017

Childhood Pneumonia

JAMA. 2017;318(5):490. doi:10.1001/jama.2017.9428

Pneumonia is a serious infection in the lung that is usually caused by a virus or bacteria.

In school-aged children, Streptococcus pneumoniae (pneumococcus) and Mycoplasma pneumoniae are the most common causes of bacterial pneumonia. Viruses such as influenza and respiratory syncytial virus can also cause pneumonia, particularly in younger children. Often, it can be difficult to determine if pneumonia is caused by bacteria or a virus. Bacterial pneumonia may be preceded by viral upper respiratory tract infections.

Symptoms

Most children with pneumonia have cough or rapid breathing. Older children may have chest pain or shortness of breath.

Symptoms of pneumonia can range from mild to severe, depending on factors such as age, extent of lung involvement, and the type of organism causing the infection.

Diagnosis

Pneumonia can be diagnosed by a physician based on measurement of vital signs (including oxygen level), work of breathing, and physical examination findings. A chest radiograph (x-ray) is sometimes done to diagnose pneumonia or to identify complications of pneumonia.

Treatment

Bacterial pneumonia is treated with antibiotics. If the pneumonia is suspected to be caused by a virus, antibiotics are not helpful.

Sometimes, a child may need to be hospitalized to treat pneumonia. This decision is made by the doctor taking care of the patient, generally based on the degree of breathing difficulty, need for extra oxygen, or need for intravenous antibiotics and fluids. Pneumonia is a leading cause of hospitalization among children, especially among infants and young children.

Prevention

Widespread childhood immunizations, particularly the pneumococcal vaccine, have substantially reduced the rate of bacterial pneumonia in children. The influenza vaccine can also help prevent both viral and secondary bacterial pneumonias. Spread of pneumonia can be prevented by good hygiene practices, including hand washing and use of disinfectants on frequently used surfaces.

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Article Information

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Bachur reports receipt of personal fees from UpToDate, the American Board of Pediatrics, and Wolters-Kluwer and grants from Astute Medical. Dr Simel reports receipt of honoraria for contributions to JAMAEvidence.com. Dr Neuman reports receipt of royalties from UpToDate and a stipend as assistant editor for Pediatrics and is a co-inventor of a device to measure capillary refill. No other disclosures were reported.

Source: Shah SN, Bachur RG, Simel DL, Neuman MI. Does this child have pneumonia? the Rational Clinical Examination systematic review. JAMA. doi:10.1001/jama.2017.9039

Topic: Pediatric Diseases

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