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A Family’s Guide to Pneumonia

Cold and flu season can hit your family hard. As the season wears on, immunity systems become more compromised and illnesses can sneak their way into your home. But what happens when an illness more serious than a cold or the flu presents itself? According to pediatrician Dr. Adam Aronson, still maturing immune systems cause children to be more susceptible to pneumonia. Additionally, he notes that “their behavior patterns, such as reduced occurrences of hand-washing and lessened ability to efficiently blow their noses, make children more prone to contract bacteria and viruses that can eventually lead to pneumonia.” By learning how to identify the different causes of pneumonia, how to treat it and how to prevent it, your family will breathe more easily this winter.

Causes of pneumonia

Most pneumonia in children is termed ‘Community Acquired Pneumonia’ (CAP), as it is not contracted in a health care environment, such as a hospital.

The causes of CAP are broken down into two main categories, viral and bacterial:

1. Viral pneumonia - Viral pneumonia, as the name suggests, is caused by a viral infection of some sort. Most pneumonia in very young children is caused by viral infections.

While there are a number of different viruses that can cause pneumonia, Dr. David Harrison, Medical Director at Best Doctors, Inc. and a practicing pediatrician, says that “in children under age one, Respiratory Syncytial Virus (RSV) is the most common cause of pneumonia and viruses in general cause most pneumonia in children under age five.”

2. Bacterial pneumonia - Many different bacterial infections can cause pneumonia. Outside of hospitals, Dr. Harrison attributes streptococcus pneumonia and pneumococcal pneumonia as the most common sources of bacterial pneumonia. In children over five, these bacteria are the most common culprits of pneumonia overall.

Sometimes other situations lead to a case of pneumonia. These cases that do not fall into one of the two main causes of pneumonia are deemed ‘atypical.’ Aspirating food, congenital diseases and allergens can all contribute to an atypical case of pneumonia. The most common type of atypical pneumonia is mycoplasma pneumonia.

Mycoplasma pneumonia, also called ‘walking pneumonia’ due to its sometimes milder symptoms that allow the afflicted individual to continue their day-to-day routines, is caused by bacteria called mycoplasmas. Mycoplasma pneumonia is contagious and, even when treated, can last much longer than other types of pneumonia.

Symptoms and diagnosis

The initial symptoms of pneumonia often look just like the flu or a common cold. Fever, chills, cough and nasal congestion frequently present prior to diagnosis. In some patients, however, the only symptom displayed is unusually rapid breathing or breathing accompanied by grunting or wheezing sounds.

Both Dr. Aronson and Dr. Harrison cite the importance of a clinical exam when the possibility of pneumonia is present. Dr. Aronson notes that if a child appears to be breathing in a more labored manner, they should be seen by a doctor as soon as possible.

If the doctor suspects pneumonia, they may order a chest X-ray for confirmation before treatment begins. They will also want to monitor your child’s oxygen level. If these levels fall too low, your pediatrician may admit your child to the hospital to monitor their treatment.


Doctors will generally treat bacterial pneumonia, including mycoplasma pneumonia, with antibiotics. Viral pneumonia cannot be cured with antibiotics, although an antibiotic may be prescribed to offset secondary infections.

Dr. Aronson suggests that because a virus must run its course, supportive care for viral pneumonia include use of a vaporizer, nebulizer breathing treatments and possible steroid intervention to alleviate symptoms and heal the lungs. Antibiotics will only be used for a case of viral pneumonia if there are signs of secondary infections, such as an ear infection.

With treatment, most types of bacterial pneumonia can be cured within one to two weeks. Viral pneumonia may last a bit longer, and mycoplasma pneumonia may take four to six weeks to resolve completely.

Reducing your child’s risk

Dr. Harrison stresses immunizations as the most important line of defense for children in the prevention of pneumonia. “An ounce of prevention is truly worth a pound of cure,” he says. Pneumonia can be prevented, in many cases, by ensuring that your child’s vaccines are up-to-date. Pneumococcal, Haemophilus influenzae type b (Hib), pertussis (whooping cough), varicella (chickenpox), measles and flu vaccines can help you sidestep some of the many illnesses that lead to pneumonia.

Additionally, encouraging hygienic practices such as regular hand-washing and coughing or sneezing into a tissue or an elbow or sleeve can help you reduce the spreading of germs to or between children.

Pneumonia seems scary, but most cases that are treated promptly and appropriately are quickly resolved. Dr. Harrison notes that “most coughs and fevers are not pneumonia,” but treating illnesses before they have a chance to progress will give your child the upper hand.

If you notice signs or symptoms of pneumonia, consult your child’s doctor. If you are concerned, go with your gut. It can only take a few days for pneumonia to set in and a mild cough on Thursday evening can turn into a bad case of pneumonia come Monday morning.

Beth writes from Silver Spring where she and her husband are raising their four children.


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