Pneumonia: Often mistaken for the common cold in children

AS soon as a child presents with cold or flu-like symptoms, it is a reflex for many parents to self-diagnose and begin treatment with over-the-counter medication or their assorted collection of cold/flu fighting herbs. And while they may be right and their efforts might be successful, paediatrician Dr Anona Griffith recommends that you pay close attention to the symptoms that your child presents, because you may be misdiagnosing a more serious condition such as pneumonia.

“Pneumonia is the term used to describe infection of the lungs — the lower part of the respiratory tract — which is the main part of the respiratory system. It is responsible for the exchange of oxygen from inspired or breathed-in the air into the bloodstream, and carbon dioxide that is passed out of the bloodstream into the air to be expired,” Dr Griffith explained.

She said that the infection, which can be life-threatening if untreated or undiagnosed, is commonly caused by viruses followed by bacteria as well as other organisms that are mainly airborne and transmitted to young children from other infected individuals in their environment.

“The organisms as well as the viruses and bacteria which cause the infection are mainly airborne. Common organisms to include influenza, rhinovirus, parainfluenza virus, RSV (respiratory syncytial virus) and streptococcus pneumonia are notorious for causing the severe form of the condition,” Dr Griffith outlined.

In addition to these causes, Dr Griffith noted that certain environmental conditions and practices also contribute to the development of pneumonia, including smoking, pollution, and overcrowding.

“Pneumonia often starts off mimicking symptoms of the cold such as a little cough, then coughing and fever usually get worse. What happens is that the infection goes hand in hand with inflammation, hence there is swelling of the airway as well as the production of excessive amounts of mucus in response to exposure to the infectious agent. Ordinarily the airways are naturally equipped with cells that help to remove small particles and debris from the airway; however, in the presence of infection and inflammation, these become overwhelmed and disabled in their ability to clear the airway, leading to shortness of breath, increase in respiratory rate, coughing and fever,” Dr Griffith advised.

She warned that once these symptoms are identified, medical attention must be sought urgently.

The diagnosis of pneumonia is made based on the history of the condition as well as the examination findings. Blood investigations will assist in further identifying the causative agents as well as the degree of respiratory compromise caused by the infection. In addition, X-rays are used to identify the portion of lung affected and other imaging sources may become necessary.

To adequately treat bacterial pneumonia, Dr Griffith said that antibiotics are administered, while in severe cases it may require hospitalisation.

Protection against this infectious disease is possible, and Dr Griffith said much of it has to do with proper hygiene and lifestyle choices. She encourages parents to breastfeed and aim for adequate nutrition for themselves as well as their children, including fresh fruits and vegetables.

Other preventative measures include:

•Proper hygiene — hand washing, reducing smoking and pollutant exposure

•Vaccination, which includes the pneumococcal vaccine, especially for the vulnerable population such as those with sickle-cell disease; congenital heart disease; children who were premature at birth and required supplemental oxygen for breathing for a prolonged period after birth; children whose immune systems are immunocompromised, such as those with cancer undergoing chemotherapy; those on high-dose, prolonged steroid therapy; and HIV-infected patients since they are at a greater risk of developing the condition.

Dr Griffith also advised that follow-up care may be necessary for those patients predisposed to pneumonia. Enquiries about vaccines should be directed to your paediatrician.