Learn more about pediatric pneumonia

The severity of pneumonia in children can vary greatly. Generally, the symptoms are milder in older children, while severe cases are more common in infants and young children. Children with pneumonia can recover quickly as long as they are discovered and treated effectively. However, severe cases are prone to complications, and if not treated in time, the prognosis is poor.

1. Incubation period: usually 2 to 3 days or slightly longer.

2. Mild symptoms: Only nasal symptoms, such as runny nose, nasal congestion, sneezing, etc., can also be accompanied by tears, slight cough or throat discomfort, which can be cured naturally within 3 to 4 days. It starts with frequent irritating dry coughs, followed by sputum sounds in the throat, and coughing may be accompanied by vomiting and choking. If infected, it often involves the nasopharynx and pharynx, often with fever, sore throat, tonsillitis and congestion and hyperplasia of the lymphatic tissue on the posterior pharyngeal wall, and sometimes the lymph nodes may be slightly enlarged. Respiration is shallow and faster, the nose is fanning, and some children have mild cyanosis around the mouth and nails. In addition to respiratory symptoms, children may be accompanied by systemic symptoms such as mental depression, irritability, loss of appetite, shivering, diarrhea, etc. It is easy to cause vomiting and diarrhea in infants and young children. Most of them have a high fever, which can last for 2 to 3 days to about 1 week.

3. Severe cases: In addition to the worsening symptoms of mild pneumonia, there are severe symptoms such as persistent high fever and systemic poisoning, accompanied by damage to the functions of other organs.

The body temperature can reach 39-40℃ or higher, accompanied by a sense of cold, headache, general weakness, a sharp loss of appetite, and restless sleep. Soon, the skin may turn slightly red, and herpes and ulcers may occur, which is called herpes pharyngitis. Sometimes the redness and swelling are obvious, affecting the tonsils, and follicular purulent exudates appear. Throat pain and systemic symptoms are added, and nasopharyngeal secretions change from thin to viscous. Respiration is shallow and rapid, reaching more than 80 times per minute, the nose wings are flaring, there are three concave signs, exhalation groans, and obvious cyanosis of the face and extremities, and even pale or grayish complexion. Dense and fine wet rales can be heard in both lungs. The submandibular lymph nodes are significantly enlarged and tenderness is also obvious. If the inflammation spreads to the sinuses, middle ears or trachea, other symptoms will occur, and the systemic symptoms will also be more serious. Among the more serious symptoms, attention should be paid to high fever convulsions and acute abdominal pain, and differential diagnosis should be made from other diseases.

High fever convulsions caused by acute upper respiratory tract infection are mostly seen in infants and young children, and occur several times in succession 1 to 2 days after onset. Children have decreased appetite, vomiting, diarrhea, abdominal distension, and in severe cases, the vomitus is coffee-colored or bloody, bowel sounds disappear, toxic intestinal paralysis, and toxic hepatitis. Acute abdominal pain is sometimes very severe, mostly around the umbilicus, without tenderness, often appears early, mostly temporary, and may be related to hyperperistalsis; but it can also persist, sometimes similar to the symptoms of appendicitis, mostly due to concurrent acute mesenteric lymphadenitis. Infant pneumonia is often accompanied by heart failure. Severe pneumonia is often accompanied by irritability, drowsiness, staring, squinting, eyeballs moving upward; lethargy, even coma, convulsions; conjunctival edema; pupil changes, slow or absent light response; irregular breathing rhythm; expansion of the anterior fontanelle, meningeal irritation signs, and cerebrospinal fluid pressure increased, but other normal conditions are called toxic encephalopathy. In severe cases, intracranial pressure is even higher, and brain herniation may occur. Sometimes metabolic acidosis, respiratory acidosis, etc., may also occur mixed acidosis.

4. Blood picture: In viral infection, the white blood cell count is generally low or within the normal range, but in the early stages the total white blood cell count and the percentage of neutrophils may be higher. In bacterial infection, the total white blood cell count usually increases, and may sometimes decrease in severe cases, but the percentage of neutrophils remains increased.

5. Course of disease: In mild cases, the fever duration ranges from 1 to 2 days to 5 to 6 days. In more severe cases, the high fever can last for 1 to 2 weeks. Occasionally, there may be a long-term low fever, up to several weeks. As the lesions have not been cleared, it takes a long time to recover.

In addition, pneumonia in children may also be complicated by atelectasis, emphysema, bullae, bronchiectasis, etc. Therefore, pneumonia in children is both a common disease and a critical disease, so parents must pay attention to prevention and care.