Pneumonia (after diagnosis)

Advice intended for parents/carers taking their child home after seeing a healthcare professional

Pneumonia is infection of one or both of the lungs and can be caused by viruses and bacteria. Usually only part of the lung is affected. It can affect people of any age, but is more common and can be more serious in young children.

Symptoms

Symptoms of pneumonia can come on over 24-48 hours or more slowly over several days. A child with pneumonia is usually very tired and looks unwell.

Common symptoms include:

• Fever
• Breathing faster than usual
• Using extra effort when breathing
• Being too breathless to feed (young children)
• Cough
• Chest pain when breathing or coughing

These symptoms usually pass within 4-7 days.

Causes

Pneumonia is caused by bacteria and viruses, of which there are many types. These viruses are catching (contagious) meaning they can spread easily between people. Viruses are more common in the winter and young children are particularly at risk of catching them. Having your child immunised, including the flu vaccine, reduces the risk of them getting pneumonia.

Treatment

Mild pneumonia often gets better by itself without antibiotic treatment. If your child's fever lasts for more than 2 days and they are breathing more quickly than usual, they may need treatment with oral antibiotics, usually Amoxicillin.

Treatment with intravenous antibiotics (given into a vein) is usually only needed for severe cases or those that have not responded to antibiotics given by mouth. Your child may also need extra help with their breathing, such as being given oxygen.

Children who need intravenous antibiotics are usually admitted to hospital. Some children may be able to be at home for part, or all of, the intravenous antibiotic course. These children would come into hospital once a day for someone to look at them and for their antibiotics to be given.

The decision on when to change from intravenous to oral antibiotics (tablets or liquid) will be made by the medical team caring for your child. this will depend on how quickly your child responds to treatment (improvement in fever, breathing difficulty and sometimes their blood tests) and whether your child has other health conditions. Antibiotics are usually given for a total of 5 to 7 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.

Complications

Most children recover without any complications. Complications of pneumonia are rare, but can be serious, including:

• Empyema - a collection of pus (infection) in the space that surrounds the lung
• Septicaemia - overwhelming infection that can affect the whole body, including vital organs

If you are concerned that your child's condition is getting worse, you should contact your discharging ward.

Things to look out for include:

• Worsening of fever
• Fast heart beat
• Breathing rate getting quicker and your child finding it harder to breath
• Blue lips
• Changes in behaviour, such as confusion or disorientation

Prevention

It is difficult to prevent pneumonia, however good standards of hygiene can help prevent germs from spreading.

• Washing hands regularly and thoroughly
• Ensure that prescribed courses of antibiotics are completed, even if they are feeling better. If the course is stopped part way through, this can lead to the bacteria becoming resistant to the antibiotic and therefore not being eradicated

It can take a couple of weeks for a child to fully recover. During this time the immune system will be clearing up the pneumonia. Coughing up the mucus on the chest is part of that process; hence the cough can last for 1-2 weeks or even longer. If you are worried that the cough is getting worse again, or not getting better after 4 weeks, you should take your child to see their GP. Most children make a full recovery from pneumonia with no lasting effects. Some children may be followed up by the doctors at the hospital with an x-ray.