SYMPTOMS / PRESENTATION
Usually a pneumonia starts out with cold like symptoms. When the cough or breathing worsens to the point where your child has multiple coughing fits, can’t stop coughing, has chest pain, labored breathing, multiple coughing events to the point of vomiting, then its time to start thinking they might have pneumonia. A headache with a cough and stomach pain with a cough are not common, but can be signs of a pneumonia. Classic signs of a pneumonia often shows up on day 3-5 of a cold, but might be sooner or later. The term “walking pneumonia” is used to describe someone whom has a cold / cough that just lingers for days to weeks until they finally go to the doctor and we hear a pneumonia in the chest. Whether the cough is “productive of sputum” or not is less important than a significant worsening of cough or breathing several days into a cold. Occasionally a child will suddenly develop severe respiratory symptoms early in an illness. This should be considered an emergency and you should call the office on an emergency basis or go to the emergency room. If you have think about whether it’s that bad or not, then it’s probably not. When it’s bad you will have no problem knowing.
If you think your child might have signs of a pneumonia, call the office 24/7 and we will help you decide what to do next.
The remainder of this page was originally meant to give out to patients diagnosed with pneumonia in the office.
CAUSE
- Pneumonia’s can be caused by viruses or bacteria
- We cannot often tell which is the cause without a sputum culture which is often impossible to get in a child
- We therefore must treat most with antibiotics
- Most are complications of viral infections
- Exposure to cold weather is not a cause
CONTAGIOUS
- Pneumonia’s are spread by oral, nasal and coughed up secretions
- Pneumonia’s are not that easy to catch
- Pneumonia’s can be very serious to those with certain medical conditions
You should not be around those with these conditions for 5 days after the start of the antibiotics
- Heart disease, any
- Lung disease, especially asthma
- Chronic diseases, especially kidney
- Those in institutions
- Those over 65 or infants
YOU SHOULD BE BETTER IN 3 TO 5 DAYS
- Most patients see improvement within 48 to 72 hours
- Most are much better in 3 to 5 days
- Some may not be completely normal for 1 to 3 weeks
- Some may cough for a few weeks due to inflammation despite the pneumonia being gone
FOLLOW UP
- The follow up can be from 10 days to 3 weeks
- If you have heart or lung disease we may need to see you back sooner
- The follow up visit is essential to ensure the pneumonia is gone
CALL BACK EARLY IF:
- You worsen at any time
- You cannot take the medicine
- You have great difficulty breathing
- You show no signs of improvement in 3 to 5 days
MEDICINES
- You may take Acetaminophen (Tylenol) and / or Ibuprofen (Motrin) to help the fever and discomfort
- Theoretically, cough suppressants may keep you from coughing out the secretions you should be coughing out and therefore should not be used until the cough turns dry.
- If the cough is wet, then drink plenty of water to help loosen the secretions. The goals is to cough them out of the lungs. Swallowing the phlegm is not harmful and is what most children do. Cough EXPECTORANTS (like guaifenesin / plain Robitussin / Mucinex) might help loosen the secretions and help you cough them out. There is little evidence of this but these medicines rarely cause side effect in recommended doses.
- Antihistamines, decongestants and your chronic / routine medicines may be given as usual, but please ask the pharmacist about drug interactions.
