Children & Adolescents Clinic

 Home Parent's Guide

Clinical Reference Systems: Pediatric Advisor 10.0

Pneumonia (for Teenagers)

DESCRIPTION

  • labored breathing (respiratory distress)
  • rapid breathing
  • occasionally painful breathing
  • coughing
  • fever, sometimes with chills
  • abnormal patch (infiltrate) on chest x-ray.

Note: Most rattly breathing is not pneumonia.

CAUSES

Pneumonia is an infection of the lung that causes fluid to collect in the air sacs (alveoli). About 80 percent of pneumonia cases are caused by viruses and 20 percent by bacteria.

Viral pneumonia is usually milder than bacterial pneumonia. Bacterial pneumonia tends to occur more suddenly and cause higher fevers (often over 104 degrees F, or 40 degrees C). Also, usually larger patches (infiltrates) are visible on the chest x-ray, when the lung is affected by bacterial pneumonia than by viral pneumonia.

Because pneumonia is usually a complication of a cold, it is not considered contagious.

EXPECTED COURSE

Only bacterial pneumonia is helped by antibiotics. Because it's difficult to distinguish bacterial from viral pneumonia in all cases, sometimes antibiotics are prescribed for viral pneumonia.

Before antibiotics were available, bacterial pneumonia was dangerous. With antibiotics it improves within 24 to 48 hours. On the other hand, viral pneumonia can continue for 2 to 4 weeks. Recovery from viral pneumonia is gradual but complete.

Most teenagers with pneumonia can be cared for at home. Admission to the hospital for oxygen or intravenous fluids is required in less than 10 percent of cases.

Recurrences of pneumonia are rare.

HOME TREATMENT

  1. Antibiotics

    Teenagers with bacterial pneumonia need an antibiotic prescribed by their physician.

  2. Medicines for fever

    Take acetaminophen or ibuprofen for moderate fever (over 102 degrees F, or 38.9 degrees C). This can be repeated every 4 to 6 hours. These medicines can also help chest pain.

  3. Warm fluids for coughing spasms

    Coughing spasms are often caused by sticky secretions in the back of the throat. Warm liquids usually relax the airway and loosen the secretions. Drink warm lemonade, apple juice, or herbal tea. Sipping chicken broth might also help.

    In addition, breathing warm moist air helps to loosen up the sticky mucus. Fill a humidifier with warm water and breathe in the warm mist it produces. Avoid steam vaporizers because they can cause burns.

    Don't take cough suppressant medicines (such as those containing dextromethorphan) if you have pneumonia. The infectious secretions need to be coughed up.

  4. Humidity

    Dry air tends to make coughs worse. Use a humidifier in your bedroom. The new ultrasonic humidifiers are very quiet and they kill molds and most bacteria that might be in the water.

  5. No smoking

    Tobacco smoke aggravates coughing and makes coughs last longer. Don't smoke nor be around anyone who smokes. If you smoke, the cough will last weeks longer.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

  • Your breathing becomes more labored or difficult.
  • You start feeling very sick.

CALL YOUR PHYSICIAN WITHIN 24 HOURS IF:

  • The fever lasts over 48 hours after you start taking the antibiotic.
  • The cough lasts over 3 weeks.
  • You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems