Pneumonia

Pneumonia is a discreet illness perhaps preceded by a cold but with fever not necessarily a cough initially, chest pain, sometimes abdominal pain (a notorious trap for the unwary) and the child is undoubtedly unwell. In older children you may with a stethoscope hear characteristic bronchial breathing but in babies and toddlers nothing at all may be heard and all one finds is a fast breathing rate (tachypnoea) and recession with or without a reduced oxygen saturation. It is usually caused by a bacteria called pneumococcus but since vaccination has been introduced this is now less common than before but there are other causes such as mycoplasma, the commonest cause of pneumonia in people of ages 5 to 50 years. Distinguishing between pneumonia and an above average viral illness can be sometimes very difficult which is why antibiotics are frequently prescribed even when with hindsight it was clearly viral. A chest x-ray usually shows a discreet abnormality. Bits of changes on x-ray in several parts of the lungs is rarely due to pneumonia in children.