Pneumonia is an inflammation of the lung, usually caused by an infection. Three common causes are bacteria, viruses and fungi. You can also get pneumonia by accidentally inhaling a liquid or chemical. People most at risk are older than 65 or younger than 2 years of age, or already have health problems.

About 80% of pneumonia cases are caused by viruses and 20% by bacteria. Viral pneumonia is usually milder than bacterial pneumonia. Bacterial pneumonia tends to occur more suddenly and cause higher fevers (often over 40°C, or 104°F). Pneumonia is usually a complication of a cold. Although colds can be passed from person to person, bacterial pneumonia is not considered contagious.

Symptoms of pneumonia vary, depending on the age of the child and the cause of the pneumonia. Common symptoms include:

• fever
• chills
• cough
• unusually rapid breathing
• breathing with grunting or wheezing sounds
• labored breathing that makes a child’s rib muscles retract (when muscles under the rib cage or between ribs draw inward with each breath)
• vomiting
• chest pain
• abdominal pain
• decreased activity
• loss of appetite (in older kids) or poor feeding (in infants)
• in extreme cases, bluish or gray color of the lips and fingernails

Sometimes a child’s only symptom is rapid breathing. Sometimes when the pneumonia is in the lower part of the lungs near the abdomen, there may be no breathing problems, but there may be fever and abdominal pain or vomiting.

Most cases of pneumonia can be treated without hospitalization. Typically, oral antibiotics, rest, fluids, and home care are sufficient for complete resolution. However, people with pneumonia who are having trouble breathing, people with other medical problems, and the elderly or children may need more advanced treatment. If the symptoms get worse, the pneumonia does not improve with home treatment, or complications occur, the person will often have to be hospitalized.

Vaccines can prevent infections by viruses or bacteria that cause some types of pneumonia. Kids usually receive routine immunizations against Haemophilus influenzae and pertussis (whooping cough) beginning at 2 months of age. (The pertussis immunization is the “P” part of the routine DTaP injection.) Vaccines are now also given against the pneumococcus organism (PCV), a common cause of bacterial pneumonia.

Children with chronic illnesses, who are at special risk for other types of pneumonia, may receive additional vaccines or protective immune medication. The flu vaccine is strongly recommended for kids with chronic illnesses such as chronic heart or lung disorders or asthma, as well as otherwise healthy children ages 6 months through 19 years.