Pneumonia in Children and Adults: When to Seek Help

Pneumonia: A Serious Threat Across All Ages

Pneumonia remains one of the leading causes of death in the Philippines, claiming lives across all age groups but particularly devastating for children under 5 and adults over 65. Despite being treatable, pneumonia kills approximately 50,000 Filipinos annually—many of whom could have survived with earlier detection and proper treatment.

Understanding pneumonia—its symptoms, causes, and warning signs—can help you make decisions that save lives. This is especially critical for parents of young children and caregivers of elderly family members, who are most vulnerable to this serious infection.

"Pneumonia is often called 'the old man's friend' because it historically provided a relatively peaceful death for the elderly. But today, with proper treatment and vaccination, pneumonia doesn't have to be deadly. The key is recognizing it early and seeking appropriate care." — Philippine College of Chest Physicians

What is Pneumonia?

Pneumonia is an infection that inflames the air sacs (alveoli) in one or both lungs. These tiny sacs, normally filled with air during breathing, instead fill with fluid or pus, causing cough with phlegm, fever, chills, and difficulty breathing.

Types of Pneumonia by Cause

Types by Location of Acquisition

• Community-acquired pneumonia (CAP): Contracted outside of hospitals—the most common type
• Hospital-acquired pneumonia (HAP): Develops 48+ hours after hospital admission; often more resistant to antibiotics
• Ventilator-associated pneumonia (VAP): Develops in patients on mechanical ventilation

Pneumonia Symptoms in Adults

Symptoms can range from mild to severe and may develop rapidly or gradually:

• Cough: Often producing phlegm that may be green, yellow, rusty, or blood-tinged
• Fever: Can be high (39-40°C) with chills and sweating; elderly may have low-grade or no fever
• Shortness of breath: Difficulty breathing, especially with activity
• Chest pain: Sharp or stabbing pain that worsens with deep breathing or coughing (pleuritic pain)
• Rapid, shallow breathing: Body's attempt to compensate for reduced oxygen exchange
• Fatigue: Profound tiredness and weakness
• Loss of appetite: Often accompanied by nausea and vomiting
• Confusion: Especially common in elderly patients; may be the primary symptom
• Headache and muscle aches: Particularly in viral pneumonia

Pneumonia in Children: Recognizing the Signs

Children, especially those under 5, are particularly vulnerable to pneumonia. In the Philippines, pneumonia is the leading cause of death in children aged 1-4 years. Parents and caregivers must recognize the warning signs:

Symptoms in Infants and Young Children

• Fast breathing (tachypnea): Most reliable sign
  • Under 2 months: 60+ breaths/minute
  • 2-12 months: 50+ breaths/minute
  • 1-5 years: 40+ breaths/minute
• Difficulty breathing: Visible effort to breathe
• Chest retractions: Skin pulling in between ribs, under ribcage, or at the neck with each breath
• Nasal flaring: Nostrils widening with breathing
• Grunting: Sound at end of each breath
• Fever: May be high or absent in very young infants
• Cough: May be absent in infants
• Poor feeding: Refusing breast or bottle
• Lethargy: Unusually tired, difficult to wake
• Irritability: Inconsolable crying
• Cyanosis: Blue or gray color around lips or fingernails (emergency sign)

When to Seek Medical Care

Not all respiratory infections require immediate medical attention, but pneumonia can deteriorate rapidly. Seek care if:

Adults

• Difficulty breathing or shortness of breath at rest
• Fever above 39°C (102°F) that persists despite treatment
• Cough producing large amounts of discolored phlegm
• Chest pain when breathing
• Confusion or altered mental state (especially in elderly)
• Symptoms worsening after initially improving
• Underlying conditions: diabetes, heart disease, lung disease, weakened immune system

Children

• Any emergency signs listed above
• Fast breathing for age
• Fever lasting more than 3 days
• Refusing to eat or drink
• Worsening symptoms after initial improvement
• Age under 3 months with any fever

Diagnosis and Treatment

How Pneumonia is Diagnosed

• Physical examination: Listening to lungs with stethoscope for crackling or decreased breath sounds
• Chest X-ray: Shows area of infection in lungs; confirms diagnosis
• Blood tests: White blood cell count, inflammatory markers
• Pulse oximetry: Measures oxygen levels in blood
• Sputum culture: Identifies bacterial cause (if bacterial pneumonia suspected)
• Additional tests: CT scan, bronchoscopy, or pleural fluid analysis in severe or unusual cases

Treatment

Preventing Pneumonia

Many cases of pneumonia are preventable through vaccination and healthy practices:

Vaccination

• Pneumococcal vaccines: Protect against the most common bacterial cause
  • PCV13 (Prevnar 13): For children and high-risk adults
  • PPSV23 (Pneumovax 23): For adults 65+ and high-risk groups
• Influenza vaccine: Annual flu shot reduces viral pneumonia risk
• COVID-19 vaccine: Reduces severe COVID-related pneumonia
• Childhood vaccines: Hib, measles, and pertussis vaccines prevent infections that can lead to pneumonia

Healthy Habits

• Hand hygiene: Wash hands frequently with soap and water
• Don't smoke: Smoking damages lung defenses
• Breastfeed infants: Provides antibodies that protect against infections
• Good nutrition: Supports immune function
• Manage chronic conditions: Keep diabetes, heart disease, and lung conditions well-controlled
• Avoid close contact with sick individuals
• Cover coughs and sneezes

"The best treatment for pneumonia is prevention. Get vaccinated, practice good hygiene, and don't ignore respiratory symptoms. Early treatment saves lives—especially in children and the elderly." — Dr. Ricardo Santos, Pulmonologist

Recovery and Complications

Most healthy adults recover from pneumonia within 1-3 weeks, though fatigue may persist for a month or more. Older adults, children, and those with weakened immune systems may take longer.

Potential Complications

• Bacteremia: Bacteria entering the bloodstream
• Lung abscess: Collection of pus in the lung
• Pleural effusion: Fluid around the lungs
• Respiratory failure: Inability to breathe adequately
• Sepsis: Life-threatening infection response

Protect Your Family

Pneumonia is serious but often preventable and treatable. Know the symptoms, especially in vulnerable family members. Don't delay seeking care when warning signs appear. Ensure your family is up-to-date on vaccinations.

Breathe easier knowing you're prepared. Early recognition and prompt treatment can mean the difference between a week of illness and a life-threatening emergency.