Pneumonia is an infection of the child’s lungs. Pneumonia usually clears up rapidly with usual antibiotics and would not occur again. Some children get repeated or frequent episodes of pneumonia. Here we discuss why some children get repeated pneumonia episodes and how they are managed. Since many children have an underlying medical condition leading to repeated episodes of pneumonia it is imperative to identify these conditions.
What are the causes of repeated episodes of pneumonia in children?
Some of the common conditions causing repeated episodes of pneumonia in children are gastroesophageal reflux disease, suppurative lung diseases or bronchiectasis, congenital cardiac defects, repeated aspirations and asthma. Some rare causes of repeated episodes of pneumonia in children are abnormal airways like tracheomalacia, bronchomalacia, immunodeficiency disorders, cystic fibrosis and repeated bleeding into the lungs called pulmonary hemosiderosis.
When does pneumonia need to be investigated further?
Repeated episodes of pneumonia is a red flag that an underlying disease process may be present. Hence, all children with repeated episodes of pneumonia or a single episode not clearing up need further evaluation for an underlying cause.
How would we evaluate a child with repeated episodes of pneumonia?
Evaluation of children with repeated episodes of pneumonia requires a detailed history and examination. This is followed by review of all outside investigations including chest X-rays. Further investigations are done on a case-to-case basis. These investigations might include a CT Scan of the chest; a flexible bronchoscopy for checking airways from inside, studies for gastro-esophageal reflux disease, swallow study to look for aspiration, etc. Blood samples for immune deficiency work-up might be needed. A sweat chloride test for diagnosis of cystic fibrosis is required for a few children.
How do we treat a child with repeated episodes of pneumonia?
Treatment of repeated episodes of pneumonia requires treating the current pneumonia episode and also treating the underlying cause. The aim of treating the current episode is to improve symptoms and prevent complications. This treatment includes antibiotics, bronchodialtors and supportive care.
If your child is having repeated episodes of pneumonia you need to consult a pediatric pulmonologist for evaluation and further treatment.