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A Diagnosis is made by detecting bacteria on microscopic examination of the sputum by a chest X-Ray or by blood test (Mycoplasma complement fixations, and cold agglutinins).
When physicians diagnose someone with walking pneumonia, they are usually referring to an infection with an organism called Mycoplasma pneumoniae. (Apart from being a pain, mycoplasmas are kind of cool. They are the smallest self-replicating biologic systems known.) Mycoplasma is a major cause of respiratory infections in school-aged children and young adults. It is most common between the ages of 5 and 15, accounting for 70% of pneumonias in children aged 9 to 15.
The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis of pneumonia is based on symptoms and listening to your chest with a stethoscope. In addition, tests may include:
- Chest x-ray
- CT scan a type of x-ray that uses a computer to make pictures of structures inside the chest
- Blood tests
- Bronchoscopy direct examination of airways
- Sputum culture testing mucus coughed up from deep in the lungs
- Pulse oximetry measures the amount of oxygen in the blood
- Arterial blood gas measures oxygen, carbon dioxide and acid in the blood
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Erythromycin is the antibiotic most often used. Other antibiotics that can also be used include Doxycycline, Azithromycin, Clarithromycin, or Ciprofloxacin.
- Antibiotics - these are usually used to help fight the bacterial infection. However, some pneumonia is caused by a virus, in which case antibiotics are not helpful. Only your doctor can decide if it is bacterial or viral.
- Chest pounding (percussion) therapy - this is VERY IMPORTANT. Four to six times each day, take your child into the bathroom with the hot shower on and let him breathe the steam for 10 minutes. Use your cupped hand to firmly clap on your child's chest, concentrating on the area that the pneumonia is. Pound rapidly for one minute, then rest a minute, then continue again on and off for ten minutes. This will shake the mucus and pus pocket loose so your child can cough it up. Encourage coughing during this time.
- Cough medicine - do not suppress the cough during the day. Your child needs to cough it up. You can use an expectorant (to loosen the mucus stuck in the chest) during the day. At night (or during the day if your child is miserable from coughing) you can use a combination expectorant and cough suppressant if your child is coughing a lot. If the cough is not too frequent, then don't use a suppressant.
The elderly, people with underlying medical conditions, and people who are having difficulty breathing are usually treated for pneumonia in a hospital. The most common treatment is antibiotics, usually given intravenously, oxygen therapy, and intravenous fluids. Others can be treated with oral antibiotics at home. The type of antibiotic you are given depends upon the type of pneumonia you have. All patients with pneumonia require complete bed rest and plenty of fluids. Drinking warm fluids can help thin secretions in the lungs so it is easier to cough them up. Your doctor may also recommend using a humidifier to keep the air you breathe moist. You can help relieve fever and pain with acetaminophen or ibuprofen. However, never give a child aspirin, which can cause a serious condition called Reyes syndrome. Most people recover completely from pneumonia. However, some people are more likely to develop complications despite treatment. These include those with an underlying illness, the very young, and the very old.
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