What are the symptoms and signs of pneumonia?

  • The child is generally unwell.
  • Fever, often high fever
  • Cough
  • Breathlessness (difficulty breathing). The breathing is usually fast and shallow.
  • Chest wall indrawing (recession or retraction)
  • Refusal to eat or drink due to shortness of breath
  • The infant may become cyanosed (with a low oxygen saturation).
  • Chest pain may be present.

Fast breathing is the most important sign of pneumonia.

There are some causes of fast breathing, other than lung conditions, such as a high fever or a metabolic acidosis (seen in diarrhoea with severe dehydration). It is best to look for fast breathing when the child is calm and the fever has been lowered.

A normal breathing rate usually excludes pneumonia.

Nothing abnormal may be heard on auscultation with a stethoscope as the classical chest signs of pneumonia (dullness, bronchial breathing, crepitations) are often not present in children with pneumonia.

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