- The child is generally unwell.
- Fever, often high fever
- 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.