What are the signs and symptoms of pneumonia in adolescents?

From the Guidelines

Pneumonia in adolescents typically presents with respiratory symptoms including cough, fever, shortness of breath, rapid breathing, and chest pain that worsens with deep breathing or coughing, and diagnosis typically involves chest X-ray and laboratory tests to determine the causative organism and appropriate treatment. The signs and symptoms of pneumonia in adolescents can vary, but common symptoms include:

• Cough, which may be productive with sputum
• Fever
• Shortness of breath
• Rapid breathing
• Chest pain that worsens with deep breathing or coughing
• Fatigue
• Decreased appetite
• Headache
• General malaise Physical examination may reveal:
• Decreased breath sounds
• Crackles or rales when listening to the lungs
• Wheezing
• Signs of respiratory distress, including nasal flaring, use of accessory muscles for breathing, and cyanosis (bluish discoloration of lips or skin)
• Tachycardia (rapid heart rate) and tachypnea (rapid breathing) Atypical pneumonia, commonly caused by Mycoplasma pneumoniae in this age group, may present more gradually with persistent cough, low-grade fever, and fewer respiratory symptoms 1. It's essential to seek medical attention promptly if pneumonia is suspected, as adolescents can deteriorate quickly despite their otherwise healthy status. The most recent and highest quality study, published in 2011 by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America, provides guidelines for the management of community-acquired pneumonia in infants and children older than 3 months of age, including adolescents 1. This study emphasizes the importance of clinical evaluation, laboratory tests, and chest X-ray in diagnosing pneumonia and determining the appropriate treatment. In addition, the study highlights the need for prompt medical attention and hospitalization if necessary, especially in cases of severe pneumonia or respiratory distress 1. Overall, the diagnosis and treatment of pneumonia in adolescents require a comprehensive approach, taking into account the patient's symptoms, physical examination, laboratory tests, and chest X-ray results, as well as the potential for complications and the need for prompt medical attention.

From the Research

Signs and Symptoms of Pneumonia in Adolescents

• Cough, wheeze, coryza, crepitations, fever, rhonchi, shortness of breath, chest pain, diarrhea, myalgia, and headache are common symptoms of pneumonia in adolescents 2
• The presence of chest pain can more than double the probability of Mycoplasma pneumoniae, a significant cause of community-acquired pneumonia in children and adolescents 2
• Wheeze is 12% more likely to be absent in children with Mycoplasma pneumoniae 2
• Crepitations may be associated with Mycoplasma pneumoniae, but this finding is of borderline statistical significance 2

Clinical Manifestations

• Presenting symptoms of pneumonia typically include cough, pleuritic chest pain, fever, fatigue, and loss of appetite 3
• Adolescents may also experience headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms 3

Diagnosis and Treatment

• Pneumonia cannot be reliably diagnosed in children and adolescents with community-acquired pneumonia based on clinical symptoms and signs alone 2
• Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is key for effective pharmacologic selection and treatment of pneumonia 3
• Azithromycin and amoxicillin-clavulanate are effective treatments for community-acquired pneumonia, with clinical success rates of 92.6% and 93.1%, respectively 4