Respiratory expert: About 10%-15% of children who do not have obvious cough but show pneumonia on examination

Recently, many parents have reported that their children show no obvious cough, but upon examination at the hospital, they are found to have pneumonia. Why does pneumonia develop when the cough is not apparent, and how can one quickly detect tendencies of pneumonia in these children?According to respiratory specialists, in the recent cases of Mycoplasma pneumonia infection, there is indeed a portion of children with no obvious cough, and they may not even have a significant fever. These children show no significant abnormalities upon lung auscultation, but imaging examinations reveal pneumonia. Such cases account for approximately 10%-15% of affected children. Pneumonia is inflammation of the lungs caused by pathogenic infections. Clinical diagnosis of pneumonia is mainly based on imaging examinations of the lungs. While coughing is a common symptom of pneumonia, not all patients exhibit it.

Respiratory Specialist: About 10%-15% of Children with Pneumonia Have No Obvious Cough

Respiratory doctors explain that there are three possible considerations for this situation. Firstly, considering the age factor, children under the age of 1 often do not have a very noticeable cough. Instead, they may experience a decrease in milk intake, poor mood, occasional fever or no increase in body temperature, drooling, coughing, shortness of breath, cyanosis of the lips, rapid breathing, and other non-typical signs of pneumonia. Any of these conditions can be indicative of pneumonia in infants. Secondly, looking at the infectious pathogen, patients with viral or bacterial pneumonia are more likely to experience symptoms such as coughing and producing sputum. However, for fungal pneumonia, tuberculosis, and other types of pneumonia, coughing may not be the primary symptom.

Furthermore, the symptoms of pneumonia can vary due to individual differences. Some patients may only exhibit symptoms like fever, fatigue, and shortness of breath, without coughing. As the condition worsens, patients may experience shortness of breath, chest pain, and altered consciousness. In summary, not all pneumonia patients will necessarily have a cough, but coughing is one of the typical symptoms of pneumonia.

Coughing is a common symptom of pneumonia and serves as a defense mechanism. However, the severity of coughing varies among individuals. Cough receptors are mainly distributed in the throat and large airways, so the severity of coughing depends on the primary affected areas by different pathogens. For example, Mycoplasma pneumonia often affects the epithelial cilia cells of the airways, and its toxin is homologous to pertussis toxin, resulting in a relatively severe cough. In some cases of viral pneumonia, small airways are affected, leading to pronounced wheezing symptoms. Some bacterial pneumonia shows significant alveolar inflammation early on, and coughing may intensify during the recovery period.

Doctors advise that for children under the age of 5, the most reliable criterion for judging pneumonia is shortness of breath, which means a respiratory rate exceeding the standard for the corresponding age group. For instance, for children under 12 months, a rate exceeding 60 breaths per minute, for children aged 2-12 months, a rate exceeding 50 breaths per minute, and for children aged 12 months to 3 years, a rate exceeding 40 breaths per minute. Additionally, assessing mental status, body temperature, the presence of wheezing, and conducting chest X-ray examinations when necessary can also aid in diagnosis.