Distinguishing pneumonia, common cough from pertussis in children

This is an automatically translated article.

This article is professionally consulted by Resident Doctor, Doctor Nguyen Hung Tien - Resident Doctor of Pediatrics - Neonatology - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital.
Due to the weak resistance, children are very susceptible to a number of respiratory-related diseases, however, many mothers still cannot distinguish some common respiratory diseases in children such as pneumonia, cough caused by colds, etc. cold and whooping cough. This causes great consequences in hospital treatment for children.
Here are the characteristics that help parents distinguish pneumonia, cough caused by cold with whooping cough in children:

1. Pneumonia

In children with pneumonia, some of the following symptoms are common:
Rapid breathing is a sign with the highest diagnostic value for pneumonia. According to WHO standards, children under 5 years of age have rapid breathing as follows: Breathing rate is 60 times/minute or more for children under 2 months old; Breathing rate of 50 breaths/minute or more for children 2 months - 12 months old; Breathing rate from 40 breaths/minute or more for children 1 - 5 years old. Parents or caregivers can count breathing when the child is lying still or sleeping and must count for 1 minute, for accurate results, count 2-3 times.
Chest indrawing is also a sign to diagnose pneumonia. To detect this sign, look at the lower part of the ribcage (1/3) that is recessed when the child inhales. Note that, when only the soft midrib or supraclavicular area is seen, it is not a sign of thoracic indrawing. On the other hand, in children under 2 months of age, if only slight thoracic indrawing is not valid, there is no classification value because the rib cage of young children is still soft and weak, so when breathing normally, it may also be slightly indented. Therefore, in these children, strong chest indrawing (deep and easily visible) is valuable for the diagnosis of pneumonia. High fever and wheezing are possible in older children with Mycoplasma pneumonia. But this symptom is also easy to mistake for asthma if there is no chest X-ray. Nasal bulging, moaning, poor feeding, irritability, and abnormalities on pulmonary examination vary with the age of the patient and the severity of the pneumonia. Symptoms such as abortion, moaning, and central cyanosis may be suggestive of hypoxia, but these symptoms are not highly sensitive or specific.

2. Cough due to cold

The cough is often accompanied by mucus, in addition to a runny nose, sore throat, watery eyes, and loss of appetite. Just a common cold, can last 1-2 weeks, the most severe (and most contagious) is during the first few days. Children get an average of 6-10 colds a year. Because colds are caused by viruses, antibiotics won't do anything.
If the baby is too young to blow his nose, please use specialized saline nasal drops and a nasal aspirator to help remove mucus, help your baby reduce itchy nose, itchy throat causing cough. A humidifier and warm shower are also very helpful at this time.
Also, you must consult your doctor before giving any over-the-counter medicines to your child, and don't forget to ask if your child's age is okay to suck on cough drops.

3. Whooping cough

Whooping cough is an acute respiratory infection that can occur in young children. Whooping cough is very contagious, causing disease in almost 100% of susceptible individuals who come into contact with droplets containing the bacteria. This is a disease in the national vaccination program when the baby is 2-3-4 months old and repeated at 18 months.
Pertussis bacteria attack the lining of the respiratory tract, causing severe inflammation that narrows the airways. Children who are not fully immunized are at increased risk of pertussis. However, infants are at greatest risk. Children under 6 months are not strong enough, so the pertussis sound is not very clear, so it will be difficult for parents to detect. Instead, when a pertussis bout can culminate, your baby will vomit, stop breathing, and his lips may turn purple because he's not getting enough oxygen.
Whooping cough disease develops in 3 main stages:
+ In the early stages, children cough for 1-2 weeks with symptoms of an upper respiratory tract infection that are not obvious such as runny nose, mild cough (most are cough at night). At this stage, the differential diagnosis of pertussis is difficult because the symptoms of pertussis are similar to those of common colds and respiratory infections.
+ In the full-blown stage (from the next 1-2 weeks), the child begins to cough more, cough intermittently, and choke. After coughing episodes, children often turn red or purple in their whole body due to coughing too much, not having enough oxygen to breathe, gradually causing respiratory failure. It is also the intense long coughs that make children tired, exhausted, anorexia leading to malnutrition.
+ Stage 3 of whooping cough is the recovery phase, the children's coughs are shortened, the number of coughs is reduced.
Treatment of pertussis:
With children under 6 months old, parents need to take the baby to the hospital for inpatient treatment and monitoring in a special emergency room. Older children and uncomplicated pertussis will be treated with specific antibiotics for 10-14 days as prescribed by the doctor. Parents absolutely do not arbitrarily use antihistamines, expectorants, cough suppressants, sedatives, ... to treat pertussis for children because it is both ineffective and easy to cause side effects.
Families with infants suffering from pertussis can be treated with Erythromycin at a dose of 30-50mg/kg/day, divided into 4 doses or Cotrimoxazol 30-50mg/kg/day; taken with Salbutamol 0.2mg/kg/day; Prednisolone 1-2mg/kg/day. Note: Do not give Cotrimoxazol to infants.
In addition to using medicine, parents also need to pay attention to the process of caring for infants with whooping cough by:
Use physiological saline to clean the baby's teeth and nose and throat, and keep the child's personal hygiene . Keep your body warm to prevent your baby from catching a sudden cold. With babies, just give them breast milk. For older children, it is recommended to give them enough nutrients to both avoid physical weakness and help them increase their resistance and recover quickly. Parents should give the baby easy-to-digest food, divide the main meal into many small meals, and feed the baby several times a day to help the child eat more easily. Also, don't forget to give your baby plenty of water to avoid dehydration. Avoid exposing infants with whooping cough to kitchen and cigarette smoke, as it will make the condition worse. It is important to keep the baby's surroundings clean and cool. Mothers during pregnancy can be vaccinated against diphtheria, pertussis, and tetanus to prevent disease for babies under 2 months old. Whooping cough is highly contagious, so it is important to isolate and avoid letting children come into contact with many people. Adults caring for a child with pertussis need to use antibiotics for preventive treatment, avoiding the risk of disease and its spread.
For children to be healthy and develop well, it is necessary to have a nutritious diet in terms of quantity and quality balance. If children are not provided with adequate and balanced nutrients, it will lead to diseases of excess or lack of nutrients, which adversely affect the comprehensive development of children in terms of physical, mental and motor skills.
Children who do not eat properly are at risk of micro-mineral deficiency causing anorexia, growth retardation, malabsorption,... If they notice the above signs, parents should supplement their children with products. The supplement contains lysine, essential micro-minerals and vitamins such as zinc, chromium, selenium, and B vitamins to help fully meet the nutritional needs of children. At the same time, these essential vitamins also support digestion, enhance nutrient absorption, help improve anorexia, and help children eat well.
Parents can learn more:
Signs of zinc deficiency in children
Micronutrient deficiency and failure to gain weight in children
Please regularly visit Vinmec.com website and update useful information to take care of your child. Take care of the baby and the whole family.