Pneumonia signs in infants and toddlers commonly include

• A. Slow breathing and no fever.
• B. Rapid breathing, grunting, wheezing, nasal flaring, crackles.
• C. Productive cough with purulent sputum in all cases.
• D. Severe chest pain with unilateral wheeze.

Answer: (B)

In young children, pneumonia often shows up as increased work of breathing. The most important clue is rapid breathing (tachypnea), because their small airways and immature lungs respond quickly to infection by breathing faster to meet oxygen needs. Along with that, signs of distress such as nasal flaring and grunting indicate they're trying to keep airways open and improve ventilation. When you listen to the lungs, crackles are a common finding, reflecting fluid or inflammation in the air spaces. Wheezing can occur, especially with viral infections, but it isn’t exclusive to pneumonia. Fever may be present, but it isn’t always, so its absence doesn’t rule out pneumonia in this age group.

This cluster—rapid breathing with signs of respiratory distress and lung sounds like crackles (and sometimes wheeze)—best fits pneumonia in infants and toddlers. The other options describe patterns that are unlikely in this age group: slow breathing with no fever underestimates the distress signals; a productive cough with purulent sputum in all cases isn’t typical for young children; severe chest pain with unilateral wheeze isn’t a classic presentation in infants.