eMedicine Specialties > Pediatrics: General Medicine > Pulmonology

Afebrile Pneumonia Syndrome: Follow-up

Author: Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Coauthor(s): Judith R Grisi, BS, PAC, Physician Assistant, Monmouth Ocean Pulmonary Medicine, CentraState Medical Center
Contributor Information and Disclosures

Updated: Jan 7, 2009

Follow-up

Further Inpatient Care

  • Supportive therapy is required as dictated by the clinical manifestations of afebrile pneumonia syndrome (APS).
  • Severe CMV pneumonitis may require CMV hyperimmunoglobulin therapy.

Transfer

  • Transfer may be necessary if the required services are not locally available.

Deterrence/Prevention

  • Detection and treatment of maternal C trachomatis infection prevents vertical transmission of the pathogen.7
  • Avoidance of other risk factors for APS is prudent.
  • Institute appropriate isolation of all patients who are hospitalized.

Complications

  • Secondary bacterial infection may occur, particularly with viral disease.
  • Following a 5-year follow-up period, 60% of infants had abnormal pulmonary function test findings.
  • More than one half of infants with chlamydial pneumonitis had obstructive airway disease and physician-diagnosed asthma starting at age 7 years.

Prognosis

  • Immediate prognosis is good for more than 95% of affected infants, although long-term prognosis for significant morbidity is high.

Patient Education

  • Discuss risk factors for APS with prospective mothers.

Miscellaneous

Medicolegal Pitfalls

  • Failure to make the diagnosis in the appropriate clinical context
  • Failure to counsel mothers of the need to seek appropriate diagnostic and treatment services in the presence of chlamydial infections in infants

Special Concerns

  • All of these infections tend to be more severe in hosts who have underlying medical abnormalities.
 


More on Afebrile Pneumonia Syndrome

Overview: Afebrile Pneumonia Syndrome
Differential Diagnoses & Workup: Afebrile Pneumonia Syndrome
Treatment & Medication: Afebrile Pneumonia Syndrome
Follow-up: Afebrile Pneumonia Syndrome
References
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Further Reading

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Keywords

afebrile pneumonia syndrome, APS, adenovirus, atypical pneumonia, bronchiolitis, Chlamydia trachomatis, chlamydial pneumonitis, conjunctivitis, croup, cytomegalovirus, CMV, human bocavirus, human metapneumovirus, infantile pneumonitis, interstitial pneumonia, laryngotracheobronchitis, newborn infection, nonbacterial pneumonia, obstructive airway disease, parainfluenza virus, pharyngitis, Pneumocystis jiroveci, pneumonia, pneumonitis, respiratory syncytial virus, RSV, rhinorrhea, RTI, tachypnea, upper respiratory tract infection, URI, Ureaplasma urealyticum, viral pneumonia

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Contributor Information and Disclosures

Author

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Consulting; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; sanofi pasteur Grant/research funds Unrestricted research grant; sanofi pasteur  Consulting; sanofi pasteur Honoraria Speaking and teaching; Tap Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Coauthor(s)

Judith R Grisi, BS, PAC, Physician Assistant, Monmouth Ocean Pulmonary Medicine, CentraState Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Susanna A McColley, MD, Director of Cystic Fibrosis Center; Head, Division of Pulmonary Medicine; Associate Professor, Department of Pediatrics, Children's Memorial Medical Center of Chicago, Northwestern University
Susanna A McColley, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Sleep Disorders Association, and American Thoracic Society
Disclosure: Genentech Honoraria Speaking and teaching; Genentech Consulting fee Consulting; Novartis Consulting fee Consulting; Altus Consulting fee Consulting; Axcan Scandi Consulting fee Consulting; Boston Scientific Consulting fee Consulting

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Heidi Connolly, MD, Associate Professor of Pediatrics and Psychiatry, University of Rochester; Director, Pediatric Sleep Medicine Services, Strong Sleep Disorders Center
Heidi Connolly, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

CME Editor

Mary E Cataletto, MD, Associate Director, Division of Pediatric Pulmonology, Winthrop University Hospital; Professor of Clinical Pediatrics, State University of New York at Stony Brook; Director of Children's Sleep Services, Winthrop University Hospital
Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians
Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD, Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Columbia University Medical Center
Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society
Disclosure: Merck Honoraria Speaking and teaching

 
 
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