eMedicine Specialties > Pediatrics: General Medicine > Infectious Disease
Pneumonia: Treatment & Medication
Updated: Jan 12, 2009
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Treatment
Medical Care
Treatment decisions in children with pneumonia are dictated based on the likely etiology of the infectious organism and the age and clinical status of the patient. Antibiotic administration must be targeted to the likely organism, bearing in mind the age of the patient, the history of exposure, the possibility of resistance (which may vary, depending on local resistance patterns), and other pertinent history.
Chest percussion is usually unnecessary in children with pneumonia. Studies in adults have not shown benefit; however, no definitive studies have been performed in children. Although most children do not expectorate sputum, they are able to clear it from their lungs and to swallow it. In young infants with bronchiolitis, chest percussion can be helpful in moving mucus and improving air entry (postpercussion auscultation often results in increased wheezes and crackles because of the better air entry) and oxygenation. However, the few studies that have involved children have not shown shortened hospital stays.
Bronchodilators should not be routinely used. Bacterial lower respiratory tract infections rarely trigger asthma attacks, and the wheezing that is sometimes heard in patients with pneumonia is usually caused by airway inflammation, mucus plugging, or both and is not bronchodilator responsive. However, infants or children with reactive airway disease or asthma may react to a viral infection with bronchospasm, which responds to bronchodilators. The role of steroids in this situation is controversial, and steroids should probably not be initiated as routine because of the lack of evidence that they are beneficial and because of the risk of immunosuppression.
A few small studies in adults suggest that glucocorticoid use might be beneficial in the treatment of serious (hospitalized) community-acquired pneumonia, although the study designs and sizes limit the ability to properly interpret this data.5 Until definitive studies are performed, steroids should not be routinely used for uncomplicated pneumonia. Extra humidification of inspired air (eg, room humidifiers) is also not useful, although supplemental oxygen is frequently humidified for patient comfort.
- School-aged children
- Many of these children do not require hospitalization and respond well to oral antibiotics. Macrolide antibiotics are useful in this age group because they cover the most common bacteriologic and atypical agents. However, increasing levels of resistance to macrolides among streptococcal isolates should be considered (depending on local resistance rates).
- Usually, these patients are not toxic or hypoxic enough to require supplemental oxygen. Unless they are vomiting, they do not require intravenous fluids or antibiotics. A parapneumonic effusion that requires drainage usually dictates a hospital admission.
- Children younger than 5 years: These children are hospitalized more often, but their clinical status, degree of hydration, degree of hypoxia, and need for intravenous therapy dictate this decision.
Surgical Care
- Drainage of parapneumonic effusions with or without intrapleural instillation of a fibrinolytic agent (eg, tissue plasminogen activator [TPA]) may be indicated.
- Chest tube placement for drainage of an effusion or empyema may be performed.
- VATS procedure may be performed for decortication of organized empyema or loculated effusions.
Diet
- No specific dietary considerations are recommended. However, anorexia is commonly associated with inflammatory conditions.
Activity
- Activity stimulates mucus mobilization, cough, and a resolution of the disease process. Gentle activity should be encouraged. Even very young infants can benefit from repositioning to help shift mucus.
- Children usually do not participate in vigorous activity if they are ill and, in general, can be trusted to limit their own activity when necessary.
Medication
Drug therapy for pneumonia is tailored to the situation. Because the etiologic agents vary, drug choice is affected by the patient's age, exposure history, likelihood of resistance (eg, pneumococcus), and clinical presentation. Macrolide antibiotics are useful in most school-aged children to cover the atypical organisms and pneumococcus, but an immigrant child with a positive purified protein derivative (PPD) of tuberculin needs a different drug. Local variations in resistance require different approaches to therapy, including cases caused by pneumococcus.
Macrolide Antibiotics
These agents are used for treatment of pneumonia in school-aged children because they cover most common bacteriologic and atypical agents.
Azithromycin (Zithromax)
Treats mild-to-moderate microbial infections.
Adult
Day 1: 500 mg PO
Days 2-5: 250 mg PO qd
Pediatric
<6 months: Not established
>6 months:
Day 1: 10 mg/kg PO once; not to exceed 500 mg/d
Days 2-5: 5 mg/kg PO qd; not to exceed 250 mg/d
May increase toxicity of theophylline, warfarin, and digoxin; effects are reduced with coadministration of aluminum or magnesium antacids; nephrotoxicity and neurotoxicity may occur when coadministered with cyclosporine
Documented hypersensitivity; hepatic impairment; do not administer with pimozide
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Bacterial or fungal overgrowth may result with prolonged antibiotic use; may increase hepatic enzymes and cholestatic jaundice; caution in patients with impaired hepatic function, prolonged QT intervals, or pneumonia; caution in patients who are hospitalized, elderly, or debilitated
Clarithromycin (Biaxin)
Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes causing RNA-dependent protein synthesis to arrest.
Adult
250-500 mg PO q12h for 7-14 d
Pediatric
7.5 mg/kg PO bid; not to exceed adult dose
Toxicity increases with coadministration of fluconazole and pimozide; clarithromycin effects decrease and GI adverse effects may increase with coadministration of rifabutin or rifampin; may increase toxicity of anticoagulants, cyclosporine, tacrolimus, digoxin, omeprazole, carbamazepine, ergot alkaloids, triazolam, HMG-CoA reductase inhibitors
Plasma levels of certain benzodiazepines may increase, prolonging CNS depression; arrhythmias and increase in QTc intervals occur with disopyramide; coadministration with omeprazole may increase plasma levels of both agents
Documented hypersensitivity; coadministration of pimozide
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Coadministration with ranitidine or bismuth citrate is not recommended with CrCl <25 mL/min; give half dose or increase dosing interval if CrCl <30 mL/min; diarrhea may be sign of pseudomembranous colitis; superinfections may occur with prolonged or repeated antibiotic therapies
Erythromycin (E.E.S., E-Mycin, Ery-Tab)
Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes causing RNA-dependent protein synthesis to arrest. For treatment of staphylococcal and streptococcal infections.
In children, age, weight, and severity of infection determine proper dosage. When bid dosing is desired, half-total daily dose may be taken q12h. For more severe infections, double the dose.
Adult
250 mg erythromycin stearate/base (or 400 mg ethylsuccinate) q6h PO 1 h ac or 500 mg q12h
Alternatively, 333 mg q8h; increase to 4 g/d depending on severity of infection
Pediatric
30-50 mg/kg/d (15-25 mg/lb/d) PO divided q6-8h; double dose for severe infection
Coadministration may increase toxicity of theophylline, digoxin, carbamazepine, and cyclosporine; may potentiate anticoagulant effects of warfarin; coadministration with lovastatin and simvastatin increases risk of rhabdomyolysis; decreases metabolism of repaglinide, increasing serum levels and effects
Documented hypersensitivity; hepatic impairment
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Caution in patients with liver disease; estolate formulation may cause cholestatic jaundice; GI adverse effects are common (give doses pc); discontinue use if nausea, vomiting, malaise, abdominal colic, or fever occurs
Antibiotics for children younger than 5 years
These children are most commonly hospitalized, but their clinical status, degree of hydration, degree of hypoxia, and need for intravenous antibiotic therapy dictate this decision.
Ceftriaxone (Rocephin)
Third-generation cephalosporin with broad-spectrum gram-negative activity; lower efficacy against gram-positive organisms; higher efficacy against resistant organisms. Arrests bacterial growth by binding to one or more penicillin-binding proteins.
Adult
1-2 g IV qd or divided bid; not to exceed 4 g/d
Pediatric
Neonates >7 days: 25-50 mg/kg/d IV/IM; not to exceed 125 mg/d
Infants and children: 50-75 mg/kg/d IV/IM divided q12h; not to exceed 2 g/d
Probenecid may increase ceftriaxone levels; coadministration with ethacrynic acid, furosemide, and aminoglycosides may increase nephrotoxicity
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in renal impairment; caution in breastfeeding women and allergy to penicillin
Cefotaxime (Claforan)
For infections caused by susceptible organisms. Arrests bacterial cell wall synthesis, which, in turn, inhibits bacterial growth. Third-generation cephalosporin with gram-negative spectrum. Lower efficacy against gram-positive organisms.
Adult
Moderate to severe infections: 1-2 g IV/IM q6-8h
Life threatening infections: 1-2 g IV/IM q4h
Pediatric
Infants and children: 50-180 mg/kg/d IV/IM divided q4-6h
>12 years: Administer as in adults
Probenecid may increase cefotaxime levels; coadministration with furosemide and aminoglycosides may increase nephrotoxicity
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in severe renal impairment; has been associated with severe colitis
Ampicillin (Marcillin, Omnipen, Polycillin)
Bactericidal activity against susceptible organisms. Alternative to amoxicillin when unable to take medication orally.
Adult
250-500 mg PO q6h
500 mg to 1.5 g IM q4-6h
500 mg to 3 g IV q4-6h; not to exceed 12 g/d
Pediatric
50-100 mg/kg/d PO divided q4-6h
100-400 mg/kg/d IM/IV divided q4-6h
Probenecid and disulfiram elevate ampicillin levels; allopurinol decreases ampicillin effects and has additive effects on ampicillin rash; may decrease effects of oral contraceptives
Documented hypersensitivity
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Adjust dose in patients with renal failure; evaluate rash and differentiate from hypersensitivity reaction
Cefuroxime (Zinacef, Ceftin, Kefurox)
Second-generation cephalosporin maintains gram-positive activity that first-generation cephalosporins have; adds activity against P mirabilis, H influenzae, E coli, K pneumoniae, and M catarrhalis. Condition of patient, severity of infection and susceptibility of microorganism determines proper dose and route of administration.
Adult
500 mg PO bid
750-1500 mg IV q8h
Pediatric
<3 months: 20-50 mg/kg/d IV divided q8-12h
>3 months: 250 mg PO bid; 100-150 mg/kg/d divided q8h
Adolescents: Administer as in adults
Disulfiramlike reactions may occur when alcohol is consumed within 72 h after taking cefuroxime; may increase hypoprothrombinemic effects of anticoagulants; may increase nephrotoxicity in patient receiving potent diuretics (eg, loop diuretics); coadministration with aminoglycosides increase nephrotoxic potential
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Administer half dose if CrCl is 10-30 mL/min and one-quarter dose if less than 10 mL/min; fungal and microorganism overgrowth may occur with prolonged therapy
Antituberculars
These agents are used in the treatment of patients with TB. Antimycobacterial agents are a miscellaneous group of antibiotics whose spectrum of activity includes Mycobacterium species. They are used to treat TB, leprosy, and other mycobacterial infections.
Isoniazid (Laniazid, Nydrazid)
Best combination of effectiveness, low cost, and minor side effects. First-line drug unless patient has known resistance or another contraindication. Therapeutic regimens of <6 mo demonstrate unacceptably high relapse rate.
Coadministration of pyridoxine is recommended if peripheral neuropathies secondary to isoniazid therapy develop. Prophylactic doses of 6-50 mg of pyridoxine daily are recommended.
Adult
5 mg/kg PO qd (usually 300 mg/d) and 10 mg/kg qd in 1-2 divided doses in patients with disseminated disease; not to exceed 300 mg/d
Directly observed therapy: 15 mg/kg twice weekly; not to exceed 900 mg/dose
Pediatric
10-15 mg/kg PO qd; not to exceed 300 mg/d
Directly observed therapy: 20-30 mg/kg PO twice weekly; not to exceed 900 mg/dose
Higher incidence of isoniazid-related hepatitis can occur with alcohol ingestion on daily basis; aluminum salts may decrease isoniazid serum levels (administer 1-2 h before taking aluminum salts); may increase anticoagulants effects with coadministration; may inhibit metabolic clearance of benzodiazepines
Carbamazepine toxicity or isoniazid hepatotoxicity may result from concurrent use (monitor carbamazepine concentrations and liver function); coadministration with cycloserine may increase CNS side effects (eg, dizziness); acute behavioral and coordination changes may occur with coadministration of disulfiram
Coadministration with rifampin after halothane anesthesia may result in hepatotoxicity and hepatic encephalopathy; may inhibit hepatic microsomal enzymes and increase toxicity of hydantoin
Documented hypersensitivity; previous isoniazid-associated hepatic injury or other severe adverse reactions
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Monitor patients with active chronic liver disease or severe renal dysfunction; periodic ophthalmologic examinations during isoniazid therapy are recommended, even when visual symptoms do not occur
Ethambutol (Myambutol)
Diffuses into actively growing mycobacterial cells, such as tubercle bacilli. Impairs cell metabolism by inhibiting synthesis of one or more metabolites, which, in turn, causes cell death. No cross-resistance demonstrated.
Mycobacterial resistance is common with previous therapy. Use in these patients in combination with second-line drugs that have not been previously administered.
Administer q24h until permanent bacteriological conversion and maximal clinical improvement observed. Absorption is not significantly altered by food.
Adult
No previous antituberculous therapy: 15 mg/kg (7 mg/lb) PO qd
Previous antituberculous therapy: 25 mg/kg (11 mg/lb) PO qd
Maximum dose is weight and regimen dependent, consult with infectious disease specialist
Pediatric
<13 years: Not recommended unless resistant to rifampin or isoniazid
>13 years: Administer as in adults
Aluminum salts may delay and reduce absorption (give several hours before or after ethambutol dose)
Documented hypersensitivity; optic neuritis (unless clinically indicated)
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Reduce dose in impaired renal function; may cause optic neuritis or atrophy; baseline and monthly visual acuity monitoring recommended in CDC guidelines; may have reversible visual adverse effects if promptly discontinued
Rifampin (Rifadin, Rimactane)
For use in combination with at least one other antituberculous drug. Inhibits RNA synthesis in bacteria by binding to beta subunit of DNA-dependent RNA polymerase, which in turn blocks RNA transcription.
Treat for 6-9 mo or until 6 mo have elapsed from conversion to sputum culture negativity.
Adult
600 mg PO/IV qd
Pediatric
10-20 mg/kg PO/IV; not to exceed 600 mg/d
Induces microsomal enzymes, which may decrease effects of acetaminophen, oral anticoagulants, barbiturates, benzodiazepines, beta-blockers, chloramphenicol, oral contraceptives, corticosteroids, mexiletine, cyclosporine, digitoxin, disopyramide, estrogens, hydantoins, methadone, clofibrate, quinidine, dapsone, tazobactam, sulfonylureas, theophyllines, tocainide, and digoxin; blood pressure may increase with coadministration of enalapril; coadministration with isoniazid may result in higher rate of hepatotoxicity than with either agent alone (discontinue one or both agents if alterations in LFT findings occur)
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Obtain CBC count and baseline clinical chemistries before and throughout therapy; in patients with liver disease, weigh benefits against risk of further liver damage; interruption of therapy and high-dose intermittent therapy are associated with thrombocytopenia that is reversible if therapy is discontinued as soon as purpura occurs; if treatment is continued or resumed after appearance of purpura, cerebral hemorrhage or death may occur; may cause orange discoloration of urine or secretions
Streptomycin sulfate
Use in combination with other antituberculous drugs (eg, isoniazid, ethambutol, rifampin). Total period of treatment for TB is a minimum of 1 y; however, indications for terminating streptomycin therapy may occur at any time. Recommended when less potentially hazardous therapeutic agents are ineffective or contraindicated.
Adult
1 g IM qd
2 times/wk dosing: 15 mg/kg/d IM; not to exceed 1 g/d
3 times/wk dosing: 25-30 mg/kg/d IM; not to exceed 1.5 g/d
Pediatric
2 times/wk dosing: 20-40 mg/kg/d IM; not to exceed 1 g/d
3 times/wk dosing: 25-30 mg/kg/d IM; not to exceed 1.5 g/d
Nephrotoxicity may be increased with aminoglycosides, cephalosporins, penicillins, amphotericin B, and loop diuretics
Documented hypersensitivity
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Narrow therapeutic index; not intended for long-term therapy; extreme caution in patients with renal failure who are not on dialysis; caution with myasthenia gravis, hypocalcemia, and conditions that depress neuromuscular transmission; may cause auditory and vestibular toxic effects
Pyrazinamide
Pyrazine analog of nicotinamide that may be bacteriostatic or bactericidal against Mycobacterium tuberculosis, depending on concentration of drug attained at site of infection; mechanism of action is unknown.
Administer for initial 2 mo of a 6-mo or longer treatment regimen for patients who are drug susceptible. Treat patients who are drug resistant with individualized regimens.
Adult
15-30 mg/kg PO qd; not to exceed 2 g/d
Indirectly observed therapy: 50-70 mg/kg PO
2 times/wk, not to exceed 4 g/d; alternatively, 50-70 mg/kg 3 times/wk, not to exceed 3 g/d
Pediatric
Administer as in adults
Coadministration with rifampin may result in higher rate of hepatotoxicity than with either agent alone (discontinue if alterations in LFT findings occur)
Documented hypersensitivity; severe hepatic damage; acute gout
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Use only in combination with other effective antituberculous agents; inhibits renal excretion of urates; may result in hyperuricemia (usually asymptomatic); assess baseline serum uric acid; discontinue drug upon signs of hyperuricemia with acute gouty arthritis; perform baseline LFTs (closely monitor in liver disease); discontinue pyrazinamide upon signs of hepatocellular damage; caution in history of diabetes mellitus
Antiviral agents
These agents must be initiated early to adequately inhibit the replicating virus. This is difficult because the clinical situation usually deteriorates over several days, such that by the time the child's condition is poor enough to require medical attention, the window of opportunity has passed.
Oseltamivir (Tamiflu) resistance has emerged in the United States during the 2008-2009 influenza season. The US Centers for Disease Control and Prevention (CDC) has issued revised interim recommendations for antiviral treatment and prophylaxis of influenza. Preliminary data from a limited number of states indicate the prevalence of influenza A (H1N1) virus strains resistant to oseltamivir (Tamiflu) is high. Because of this, zanamivir (Relenza) is recommended as the initial choice for antiviral prophylaxis or treatment when influenza A infection or exposure is suspected. A second-line alternative is a combination of oseltamivir plus rimantadine, rather than oseltamivir alone. Local influenza surveillance data and laboratory testing can assist the physician regarding antiviral agent choice.
Influenza A viruses, including two subtypes (H1N1) and (H3N2), and influenza B viruses currently circulate worldwide, but the prevalence can vary among communities and within a single community over the course of an influenza season. In the United States, 4 prescription antiviral medications (oseltamivir, zanamivir, amantadine and rimantadine) are approved for treatment and chemoprophylaxis of influenza. Since January 2006, the neuraminidase inhibitors (oseltamivir, zanamivir) have been the only recommended influenza antiviral drugs because of widespread resistance to the adamantanes (amantadine, rimantadine) among influenza A (H3N2) virus strains. The neuraminidase inhibitors have activity against influenza A and B viruses, whereas the adamantanes have activity only against influenza A viruses.
In 2007-08, a significant increase in the prevalence of oseltamivir resistance was reported among influenza A (H1N1) viruses worldwide. During the 2007-08 influenza season, 10.9% of H1N1 viruses tested in the United States were resistant to oseltamivir.
Complete recommendations are available from the CDC.
Ribavirin (Virazole)
Inhibits viral replication by inhibiting DNA and RNA synthesis. Antiviral against RSV, influenza virus, and herpes simplex virus. Little evidence has been found to demonstrate that it has much clinical benefit in a hospital setting.
Adult
Reconstitute 6 g into 300 mL of sterile water to make a concentration of 20 mg/mL
Administer as continuous aerosol over 12-18 h/d for 3-7 d
Pediatric
Administer as in adults
Decreases zidovudine effects
Documented hypersensitivity
Pregnancy
X - Contraindicated; benefit does not outweigh risk
Precautions
Closely monitor patients with asthma for deterioration of respiratory function
Oseltamivir (Tamiflu)
Inhibits neuraminidase, which is a glycoprotein on the surface of influenza virus that destroys an infected cell's receptor for viral hemagglutinin. By inhibiting viral neuraminidase, it decreases release of viruses from infected cells and, thus, viral spread. Effective for treatment of influenza A or B infection. Start within 40 h of symptom onset. Available as capsules and as an oral susp.
Oseltamivir (Tamiflu) resistance has emerged in the United States during the 2008-2009 influenza season. The CDC has issued revised interim recommendations for antiviral treatment and prophylaxis of influenza. Preliminary data from a limited number of states indicate that the prevalence of influenza A (H1N1) virus strains resistant to oseltamivir (Tamiflu) is high. Because of this, zanamivir (Relenza) is recommended as the initial choice for antiviral prophylaxis or treatment when influenza A infection or exposure is suspected. A second-line alternative is a combination of oseltamivir plus rimantadine, rather than oseltamivir alone. Local influenza surveillance data and laboratory testing can assist the physician regarding antiviral agent choice.
Adult
Acute illness: 75 mg PO bid for 5 d
Prophylaxis: 75 mg PO qd for 10 d
Pediatric
Acute illness
<1 year: Not indicated
>1 year:
<15 kg: 30 mg PO bid for 5 d
>15-23 kg: 45 mg PO bid for 5 d
>23-40 kg: 60 mg PO bid for 5 d
>40 kg: Administer as in adults
Prophylaxis:
<1 year: Not established
>1 year:
<15 kg: 30 mg PO qd for 10 d
>15-23 kg: 45 mg PO qd for 10 d
24-40 kg: 60 mg PO qd for 10 d
>40 kg: Administer as in adults
None reported
Documented hypersensitivity
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Caution in renal impairment, chronic cardiac or respiratory disease, and breastfeeding; do not use in children <1 y (preclinical trials have demonstrated death in young animals, possibly related to immature blood-brain barriers); postmarketing reports (mostly from Japan) of self-injury and delirium in patients with influenza (reports primarily among children), unknown if oseltamivir directly contributes to this behavior (monitor for abnormal behavior throughout treatment period)
Zanamivir (Relenza)
Inhibitor of neuraminidase, which is a glycoprotein on the surface of the influenza virus that destroys the infected cell's receptor for viral hemagglutinin. By inhibiting viral neuraminidase, release of viruses from infected cells and viral spread are decreased. Effective against both influenza A and B. To be inhaled through Diskhaler oral inhalation device. Circular foil discs that contain 5-mg blisters of drug are inserted into supplied inhalation device.
Adult
Treatment: 10 mg (2 inhalations, 5 mg/inhalation) inhaled PO q12h for 5 d; initiate within 2 d of symptom onset
Prophylaxis: 10 mg (2 inhalations, 5 mg/inhalation) inhaled PO qd for 10 d; initiate within 36 h of exposure
Pediatric
Treatment:
<7 years: Not established
>7 years: Administer as in adults
Prophylaxis:
<5 years: Not established
>5 years: Administer as in adults
None reported
Documented hypersensitivity; obstructive airway disease
Pregnancy
C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus
Precautions
Monitor respiratory status; may cause bronchospasm; caution in breastfeeding
More on Pneumonia |
| Overview: Pneumonia |
| Differential Diagnoses & Workup: Pneumonia |
 Treatment & Medication: Pneumonia |
| Follow-up: Pneumonia |
| Multimedia: Pneumonia |
| References |
| « Previous Page | Next Page » |
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Further Reading
Keywords
pneumonia, lower respiratory tract infection, bronchopneumonia, pneumonitis, severe acute respiratory syndrome, SARS, impaired cough reflex, ciliary dyskinesia, bronchial obstruction, gastric fluid aspiration, altered pulmonary blood flow, pulmonary edema, obstruction of the airway, ventilation/perfusion mismatch, V/Q mismatch, hypoxemia, tachypnea, hypoxia, retractions, positive end-expiratory pressure, PEEP, nasal flaring, rales, pleural friction rub, respiratory syncytial virus, RSV, parainfluenza, aspiration pneumonia, Haemophilus influenzae infection, group B Streptococcus, Listeria monocytogenes, gram-negative rods, Escherichia coli, Klebsiella pneumoniae, Chlamydia pneumoniae, Ureaplasma urealyticum, Mycoplasma hominis, cytomegalovirus, Pneumocystis carinii, adenovirus, enterovirus, rhinovirus, coronavirus, herpesvirus
