Pediatric Pneumonia Questions & Answers

Updated: Jun 05, 2020
  • Author: Muhammad Waseem, MS, MBBS, FAAP, FACEP, FAHA; Chief Editor: Russell W Steele, MD  more...
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Questions & Answers

Overview

What is the global mortality rate of pediatric pneumonia?

Does the incidence of pediatric pneumonia vary by age?

What is the presentation of pediatric pneumonia in newborns?

What are the signs and symptoms of pediatric pneumonia in infants?

What is the presentation of pediatric pneumonia in adolescents?

Which factors contribute to the variance in signs and symptoms of pediatric pneumonia?

What are the WHO respiratory rate thresholds for pediatric pneumonia?

When is assessment of oxygen saturation performed in the workup of pediatric pneumonia?

Which tests may be performed in the workup of pediatric pneumonia?

What is the efficacy of ultrasonography for the diagnosis of pediatric pneumonia?

What are the initial treatment priorities in pediatric pneumonia?

What are the treatment options for pediatric pneumonia?

What is the inpatient treatment for pediatric pneumonia?

What is the role of fluoroquinolones in the treatment of pediatric pneumonia?

What is the treatment for pediatric pneumonia in children who appear toxic?

Which vaccines are recommended for the prevention of pediatric pneumonia?

How is pediatric pneumonia diagnosed?

Where in the body does pneumonia originate?

What is the presentation of congenital pneumonia?

What is the pathogenesis of pediatric pneumonia?

What is the role of compromised respiratory tract defenses in the pathogenesis of pediatric pneumonia?

What are the respiratory tract defenses against pediatric pneumonia?

What is the role of airway secretions in the defenses against pediatric pneumonia?

What is the role of endotracheal intubation in the pathogenesis of pediatric pneumonia?

What are the systemic host defenses against the pathogenesis of pediatric pneumonia?

What is the role of biochemical cascades in the pathophysiology of pediatric pneumonia?

What is the role of secretory antibodies in the pathogenesis of pediatric pneumonia?

What is the role of phagocytes in the pathogenesis of pediatric pneumonia?

What is the role of systemic host defenses in the pathogenesis of pediatric pneumonia?

What is the pathogenesis of pediatric pneumonia?

What is the role of activated inflammatory response in the pathogenesis of pediatric pneumonia?

What causes pulmonary injuries in the pathogenesis of pediatric pneumonia?

What is the pathophysiology of pediatric pneumonia on a macroscopic level?

What is the role of viral infections in the pathogenesis of pediatric pneumonia?

What is the role of bacterial infections in the pathogenesis of pediatric pneumonia?

What are the 4 stages of lobar pneumonia?

What is bronchopneumonia?

What is interstitial pneumonia?

What is miliary pneumonia?

What is the etiology of pediatric pneumonia?

Which etiologic pathogens have been identified in children with acute community-acquired pneumonia (CAP)?

How do etiologic agents vary for pediatric pneumonia?

Which infectious agents are responsible for pediatric pneumonia in newborns?

Which infectious agents are responsible for pediatric pneumonia in later infancy?

How is group B Streptococcus (GBS) pneumonia transmitted in infants?

Which community-acquired viral infections occur in newborns with pediatric pneumonia?

What are the risk factors for development of pediatric pneumonia in newborns?

Which agents are the most common causes of bacterial pneumonia in the young children?

Which etiologic agents increase the risk of pediatric pneumonia in infants?

Which viral agents of lower respiratory tract diseases increase the risk of pediatric pneumonia in infants?

Which atypical organisms may cause pediatric pneumonia infection in infants?

What is the most common cause of pediatric pneumonia?

Which viruses are less-common causes of pediatric pneumonia?

What is the most common bacterial cause of pediatric pneumonia?

Which pediatric patients are at increased risk for invasive or resistant pneumococcal infection?

Among older children and adolescents, what are the risk factors for developing pediatric pneumonia?

Which age group is at increased risk for Chlamydophila pneumoniae (C pneumoniae)?

Which organisms increase the risk of pediatric pneumonia in immunosuppressed children?

What is the possible sequelae of influenza pneumonia in pediatric patients?

What is the most common cause of community-acquired pneumonia (CAP) during adolescence and young adulthood?

Which dimorphic fungi cause pediatric pneumonia?

What is the usual disease course of viral pneumonia during adolescence or young adulthood?

When should TB pneumonia be considered in pediatric patients?

How common is Legionella pneumophila (L pneumophila) in pediatric populations?

What are the causes of chemical pneumonitis and aspiration pneumonia in children?

What are the differences in outcomes between aspiration and nonaspiration pneumonia in pediatric patients with neurologic impairment?

Which pediatric patients are at risk for pneumonias caused by opportunistic agents?

Which infectious agents increase the risk of pneumonia in children with cystic fibrosis?

In which children is P jirovecii pneumonia (PCP) common are what are possible outcomes?

Which children are at high risk for development of fungal pneumonia?

Why are patients with sickle cell disease at an increased risk for pneumonia?

What is the prevalence of pediatric pneumonia in the US?

What may reduce the incidence of pneumonia among children younger than 5 years?

What is the incidence of bronchopneumonia in school-aged children and adolescents?

What is the global prevalence of pneumonia?

What is the prognosis of pediatric pneumonia?

What are possible severe complications of viral pneumonias in children?

Among which pediatric patients is morbidity and mortality higher for pneumonia?

What is the disease progression of TB pneumonia in children?

What is the incidence of bronchopneumonia?

In which patients is the risk of complications of pediatric pneumonia highest?

What are the mortality rates associated with pediatric pneumonia?

What information should be given to parents of children with pediatric pneumonia?

Presentation

What is the presentation of pneumonia in neonates?

What is the most common presenting symptom and what history suggests pediatric pneumonia?

What is the presentation of bacterial pneumonia in infants and young children?

What is the presentation of bacterial pneumonia in older children and adolescents?

What is the significance of travel history when pediatric pneumonia is suspected?

What should be the focus of the history in children with recurrent sinopulmonary infections and pneumonia?

When is a history of TB exposure indicated for pediatric pneumonia?

How do the signs and symptoms of pediatric pneumonia vary?

What is the protocol for the initial evaluation of suspected pediatric pneumonia?

Which pulmonary findings suggest pediatric pneumonia?

What are the WHO respiratory rate thresholds for tachypnea in children with suspected pneumonia?

How are airway secretions characterized in pediatric pneumonia?

What is the role of oxygen saturation by pulse oximetry in the workup of pediatric pneumonia?

What is the presentation of pain in patients with pediatric pneumonia?

What disease processes are considered during the exam for pediatric pneumonia?

What is the role of auscultation in the physical exam of suspected pediatric pneumonia?

How should children with upper respiratory symptoms be examined for suspected pediatric pneumonia?

What may make the exam for pediatric pneumonia difficult in infants and young children?

What is the diagnostic importance of crackles (rales) in pediatric pneumonia?

Which respiratory findings suggest pediatric pneumonia?

Which respiratory findings in infants suggest pneumonia?

Which physical findings suggest lobar pneumonia in children?

What is the role of percussion in the physical exam for pediatric pneumonia?

What systemic and local findings are useful in identifying the etiology of pediatric pneumonia?

When might the presentation of pediatric pneumonia be delayed in neonates?

What is the presentation of early onset group B streptococci infection in neonates?

What is the presentation of bacterial pneumonia in infants or toddlers?

What is the clinical presentation of pneumonia caused by B pertussis?

Which pediatric patients are at risk for pneumonia caused by H capsulatum infection?

What is the presentation of acute chest syndrome in children with sickle cell anemia?

How are children with recurrent pediatric pneumonia evaluated?

DDX

Why is it important to identify the etiological pathogen of pediatric pneumonia?

How is asthma differentiated from pneumonia in children?

Which conditions should be included in the differential diagnoses for pediatric pneumonia?

How can the differential diagnosis of pediatric pneumonia be narrowed?

What are the differential diagnoses for Pediatric Pneumonia?

Workup

Which tests should be performed in the workup of pediatric pneumonia?

Which test accurately diagnoses most cases of pneumonia in children and young adults?

When is it useful to identify the causative pathogen in pediatric pneumonia?

Which lab tests are useful in identifying the causative pathogen in pediatric pneumonia?

Which factors may interfere with the ability to grow pediatric pneumonia pathogens in the microbiology lab?

Which tests are no longer performed in the workup of pediatric pneumonia?

When is lab testing indicated in the workup of pediatric pneumonia?

Which lab tests should be performed in the workup of pediatric pneumonia?

What is the role of a sputum Gram stain in the workup of pediatric pneumonia?

When is a sputum culture indicated in the workup of pediatric pneumonia?

What is the role of blood cultures in the workup of pediatric pneumonia?

What is the essential blood culture in the workup of pediatric pneumonia in neonates?

What are the guidelines for obtaining blood cultures for pediatric pneumonia?

Which serologic tests are being investigated for the workup of pediatric pneumonia?

Which is the role of IgM serologic studies in the workup of community-acquired pneumonia (CAP) in children?

What is the role of serologic testing in the workup of pediatric pneumonia?

What is the role of inflammatory markers in the workup of pediatric pneumonia?

What are the disadvantages of using inflammatory markers in the workup of pediatric pneumonia?

What is the sensitivity of polymerase chain reaction (PCR) for the diagnosis of pediatric pneumonia?

What is the role of polymerase chain reaction (PCR) in the workup of pediatric pneumonia?

When is skin testing indicated in the workup of pediatric pneumonia?

When are gastric aspirates indicated in the workup of pediatric pneumonia?

When is cold agglutinin testing indicated in the workup of pediatric pneumonia?

What is the urine antigen assay testing in the workup of pediatric pneumonia?

Which tests should be performed to establish a rapid diagnosis of pediatric viral pneumonia?

What is the role of bronchoscopy in the workup of pediatric pneumonia?

Which bronchoscopy techniques are used in the workup of pediatric pneumonia?

How is contamination distinguished from infection in bronchoscopy samples for pediatric pneumonia?

What is the role of endotracheal aspirates culture in the workup of pediatric pneumonia in neonates?

What does the absence of significant inflammatory cells in an endotracheal aspirate suggest in the workup of pediatric pneumonia?

What is the role of bronchoscopic alveolar lavage in the workup of pediatric pneumonia?

What is the role of protected brush tracheal aspirate samplings in the workup of pediatric pneumonia?

What is the role of lung aspiration in the workup of pediatric pneumonia?

What risks are associated with lung aspiration in the workup of pediatric pneumonia?

What is the efficacy of lung aspiration for the diagnosis of pediatric pneumonia?

What is the role of lung puncture in the workup of pediatric pneumonia?

What is role of thoracentesis in the workup of pediatric pneumonia?

How is empyema diagnosed in pediatric pneumonia?

What are the risks of thoracentesis in the diagnosis of pediatric pneumonia?

What is the role of histologic findings in the diagnosis of pediatric pneumonia?

What are the limitations of histologic findings in pediatric pneumonia?

Which macroscopic histologic findings suggest pediatric pneumonia?

Which microscopic histologic findings suggest pediatric pneumonia?

How common is a finding of hemorrhage in the histology for pediatric pneumonia?

Which organisms can be identified on microscopic exam of tissue following immunohistochemical staining for pediatric pneumonia?

How are fungal agents identified in pediatric pneumonia?

What is the role of imaging studies in the workup of pediatric pneumonia?

Treatment

What is the basis for treatment decisions in pediatric pneumonia?

What are the goals of therapy for pediatric pneumonia?

What is included in the PIDS and the IDSA guidelines for the management of community-acquired pneumonia (CAP) in infants and children older than 3 months?

Why does antibiotic choice for children with community-acquired pneumonia (CAP) vary?

How should children be managed during a prehospital evaluation for suspected pneumonia?

Which pediatric patients are most likely to be hospitalized with pneumonia and what is the indication for hospitalization?

Which treatments should be given to critically ill children with pneumonia?

What is the indication for hemodynamic support in the treatment for pediatric pneumonia?

What are the initial priorities in the treatment of pediatric pneumonia?

Which respiratory support measures may be required during the treatment of pediatric pneumonia?

What is adequate gas exchange dependent upon during the treatment of pediatric pneumonia?

How are alveoli treated in the respiratory management of pediatric pneumonia?

When is chest percussion indicated in children with pneumonia?

How is the choice of an initial empiric antibiotic selected in the treatment of pediatric pneumonia?

How are the majority of children with pneumonia treated and what agents are used?

What is the role of macrolide antibiotics in the treatment of pediatric pneumonia?

How are hospitalized patients treated for pediatric pneumonia?

What are the treatment options if gram-negative pneumonia is suspected?

What is the role of aminoglycosides in the treatment of pediatric pneumonia?

How is response to therapy monitored in pediatric pneumonia?

What is the role of anti-inflammatory therapy in the treatment of pediatric pneumonia?

How are infants with RSV pneumonia treated?

How is infection with influenza A (H1N1) viruses treated in pediatric patients?

What are the CDC recommendations for antiviral treatment and prophylaxis of influenza in children?

How is herpes simplex virus pneumonia treated in pediatric patients?

How is CMV pneumonitis treated in pediatric patients?

How are invasive fungal infections treated in pediatric patients?

What is the role of bronchodilators in the treatment of pediatric pneumonia?

What is the role of pleural fluids in the pathogenesis of pediatric pneumonia?

How are pleural effusions treated in patients with pediatric pneumonia?

How is pediatric pneumonia prevented?

Which vaccines have been developed for the prevention of pediatric pneumonia and what is their efficacy?

Which vaccine for pediatric pneumonia is recommended for children 24 months or older who are at high risk of pneumococcal disease?

In which children is the influenza vaccine recommended?

What prophylaxis is used in immunocompromised children with pediatric pneumonia?

What is effective in reducing the incidence of pediatric pneumonia in patients with sickle cell disease?

What is respiratory syncytial virus (RSV) prophylaxis for pediatric pneumonia?

When is zinc supplementation indicated for prevention of pediatric pneumonia?

When are consultations indicated for pediatric pneumonia?

What long-term monitoring should be performed for pediatric pneumonia?

What is the indication for transfer to an ICU in the treatment of pediatric pneumonia?

What may cause a pneumothorax in pediatric pneumonia?

What are the possible complications of pediatric pneumonia?

What is the role of parenteral nutritional support in the treatment for pediatric pneumonia?

Medications

Which factors affect drug choice in the treatment of pediatric pneumonia?

Which agents are typically used initially in the treatment of newborns and young infants with pneumonia?

How does identification of a specific infectious pathogen affect the treatment of pediatric pneumonia?

What is the efficacy of oral amoxicillin in the treatment of pediatric pneumonia?

Which medications in the drug class Penicillins are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Cephalosporins are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Glycopeptides are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Macrolide Antibiotics are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Aminoglycosides are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Antituberculosis Agents are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Antiviral Agents are used in the treatment of Pediatric Pneumonia?

Which medications in the drug class Vaccines are used in the treatment of Pediatric Pneumonia?