Pediatrics in Review
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 Vol. 29 No. 5, May 2008
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(Pediatrics in Review. 2008;29:147-160.)
© 2008 American Academy of Pediatrics

Pneumonia


William Jerry Durbin, MD*
Christopher Stille, MD, MPH{dagger}
 * Professor of Pediatrics and Medicine
{dagger} Associate Professor of Pediatrics, University of Massachusetts Medical School, Worcester, Mass

The first 300 words of the full text of this article appear below.


   Objectives
 
After completing this article, readers should be able to:

  1. Discuss the major pathogens of childhood pneumonia, including the usual age groups affected and clinical features.
  2. Recognize the major findings that distinguish children who have pneumonia from those who have other respiratory tract infections.
  3. Outline the antibiotic regimens used to treat pneumonia in ambulatory children.
  4. Describe the clinical circumstances that warrant radiographic and laboratory studies and consideration of hospitalization.
  5. Explain the hospital management of pneumonia, lung abscess, and empyema.
  6. Identify preventive measures for reducing the risk of pneumonia.


   Introduction
 
Pneumonia (infection of the lung parenchyma) in children is encountered commonly in daily practice, and otherwise healthy children typically do well with outpatient treatment. It is important, however, to recognize those children who are at risk for or who already are experiencing severe or complicated pneumonia and to monitor and treat them. Pneumonia usually can be diagnosed clinically, although radiographs may be useful to corroborate the clinical findings or identify complications. Antibiotic selection is important, and the treating clinician should consider prevalent organisms, the child's age, and the presence of risk factors for atypical or resistant organisms. Occasionally, in more severe or complicated cases, hospitalization may be necessary to provide intravenous (IV) antibiotics, fluids, oxygen, and other supportive measures and to facilitate necessary invasive procedures to diagnose and treat complications. Fortunately, appropriate immunization and proper personal hygiene can go far in preventing pneumonia.


   Epidemiology
 
About 150 million cases of pneumonia occur worldwide each year in children younger than age 5 years, according to the World Health Organization, with up to 20 million cases classified as sufficiently severe to require hospital admission. In North America, the incidence of disease in children younger than age 5 years is estimated to be 35 to 40 cases per 1,000, with a decrease to 7 per 1,000 among adolescents . . . [Full Text of this Article]






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