Please enable JavaScript.
Coggle requires JavaScript to display documents.
Pneumonia in children (Clinical presentation (Fever High (>39),…
Pneumonia in
children
Definition
Acute infection of the
lung parenchyma by
bacteria or viruses
Epidemiology
Rare
Commonly viral
Children of any age affected,
but more common in infants
Pathophysiology
Mechanism
Infection, inflammation and consolidation
of the lower airways
Agent
Newborn - commonly bacteria from mothers genital tract e.g. Group B strep, gram -ves
Infants/children <2y: commonly viral e.g. RSV
Older children: commonly bacterial e.g. S pneumonae, GAS, S aureus, HiB
Clinical
presentation
Fever
High (>39)
Malaise
Poor feeding
Cough
Diagnosis
Examination
Resp
High RR, high HR, resp distress (chest indrawing, nasal flaring),
cyanosis, quiet breath sounds, coarse crackles, dull percussion (effusion)
Investigations
Bedside
Obs (high RR, high HR, low sats, high temp)
Bloods
FBC, CRP, U+E, LFTs
cultures (if ?septic)
Imaging
CXR: consolidation, may have effusions
Swabs
Sputum MCS
History
PMH
Growth and development
Vaccinations
Known medical conditions
DH
Meds, allergies
POH
Scans, bloods, growth, gestation,
delivery, weight, complications
FH
Recent illness, resp disease
PC/HPC
Fever, poor feeding, malaise
Previous LRTIs
SH
Living arrangements, nursery,
parental smoking
Differentials
Trauma
FB aspiration
Congenital
CF
Primary ciliary dyskinesia
Infection
Bacterial: pertussis, pharyngitis, otitis media
Viral: bronchiolitis, coryza, croup
Degenerative
Bronchiectasis
Management
Initial ABCDE
Definitive
Conservative
Information, advice, support
Admission if sats <92%,, signs of resp distress, cyanosis, reduced conciousness, comorbidity, etc.
Self care (rest, fluids, not smoking at home)
FU 4-6 wk if evidence of collapse etc, on X-ray
Medical
Analgesia
Indication: pain, fever
E.g. paracetamol, NSAIDs
Abx
Indication: all
E.g. amoxicillin 7-14d
Oxygen
Indication: sats <92%