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Pneumonia: Neonates To Adolescents
Pneumonia: Neonates To Adolescents
Pneumonia: Neonates To Adolescents
Neonates to adolescents
WHAT IS PNEUMONIA?
Infection of the lower respiratory tract
that involves Inflammation of the
alveolar space and surrounding tissues,
often compromising air exchange
Single greatest cause of death in children
worldwide
Annual incidence 3-4 cases per 100 children
<5 years old
Metastatic
Meningitis, pericarditis, endocarditis, osteomyelitis, septic arthritis
Systemic
Sepsis
WHO GETS HOSPITALIZED?
Infants less than 3 to 6 months with suspected bacterial CAP will
benefit from hospitalization
Group B streptococcus
Chlamydia trachomatis
Gram negative rods
Listeria monocytogenes
(same viruses as
above)
Preschool VIRAL + S. Pneumoniae
(2 -5 years) BACTERIAL
M. Pneumoniae
H. Flu (nontypable)
M. Pneumoniae
School aged to
BACTERIAL + S. Pneumoniae
adolescents
ATPICAL C. Pneumoniae
(5+ years)
MRSA
VIRAL PNEUMONIA
More often associated with cough or wheezing
KEY WORDS: insidious, low grade fever, wheeze, URI symptoms, mild dyspnea
KEY WORDS: rales, rhonchi, high fever, productive cough, severe, acute,
decreased breath sounds, chest pain, dyspnea
OUTPATIENT: OUTPATIENT:
Initial:
high chest-xray 7-10 days
dose Amoxicillin Azithromycin (z-pack)
Chest x-ray: interstitial, usually lower lobes. Looks worse than patient
KEY WORDS: insidious, URI symptoms with cough that worsens over weeks, rales are
most common physical finding
TREATMENT: Macrolide antibiotics 7-10 days (or ciprofloxacin)+ hydration, bed rest,
antipyretics
Mycoplasma
pneumonaie
Alveolar
consolidation
in LLL and RLL
DIAGNOSIS
Clinical diagnosis
Tachypnea is the most important clinical sign (must be counted over 1 full
minute)
In febrile children, look for chest retractions, grunting, nasal flaring, crepitation's
Hydration status, activity level, and oxygen saturation are important and may
indicate the need for hospitalization
Diagnosis
Chest x-ray IF resp. distress present, documented hypoxemia, or failed initial abx
therapy
For outpatient simple CAP, routine chest x-rays are not recommended to confirm
CAP, treat empirically
CBC and blood cultures also not recommended
TREATMENT
APA GUIDELINES
Amoxicillin is first line therapy for bacterial pneumonia
Stronger antibiotics are often not needed
Should consider MRSA in cases of pneumonia where first-line treatment fails
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