Pneumonia, Pediatric
Basics
Description
Description
- Infection of the lower respiratory tract infections diagnoses marked by the presence of fever, respiratory symptoms and lung involvement (by physical examination and/or radiography)
- Viral and bacterial causes are more prevalent during winter months and seasonal. Pathogen not confirmed in as many as 25% of cases
- Spread is by droplet exposure, oropharyngeal aspiration and hematogenous
- Lower socioeconomic status (household crowding), attendance at school/daycare, inadequate immunizations, and exposure to tobacco smoke are significant risk factors
- As many as half of children under 5 years of age with pneumonia require hospitalization
Etiology
Etiology
- <3 wk:
- Group B Streptococcus species
- Enteric gram-negative organisms
- Viruses (RSV, CMV, HSV)
- L. monocytogenes
- Maternal transmission: T. pallidum, Genital mycoplasma or ureaplasma
- 3 wk–3 mo:
- Chlamydia trachomatis
- Viruses (Parainfluenza virus, RSV)
- S. pneumoniae
- Bordetella pertussis
- 3 mo–5 yr:
- Viral (predominate):
- RSV
- Parainfluenza virus
- Influenza virus
- Adenovirus
- Rhinovirus
- S. pneumoniae
- H. influenza in unimmunized children
- M. pneumoniae (>4 yr predominantly)
- S. aureus
- M. tuberculosis
- Viral (predominate):
- >5 yr:
- M. pneumoniae most common
- Viral
- S. pneumoniae
- Chlamydophila pneumoniae
- Recent immigrants from developing countries:
- Mycoplasma tuberculosis
- H. influenza
- B. pertussis
- Immunocompromised (e.g., HIV, cancer):
- P. carinii
- Mycoplasma avium complex
- M. tuberculosis
- Klebsiella pneumoniae
- Pseudomonas aeruginosa
- Less common:
- Fungal (coccidioidomycosis, histoplasmosis)
- Rickettsia (Q fever)
- Identified patterns:
- Lobar: S. pneumoniae
- Bronchopneumonia: Sometimes associated with S. pyogenes and S. aureus
- Necrotizing: Aspiration, S. pyogenes, S. pneumoniae, S. aureus
- Caseating granuloma: M. tuberculosis
- Interstitial/peribronchial with secondary parenchymal infection: Viral pneumonia with superinfection
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Citation
Schaider, Jeffrey J., et al., editors. "Pneumonia, Pediatric." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307510/all/Pneumonia__Pediatric.
Pneumonia, Pediatric. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307510/all/Pneumonia__Pediatric. Accessed December 10, 2024.
Pneumonia, Pediatric. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307510/all/Pneumonia__Pediatric
Pneumonia, Pediatric [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307510/all/Pneumonia__Pediatric.
* Article titles in AMA citation format should be in sentence-case
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T1 - Pneumonia, Pediatric
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ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307510/all/Pneumonia__Pediatric
PB - Lippincott Williams & Wilkins
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DB - Emergency Central
DP - Unbound Medicine
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