Pneumonia

Question 1

What is pneumonia?

Answer 1

Pneumonia is an infection (bacteria/virus/fungus) of one or both lungs causing inflammation filling up alveoli with pus or other fluid.

Question 2

What are the signs and symptoms of pneumonia in children?

Answer 2

1. High temperature
2. Malaise
3. Poor feeding
4. Respiratory distress, grunting, intercostal recession, use of accessory muscles
5. Tachypnoea
6. Cyanosis
   * older children have typical lobar signs (pleural pain, crackles, bronchial breathing)

Question 3

When should you admit children with pneumonia?

Answer 3

1. SpO2 <92%

2. Signs of respiratory distresss

Question 4

What tests are carried out in children with pneumonia?

Answer 4

1. Consider CXR
2. FBC / blood
3. Sputum cultures if severe pneumonia
   * investigations are not required in children with community acquired pneumonia going home

Question 5

Viral lower respiratory tract infection (LRTI) is more common in children <2years than bacterial so those with mild symptoms can be discharged without antibiotics.
=> ensure follow up if symptoms persists

Answer 5

INFO CARD

Question 6

What is the treatment for pneumonia in children?

Answer 6

1. 1st line: Amoxicillin
2. Alternatives: Co-amoxiclav, azithromycin, clarithromycin

=> macrolides added if there is no response to 1st line

=> macrolides used if mycoplasma or chlamydia suspected

=> co-amoxiclav in pneumonia assoc. with influenza

Question 7

Which organisms likely cause pneumonia in children?

Answer 7

Pneumococcus

Mycoplasma

Haemophillus

Staphylococcus

TB

Viral

Question 8

Children with pneumonia: monitor temperature, pulse, respiratory rate (TPR) and O2 saturations

Answer 8

INFO CARD

Question 9

What is the most common bacterial cause of pneumonia in children?

Answer 9

S. pneumoniae