3. Epidemiology:
• Pneumonia causes 28–34% of all deaths in those under five years of
age of which 95% occur in the developing world.
• Countries with the greatest burden of disease include:
India (43 million)
China (21 million)
Pakistan (10 million).
4. Types of Pneumonia :
1. According to involvement of lung tissue :
a. Bronchopneumonia
b. Lobar Pneumonia
2. According to source:
a. Community acquired Pneumonia
b. Nosocomial Pneumonia
c. Pneumonia in special situation (aspiration pneumonia, opportunistic pneumonia)
3. According to severity (IMCI) :
a. Severe Pneumonia or very severe disease
b. Pneumonia
c. no pneumonia
5. Risk Factors for Pneumonia of pediatric age group:
1. Preterm baby
2. Malnutrition
3. cystic fibrosis
4. asthma
5. Diabetes
6. heart failure
7. weak immune system.
10. Organisms causing Pneumonia in different age group :
Age Organisms
Neonatal period • E. coli
• K pneumonia
• Group B streptococcus
After neonatal
period
• S. pneumoniae
• H. influenzae type B
• S. aureus
• viruses
Beyond 5 years • Mycoplasma
• Chlamydia
12. Fast breating:
0 to 2 months: Respiratory rate> 60/min
2 months to 12 months: RR > 50/min
1 year to 5 year : RR > 40/min
13. Investigations
Name of investigations Probable Findings
1. X-Ray chest In CONSOLIDATION: Homogenous radio-opacity in any area of the lung field.
In Bronchopneumonia: Patchy opacities are seen in different areas of lung field.
2. Complete blood counts Polymorphonuclear leukocytosis
ESR: high
3. Blood CS May show growth of organisms
14. Treatment
1. Counselling
2. Supportive Treatment :
Oxygen therapy: if Cyanosis or SpO2 less than 92%
Paracetamol for fever
Salbutamol for wheeze
Clear nose with normal saline drop
soothe the throat, relieve cough with a safe remedy(warm water, tulsi leaf
juice, lemon tea)
15. 3. Specific Treatment :
a. Bacterial:
Severe Pneumonia:
Hospitalization
Parenteral Ampicillin/ Amoxicillin
Pneumonia:
Oral Amoxicillin
Other antibiotics: Cloxacillin, Ceftriaxone
16. b. Viral:
Influenza A : rimantadine or amantadine
Influenza A or B: oseltamivir, zanamivir or peramivir
C. Aspiration Pneumonia:
Clindamycin
Beta lactam
Metronidazole
Aminoglycosides
17. Prevention of Pneumonia:
1. Vaccinations
2. Medications
3. Others: prevention of air pollution, avoiding of passive smoking of
children
18. Complications if untreated or maltreated:
Pleural effusion
Empyema
Lung abscess
Pneumothorax
Heart Failure
Septicemia
Dissemination to other organs: meninges, bones, joints etc.