2. 1. It is a inflammatory process involving lung
parenchyma
“Indian Academy of Pediatrics”
2. It is a inflammation with consolidation (it
is a state of being solid with exudate) of
parenchymal cells of the lung.
“Marlow – Redding”
3. INCIDENCE
Occurs most commonly in infants and
young children
30% children are admitted because of
pneumonia
90% of deaths in respiratory illnesses
are due to pneumonia
The condition kills an estimated 1.8
million children every year, according to
World Health Organization. In India, the
casualty is as high as 3 to 4 lakh
children.
4.
5. 2. ACCORDING TO ETIOLOGICAL
DISTRIBUTION
---VIRAL
---BACTERIAL
---MICOPLASMA PNEUMONIA (PRIMARY
ATYPICAL PNEUMONIA)
3.ACCORDING TO DURATION
---PERSISTENT
---RECURRENT PNEUMONIA.
4. ASPIRATION PNEUMONIA.
9. RISK FACTORS
LOW BIRTH WEIGHT
VITAMIN DEFICIENCY
LACK OF BREAST FEEDING
PASSIVE SMOKING
POOR SOCIOECONOMIC STATUS
LARGE FAMILY SIZE
OVER CROWDING
FAMILY HISTORY OF BRONCHITIS
OUT DOOR AND INDOOR AIR POLLUTIONS.
10. THE ORGANISM REACH THE PHERIPARY OF
THE LUNG AND CAUSE REACTIVE OEDEMA
WHICH ENCOURAGES PROLIFERATION OF
THE ORGANISMS.
THE INVOLVED LOBE UNDERGOES
CONSOLIDATION WITH
POLYMORPHONUCLEAR LEUKOCYTES,
FIBRIN, RBC, OEDEMA, FLUID AND
PNEUMOCOCCI FILLING ALVEOLI.
11. THERE ARE 4 STAGES OF ILLNESS
1. REACTIVE EDEMA
2. RED HEPATISATION
3. GREY HEPATSATION
4. RESOLUTION
12.
13. ☺THERE IS ABRUPT ON SET OF HIGH FEVER WITH
RESPIRATORY DISTRESS. RESTLESSNESS AND AIR
HUNGER.
☺CYANOSIS
☺GRUNTING , FLARING (NAZAL)
☺RETRACTION OF THE SUPRACLAVICULAR,
INTERCOSTAL AND SUBCOSTAL AREAS.
☺TACHYPNEA (50 BREATHS/ MINUTE) , TACHY
CARDIA.
☺COUGH APPEARS LATER.
☺DYSPNEA, ANOXIA.
☺VOMITINGS( REFUSAL OF FEEDS).
14. DIAGNOSTIC EVALUATION:
---THE DIAGNOSIS IS MADE BY 4 METHODS OF
PHYSICAL EXAMINATION
---INSPECTION OF RAPID RESPIRATION,
DYSPNEA, CYANOSIS
---ON PERCUSSION THERE MAY BE LOCALIZED
DULL NESS
15. • ---AUSCULTATION REVEALS BRONCHIAL
BREATHING CRACKLING RAYS.
• ---SEROLOGICAL EXAMINATION FOR
CULTURAL SENSITIVITY (BACTERIAL,
VIRAL, IgG/IgM IN SERUM.
• ---WBC COUNT IS ELIVATED
• ---CBP FOR EVIDENCE OF SEPSIS.
16. NASOPHARYNGEAL FOR VIRAL ANTIGEN
(CMV, ADENOVIRUS)
TUBERCULIN SKIN TEST TO RULE OUT TB
ORGANISM
CHEST X-RAY
INVASIVE PROCEDURES
- BRONCHOSCOPY
- LUNG ASPIRATION
- LUNG BIOPSY
17. OUT PATIENT MANAGEMENT
- SUPPORTIVE CARE
- FOLLOWUP OF CHILD
- ORAL COTRIMAXAZOLE OR
AMOXICILLINE/CEPHALEXIL FOR 5-7
DAYS
- ASSESS FOR CLINICAL STATUS AND
DETERIORATION OF CHILD.
18. INPATIENT MANAGEMENT
- SPECIFIC:
- AMPLICINE, SEPHALOSPORINS FOR
INFANTS BELOW 2 MONTHS.
- AMOXICILLINE, CEFITOXIME
(CHILDREN MORE THAN 2 MONTHS)
FOR 10-14 DAYS.
- ERYTHROMYCIN, CLARIPHROMYCIN
FOR 10 DAYS.
20. ASSESSEMENT OF A CHILD AND DETERMINE THE
CAUSATIVE ORGANISM.
CONTROL OF FEVER
MAINTAINE PATENT AIRWAY
PROVISION OF HIGH HUMIDIFIED OXYGEN.
POSITIONING
MONITOR RESPIRATORY STATUS AND VITAL SIGNS.
ADMINISTRATION OF ANTIBIOTICS
PROMOTION OF REST
PROVISION OF APPROPRIATE AND ADEQUATE
FLUIDS AND NUTRITION
SUPPORT AND EDUCATION TO PARENTS
PREVENTION OF COMPLICATIONS
22. INCREASED ORAL IN TAKE
ADEQUATE BED REST
FREQUENTLY CHECK TEMPERATURE
PLACE THE CHILD IN SEMI FOWLER
POSITION
GIVE ANTIPYRETICS
REGURAL FOLLOW-UPS.
23. PROGNOSIS
• DEPENDS ON NUTRITIONAL STATUS, AGE,
TYPE OF PNEUMONIA, ADEQUACY OF
TREATMENT
• STREPTOCOCCUS – GOOD WITH
TREATMENT
• STAPHYLOCOCCAL – REQUIRED
HOSPITALIZATION, MOTALITY RATE 10-
30%.
• H.INFLUENZA OR VERY HIGH BECAUSE OF
SEVEOUR COMPLICATIONS.
• RECOVERY FROM MYCOPLASMA
PNEUMONIA MAY BE SLOW.
