Pneumonia is an inflammatory lung condition common in children. It is caused by viruses like RSV or bacteria like Streptococcus. Symptoms include fever, cough, rapid breathing. Risk factors include low birth weight, malnutrition, and exposure to pollution or smoking. Diagnosis involves physical exam, chest x-ray, and tests for bacterial/viral infection. Treatment depends on the cause but involves antibiotics, oxygen, fever control and nutrition. Prognosis depends on the child's health and type of pneumonia. With proper treatment, most make a full recovery.

1. PNEUMONIA IN CHILDREN

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.

5. 2. ACCORDING TO ETIOLOGICAL
DISTRIBUTION
---VIRAL
---BACTERIAL
---MICOPLASMA PNEUMONIA (PRIMARY
ATYPICAL PNEUMONIA)
3.ACCORDING TO DURATION
---PERSISTENT
---RECURRENT PNEUMONIA.
4. ASPIRATION PNEUMONIA.

7. ETIOLOGY
BACTERIAL INFECTION: PNEUMOCOCCUS,
STREPTOCOCCUS, STEPHYLOCOCCUS,
HEMOPHILUS INFLUENZA (TYPE B GRAM –VE
ORAGNISM).
VIRAL
RESPIRATORY SYNCYTIAL VIRUS (RSV) MOST
COMMON VIRUS, INFLUENZA, CHICKEN POX,
MEASLES VIRUSES.

8. OTHER CAUSES :
ASPIRATION OF AMNIOTIC FLUID, FOOD,
FOREIGN BODY, VOMITERS, CHEMICALS.

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

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.

19. SUPPORTIVE CARE :
---ANTIPYRATICS (PARACETAMOL 10-
15MG/KG/DOSE EVERY 4-6HRS).
---OXYGEN ADMINISTRATION (OXYGEN
HOOD, MASK, NASAL PRONGS)
---HYDRATION
---CHEST PHYSIOTHERAPY
---NUTRITION

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

21.  EMPYEMA(pus in pleural cavity)
 LUNG ABSCESS
 PNEUMOTHORAX
 PYOTHORAX(inflamatory fluids)
 SEPSIS
 PERICARDIAL EFFUSION

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.