Pneumonia is an inflammatory lung condition most common in young children. It is caused by viruses like RSV or bacteria like Streptococcus. Symptoms include fever, cough, rapid breathing, and lung consolidation seen on chest x-ray. Treatment involves antibiotics, oxygen, fever control, and nutrition support. Timely treatment can resolve pneumonia, but it remains a major cause of death in children worldwide due to lack of access to care.

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,
HEMOPHILUSINFLUENZA (TYPE B GRAME –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

12. ☺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).

13. 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

14. • ---AUSCULTATION REVEALS RONCHIAL
BREATHING CRACKLING RAYS.
• ---SEROLOGICAL EXAMINATION FOR CULTURAL
SENSITIVITY (BACTERIAL, VIRAL, IgG/IGM
INSERUM.
• ---WBC COUNT IS ELIVATED UPTO MORE THAN
15000 CELLS.
• ---CBP FOR EVIDENCE OF SEPSIS.

15.  NASOPHARYNGEAL FOR VIRAL ANTIGEN (CMV,
ADENOVIRUS)
 TUBERCULIN SKIN TEST TO RULE OUT TB
ORGANISM
 CHEST X-RAY
 INVASIVE PROCEDURES
 - BRONCHOSCOPY
 - BRONCHOALVEORLAR LAVAGE
 - LUNG ASPIRATION
 - LUNG BIOPSY

16.  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.

17.  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.

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

19.  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

20.  EMPYEMA
 LUNG ABSCESS
 PNEUMOTHORAX
 PYOTHORAX
 SEPSIS
 PERICARDIAL EFFUSION

21.  INCREASED ORAL IN TAKE
 ADEQUATE BED REST
 FREQUENTLY CHECK TEMPERATURE
 PLACE THE CHILD IN SEMI FOWLER
POSITION
 GIVE ANTIPYRETICS
 REGURAL FOLLOW-UPS.

22.  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.