Pneumonia is an infection of the lower respiratory tract that involves the airways and lung tissue. It can be caused by viruses, bacteria, or other pathogens. Symptoms may include fever, cough, difficulty breathing, and chest pain. Treatment involves supportive care and antibiotics depending on the suspected cause and severity of illness. Chest x-rays are sometimes needed to identify the location and extent of lung involvement and check for complications.
The document discusses respiratory infections in children, including upper respiratory tract infections like sinusitis, pharyngitis, and ear infections, as well as lower respiratory tract infections like pneumonia and bronchiolitis. It describes the anatomy of the upper and lower respiratory tract, signs and symptoms of different infections, common causative agents, and treatment approaches.
Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid, which makes it hard for oxygen to reach the bloodstream.
Someone with pneumonia may have a fever, cough, or trouble breathing.
Epidemiology
Leading infectious cause of death globally among children < 5 yr
More than 99% of pneumonia deaths are in low- and middle-income countries
Effective vaccines against measles and pertussis contributed to the decline in pneumonia-related mortality during the 20th century.
H.influenzae type b uncommon following licensure of a conjugate vaccine in 1987
PCVs has been an important contributor to the further reductions in pneumonia-related mortality
Etiology
Microorganisms (most)
Noninfectious
Aspiration (food or gastric acid, foreign bodies, hydrocarbons)
Hypersensitivity reactions
Drug- or radiation-inducedpneumonitis
Strep pneumoniae (pneumococcus) is the most common bacterial pathogen in children 3 wk to 4 yr
Mycoplasma pneumoniae and Chlamydophila pneumoniae are the most frequent bacterial pathogens in children age 5 yr and older.
S. aureus pneumonia often complicates an illness caused by influenza viruses.
The document summarizes respiratory diseases and conditions. It begins with an introduction to the respiratory system and its functions. It then discusses various respiratory diseases including sinusitis, viral upper respiratory infections, pneumonia, bronchitis, bronchiolitis, asthma, and classifications of respiratory diseases. For each condition, it describes clinical findings, management, and in some cases oral health considerations. The highest level information is that the document classifies and describes several common respiratory diseases and infections, focusing on symptoms, causes, and treatment approaches for each.
Respiratory diseases and associated with dental managment Student طالب جامعي
The document provides an overview of respiratory diseases. It begins by describing the functions of the respiratory system and its main components. It then discusses specific respiratory conditions like sinusitis, viral infections, bronchitis, pneumonia, bronchiolitis, asthma and COPD. For each condition, it describes the causes, clinical findings, management and oral health considerations. The document aims to comprehensively cover the major respiratory diseases and related topics.
Pneumonia is an inflammation of the lung parenchyma caused by a microbial agent. It can be caused by bacteria, viruses, fungi or parasites. There are different classifications including community-acquired pneumonia (CAP), hospital-acquired pneumonia, and pneumonia in immunocompromised hosts. CAP is usually caused by Streptococcus pneumoniae or Haemophilus influenzae. Hospital-acquired pneumonia has a higher risk of drug-resistant organisms. Clinical manifestations include fever, cough, shortness of breath and chest pain.
This document discusses community-acquired pneumonia (CAP) in children. CAP is an acute lung infection acquired outside the hospital in a previously healthy child. Common causes are viruses like respiratory syncytial virus and bacteria such as Streptococcus pneumoniae. Clinical features include fever, cough, tachypnea and increased work of breathing. Diagnosis is usually made clinically but investigations like chest X-ray, blood tests and PCR may be done. Treatment involves antibiotics and supportive care. Complications can include pleural effusions, empyema and bacteremia. Vaccines against pneumococcus and influenza can help prevent CAP.
Community Acquired Pneumonia in Children (for undergraduate studens)Dr Anand Singh
Pneumonia is a common lung infection in children characterized by fever, respiratory symptoms, and evidence of lung involvement on physical exam or chest imaging. It can be caused by bacteria, viruses, or other pathogens. Clinical features include tachypnea, cough, hypoxemia, and abnormal breath sounds. Chest x-ray is used to confirm the diagnosis. Treatment involves antibiotics, oxygen, and hospitalization for severe cases. Prevention strategies include vaccination, hand hygiene, and reducing hospital-acquired infections.
The document discusses respiratory infections in children, including upper respiratory tract infections like sinusitis, pharyngitis, and ear infections, as well as lower respiratory tract infections like pneumonia and bronchiolitis. It describes the anatomy of the upper and lower respiratory tract, signs and symptoms of different infections, common causative agents, and treatment approaches.
Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid, which makes it hard for oxygen to reach the bloodstream.
Someone with pneumonia may have a fever, cough, or trouble breathing.
Epidemiology
Leading infectious cause of death globally among children < 5 yr
More than 99% of pneumonia deaths are in low- and middle-income countries
Effective vaccines against measles and pertussis contributed to the decline in pneumonia-related mortality during the 20th century.
H.influenzae type b uncommon following licensure of a conjugate vaccine in 1987
PCVs has been an important contributor to the further reductions in pneumonia-related mortality
Etiology
Microorganisms (most)
Noninfectious
Aspiration (food or gastric acid, foreign bodies, hydrocarbons)
Hypersensitivity reactions
Drug- or radiation-inducedpneumonitis
Strep pneumoniae (pneumococcus) is the most common bacterial pathogen in children 3 wk to 4 yr
Mycoplasma pneumoniae and Chlamydophila pneumoniae are the most frequent bacterial pathogens in children age 5 yr and older.
S. aureus pneumonia often complicates an illness caused by influenza viruses.
The document summarizes respiratory diseases and conditions. It begins with an introduction to the respiratory system and its functions. It then discusses various respiratory diseases including sinusitis, viral upper respiratory infections, pneumonia, bronchitis, bronchiolitis, asthma, and classifications of respiratory diseases. For each condition, it describes clinical findings, management, and in some cases oral health considerations. The highest level information is that the document classifies and describes several common respiratory diseases and infections, focusing on symptoms, causes, and treatment approaches for each.
Respiratory diseases and associated with dental managment Student طالب جامعي
The document provides an overview of respiratory diseases. It begins by describing the functions of the respiratory system and its main components. It then discusses specific respiratory conditions like sinusitis, viral infections, bronchitis, pneumonia, bronchiolitis, asthma and COPD. For each condition, it describes the causes, clinical findings, management and oral health considerations. The document aims to comprehensively cover the major respiratory diseases and related topics.
Pneumonia is an inflammation of the lung parenchyma caused by a microbial agent. It can be caused by bacteria, viruses, fungi or parasites. There are different classifications including community-acquired pneumonia (CAP), hospital-acquired pneumonia, and pneumonia in immunocompromised hosts. CAP is usually caused by Streptococcus pneumoniae or Haemophilus influenzae. Hospital-acquired pneumonia has a higher risk of drug-resistant organisms. Clinical manifestations include fever, cough, shortness of breath and chest pain.
This document discusses community-acquired pneumonia (CAP) in children. CAP is an acute lung infection acquired outside the hospital in a previously healthy child. Common causes are viruses like respiratory syncytial virus and bacteria such as Streptococcus pneumoniae. Clinical features include fever, cough, tachypnea and increased work of breathing. Diagnosis is usually made clinically but investigations like chest X-ray, blood tests and PCR may be done. Treatment involves antibiotics and supportive care. Complications can include pleural effusions, empyema and bacteremia. Vaccines against pneumococcus and influenza can help prevent CAP.
Community Acquired Pneumonia in Children (for undergraduate studens)Dr Anand Singh
Pneumonia is a common lung infection in children characterized by fever, respiratory symptoms, and evidence of lung involvement on physical exam or chest imaging. It can be caused by bacteria, viruses, or other pathogens. Clinical features include tachypnea, cough, hypoxemia, and abnormal breath sounds. Chest x-ray is used to confirm the diagnosis. Treatment involves antibiotics, oxygen, and hospitalization for severe cases. Prevention strategies include vaccination, hand hygiene, and reducing hospital-acquired infections.
This document discusses various types and causes of pneumonia in children. It describes the differences between lobar pneumonia, bronchopneumonia, and interstitial pneumonitis. Common infectious causes include respiratory viruses in young children and Streptococcus pneumoniae and Mycoplasma pneumoniae in older children. Clinical features, investigations, treatment, and prognosis are outlined. Pneumonia is a major cause of illness and death in developing countries. Immunizations have reduced cases of pneumonia from certain pathogens.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It occurs when the alveoli in the lungs become filled with fluid or pus, making breathing painful and limiting oxygen intake. There are different classifications and types of pneumonia depending on the causative agent and where it was acquired. Diagnosis involves physical exams, imaging tests like chest x-rays, and lab tests of sputum, blood, or fluid samples. Complications can include respiratory failure or sepsis. Treatment involves antibiotics for bacterial pneumonia, antivirals for viral pneumonia, and managing symptoms at home with rest, fluids, and fever control.
Pediatric pneumonia has several causes and presentations depending on a child's age. Viruses are a common cause in infants and toddlers, while bacterial pathogens like Streptococcus pneumoniae become more frequent causes in older children. Clinical signs include fever, cough, tachypnea and respiratory distress. Diagnosis is usually made clinically, though imaging can identify complications. Treatment involves antibiotics when bacteria are suspected along with supportive care. Hospitalization is needed for young infants, severe cases and those with underlying conditions or complications.
Stridor is a harsh sound caused by partial obstruction of the upper airway. Common causes include viral infections like croup. The severity of obstruction can be assessed clinically by characteristics of stridor and degree of chest retraction. Complete obstruction can cause cyanosis and reduced consciousness. Viral croup accounts for over 95% of laryngotracheal infections and usually occurs in children aged 6 months to 6 years, peaking at age 2.
Pneumonia is an inflammation of the lung parenchyma that is most commonly caused by infectious agents like bacteria and viruses. It is a leading cause of death among children under 5 years old globally. Symptoms include cough, fever, tachypnea, and respiratory distress. Diagnosis involves physical exam findings and chest x-ray. Treatment depends on the suspected cause and severity of illness, and may involve hospitalization, antibiotics, oxygen support, and fluid resuscitation. Prognosis is generally good with appropriate treatment, but complications can occur.
This document discusses the approach to a child with recurrent or persistent pneumonia. It begins by defining recurrent pneumonia as 2 or more episodes in a year or 3 or more episodes ever, with radiographic clearing between occurrences. Persistent pneumonia is defined as symptoms and radiological abnormalities persisting for over 1 month despite treatment. Potential underlying causes include congenital malformations, aspirations, defects in airway clearance, and disorders of local or systemic immunity. A detailed clinical history and preliminary investigations can provide clues to the underlying illness in many cases. The approach involves obtaining a thorough history, performing physical examinations and initial tests, and considering possible etiologies.
This document discusses the approach to a child with recurrent or persistent pneumonia. It begins by defining recurrent pneumonia as 2 or more episodes in a year or 3 or more episodes ever, with radiological clearing between occurrences. Persistent pneumonia is defined as symptoms and radiological abnormalities persisting for over 1 month despite treatment. Potential underlying causes include congenital malformations, aspirations, defects in airway clearance, and disorders of local or systemic immunity. A detailed clinical history and preliminary investigations can provide clues to the underlying illness in many cases. The approach involves obtaining a thorough history, performing physical examinations and initial tests, and considering possible etiologies.
Pneumonia is an inflammatory lung condition caused by infection. It can be caused by viruses, bacteria, or fungi. The document discusses pneumonia in detail, including defining it, risk factors, classification, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Pneumonia has a high incidence rate in children under 5 years old and is a leading cause of child mortality worldwide. Treatment depends on the severity and cause of the pneumonia.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or other pathogens. Common symptoms include cough, fever, shortness of breath, and chest pain. Pneumonia is usually spread through airborne droplets from coughing or sneezing. Treatment involves antibiotics if bacterial or antivirals if viral. Prevention strategies include vaccination, reducing indoor smoke and pollution, and improving nutrition and primary healthcare access.
Dental consideration in respiratory disorders/prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Dental consideration in respiratory disorders/ dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. Symptoms may include fever, chills, cough with phlegm, shortness of breath, and chest pain. In more severe cases, nausea, vomiting, and diarrhea may occur. Treatment depends on the cause but often involves antibiotics, breathing exercises, and medications to reduce fever and suppress cough. Pneumonia occurs when air sacs in the lungs called alveoli are filled with fluid or pus, making breathing painful and limiting oxygen intake.
This document provides an overview of pediatric pneumonia. It begins by defining pneumonia as inflammation of the lung parenchyma that fills alveolar air spaces with exudate and inflammatory cells. It then discusses the epidemiology, risk factors, classifications, diagnosis, differential diagnosis, prevention, and management of pediatric pneumonia. Nursing care focuses on assessing respiratory status, managing secretions, positioning, encouraging coughing and deep breathing, and providing comfort measures. Complications can include pleural effusions, empyema, lung abscesses, and extra-pulmonary issues like dehydration or meningitis. Medical management depends on factors like age, severity and chest x-ray findings.
Pneumonia is an inflammatory lung condition caused by bacteria or viruses that enter the lungs. When pathogens enter the alveoli, or air sacs, white blood cells rush to fight the infection, filling the sacs with fluid and pus. Streptococcus pneumoniae is the most common bacterial cause. Risk factors include old age, smoking, lung diseases, and weakened immunity. Symptoms include fever, chills, cough with colored mucus, chest pain, and difficulty breathing. Diagnosis involves physical exam, chest x-rays, and tests of sputum or blood. Antibiotics treat bacterial pneumonia while rest and fluids help viral cases. Vaccines can prevent pneumococcal pneumonia.
Pneumonia is inflammation of the lung parenchyma that can be caused by infectious or non-infectious etiologies. Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children aged 3 weeks to 4 years. Pneumonia is the leading infectious cause of death in children under 5 years globally. Clinical manifestations include cough, increased respiratory rate, grunting, and fever. Chest x-ray and laboratory tests are used for diagnosis. Management involves oxygen therapy, fluid therapy, antibiotics, and admission is indicated for young infants or those with respiratory distress. Prevention includes vaccines for pathogens like Streptococcus pneumoniae, influenza, and RSV.
This document discusses pneumonia in children. It defines pneumonia as an inflammation of the lungs and notes it is a leading cause of death in children worldwide. The document covers clinical presentation, classification, diagnosis and treatment of pneumonia in various pediatric populations. It discusses complications such as parapneumonic effusion/empyema and approaches to management including supportive care, antibiotic treatment and drainage if needed. Non-resolution of pneumonia is also addressed.
This document provides information on acute respiratory infections (ARIs) in children. It notes that ARIs are a major cause of morbidity and mortality worldwide, especially in developing countries. Upper respiratory infections include conditions like the common cold, sinusitis, and tonsillitis. Lower respiratory infections include bronchiolitis and pneumonia. The document outlines signs and symptoms, risk factors, diagnostic criteria and management recommendations for various ARIs like pneumonia, croup, bronchitis, and others in children. It emphasizes supportive care, oxygen supplementation, antibiotics when indicated, and referral criteria for severe or complicated cases.
Pneumonia is an inflammation of the lung caused by various microorganisms. It is classified as community-acquired, hospital-acquired, or in immunocompromised patients. Clinical features include fever, cough, chest pain, and difficulty breathing. Diagnosis involves a chest x-ray and cultures. Treatment consists of antibiotics based on culture results and supportive care like oxygen and hydration. Nursing focuses on improving airway clearance and promoting rest. Complications can include continuing symptoms, shock, respiratory failure, or fluid buildup in the lungs.
This document provides an overview of pneumonia, including its classifications, etiology, pathophysiology, clinical manifestations, diagnosis, medical management, nursing management, potential complications, and references. Key points covered include how pneumonia is classified based on location (lobar vs. bronchopneumonia) and setting (community-acquired, hospital-acquired, etc.), common causative agents like Streptococcus pneumoniae and viruses, the inflammatory response in the lungs, symptoms like fever and cough, diagnostic tests, treatments like antibiotics and breathing therapies, nursing interventions like positioning and coughing techniques, and risks such as respiratory failure.
A hydrocele is a collection of fluid within the processus vaginalis that causes swelling in the scrotum. It can be primary (idiopathic) or secondary to diseases like tuberculosis. The processus vaginalis normally closes after birth but failure of closure can lead to a communicating hydrocele. Surgery is usually not needed for small hydroceles in infants but may be required for larger or symptomatic hydroceles to prevent complications. Common surgical techniques include excision or plication of the hydrocele sac. Postoperative follow up is needed to ensure complete recovery. Recurrence after surgery is rare.
Urinary tract infections (UTIs) occur more commonly in girls than boys, with the highest rates in infants and during toilet training. In boys, most UTIs occur in the first year of life and are more common in uncircumcised boys. UTIs are usually caused by bacteria that enter the bladder from the gastrointestinal tract. The main types of UTIs are pyelonephritis, cystitis, and asymptomatic bacteriuria. Pyelonephritis involves the kidneys and can cause fever and other systemic symptoms, while cystitis only involves the bladder. Imaging studies like ultrasound and voiding cystourethrogram help identify anatomical abnormalities and assess renal involvement and function in children with UTIs.
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Similar to pneumoniainchildren-151125034426-lva1-app6892.pdf
This document discusses various types and causes of pneumonia in children. It describes the differences between lobar pneumonia, bronchopneumonia, and interstitial pneumonitis. Common infectious causes include respiratory viruses in young children and Streptococcus pneumoniae and Mycoplasma pneumoniae in older children. Clinical features, investigations, treatment, and prognosis are outlined. Pneumonia is a major cause of illness and death in developing countries. Immunizations have reduced cases of pneumonia from certain pathogens.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It occurs when the alveoli in the lungs become filled with fluid or pus, making breathing painful and limiting oxygen intake. There are different classifications and types of pneumonia depending on the causative agent and where it was acquired. Diagnosis involves physical exams, imaging tests like chest x-rays, and lab tests of sputum, blood, or fluid samples. Complications can include respiratory failure or sepsis. Treatment involves antibiotics for bacterial pneumonia, antivirals for viral pneumonia, and managing symptoms at home with rest, fluids, and fever control.
Pediatric pneumonia has several causes and presentations depending on a child's age. Viruses are a common cause in infants and toddlers, while bacterial pathogens like Streptococcus pneumoniae become more frequent causes in older children. Clinical signs include fever, cough, tachypnea and respiratory distress. Diagnosis is usually made clinically, though imaging can identify complications. Treatment involves antibiotics when bacteria are suspected along with supportive care. Hospitalization is needed for young infants, severe cases and those with underlying conditions or complications.
Stridor is a harsh sound caused by partial obstruction of the upper airway. Common causes include viral infections like croup. The severity of obstruction can be assessed clinically by characteristics of stridor and degree of chest retraction. Complete obstruction can cause cyanosis and reduced consciousness. Viral croup accounts for over 95% of laryngotracheal infections and usually occurs in children aged 6 months to 6 years, peaking at age 2.
Pneumonia is an inflammation of the lung parenchyma that is most commonly caused by infectious agents like bacteria and viruses. It is a leading cause of death among children under 5 years old globally. Symptoms include cough, fever, tachypnea, and respiratory distress. Diagnosis involves physical exam findings and chest x-ray. Treatment depends on the suspected cause and severity of illness, and may involve hospitalization, antibiotics, oxygen support, and fluid resuscitation. Prognosis is generally good with appropriate treatment, but complications can occur.
This document discusses the approach to a child with recurrent or persistent pneumonia. It begins by defining recurrent pneumonia as 2 or more episodes in a year or 3 or more episodes ever, with radiographic clearing between occurrences. Persistent pneumonia is defined as symptoms and radiological abnormalities persisting for over 1 month despite treatment. Potential underlying causes include congenital malformations, aspirations, defects in airway clearance, and disorders of local or systemic immunity. A detailed clinical history and preliminary investigations can provide clues to the underlying illness in many cases. The approach involves obtaining a thorough history, performing physical examinations and initial tests, and considering possible etiologies.
This document discusses the approach to a child with recurrent or persistent pneumonia. It begins by defining recurrent pneumonia as 2 or more episodes in a year or 3 or more episodes ever, with radiological clearing between occurrences. Persistent pneumonia is defined as symptoms and radiological abnormalities persisting for over 1 month despite treatment. Potential underlying causes include congenital malformations, aspirations, defects in airway clearance, and disorders of local or systemic immunity. A detailed clinical history and preliminary investigations can provide clues to the underlying illness in many cases. The approach involves obtaining a thorough history, performing physical examinations and initial tests, and considering possible etiologies.
Pneumonia is an inflammatory lung condition caused by infection. It can be caused by viruses, bacteria, or fungi. The document discusses pneumonia in detail, including defining it, risk factors, classification, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Pneumonia has a high incidence rate in children under 5 years old and is a leading cause of child mortality worldwide. Treatment depends on the severity and cause of the pneumonia.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or other pathogens. Common symptoms include cough, fever, shortness of breath, and chest pain. Pneumonia is usually spread through airborne droplets from coughing or sneezing. Treatment involves antibiotics if bacterial or antivirals if viral. Prevention strategies include vaccination, reducing indoor smoke and pollution, and improving nutrition and primary healthcare access.
Dental consideration in respiratory disorders/prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Dental consideration in respiratory disorders/ dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. Symptoms may include fever, chills, cough with phlegm, shortness of breath, and chest pain. In more severe cases, nausea, vomiting, and diarrhea may occur. Treatment depends on the cause but often involves antibiotics, breathing exercises, and medications to reduce fever and suppress cough. Pneumonia occurs when air sacs in the lungs called alveoli are filled with fluid or pus, making breathing painful and limiting oxygen intake.
This document provides an overview of pediatric pneumonia. It begins by defining pneumonia as inflammation of the lung parenchyma that fills alveolar air spaces with exudate and inflammatory cells. It then discusses the epidemiology, risk factors, classifications, diagnosis, differential diagnosis, prevention, and management of pediatric pneumonia. Nursing care focuses on assessing respiratory status, managing secretions, positioning, encouraging coughing and deep breathing, and providing comfort measures. Complications can include pleural effusions, empyema, lung abscesses, and extra-pulmonary issues like dehydration or meningitis. Medical management depends on factors like age, severity and chest x-ray findings.
Pneumonia is an inflammatory lung condition caused by bacteria or viruses that enter the lungs. When pathogens enter the alveoli, or air sacs, white blood cells rush to fight the infection, filling the sacs with fluid and pus. Streptococcus pneumoniae is the most common bacterial cause. Risk factors include old age, smoking, lung diseases, and weakened immunity. Symptoms include fever, chills, cough with colored mucus, chest pain, and difficulty breathing. Diagnosis involves physical exam, chest x-rays, and tests of sputum or blood. Antibiotics treat bacterial pneumonia while rest and fluids help viral cases. Vaccines can prevent pneumococcal pneumonia.
Pneumonia is inflammation of the lung parenchyma that can be caused by infectious or non-infectious etiologies. Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children aged 3 weeks to 4 years. Pneumonia is the leading infectious cause of death in children under 5 years globally. Clinical manifestations include cough, increased respiratory rate, grunting, and fever. Chest x-ray and laboratory tests are used for diagnosis. Management involves oxygen therapy, fluid therapy, antibiotics, and admission is indicated for young infants or those with respiratory distress. Prevention includes vaccines for pathogens like Streptococcus pneumoniae, influenza, and RSV.
This document discusses pneumonia in children. It defines pneumonia as an inflammation of the lungs and notes it is a leading cause of death in children worldwide. The document covers clinical presentation, classification, diagnosis and treatment of pneumonia in various pediatric populations. It discusses complications such as parapneumonic effusion/empyema and approaches to management including supportive care, antibiotic treatment and drainage if needed. Non-resolution of pneumonia is also addressed.
This document provides information on acute respiratory infections (ARIs) in children. It notes that ARIs are a major cause of morbidity and mortality worldwide, especially in developing countries. Upper respiratory infections include conditions like the common cold, sinusitis, and tonsillitis. Lower respiratory infections include bronchiolitis and pneumonia. The document outlines signs and symptoms, risk factors, diagnostic criteria and management recommendations for various ARIs like pneumonia, croup, bronchitis, and others in children. It emphasizes supportive care, oxygen supplementation, antibiotics when indicated, and referral criteria for severe or complicated cases.
Pneumonia is an inflammation of the lung caused by various microorganisms. It is classified as community-acquired, hospital-acquired, or in immunocompromised patients. Clinical features include fever, cough, chest pain, and difficulty breathing. Diagnosis involves a chest x-ray and cultures. Treatment consists of antibiotics based on culture results and supportive care like oxygen and hydration. Nursing focuses on improving airway clearance and promoting rest. Complications can include continuing symptoms, shock, respiratory failure, or fluid buildup in the lungs.
This document provides an overview of pneumonia, including its classifications, etiology, pathophysiology, clinical manifestations, diagnosis, medical management, nursing management, potential complications, and references. Key points covered include how pneumonia is classified based on location (lobar vs. bronchopneumonia) and setting (community-acquired, hospital-acquired, etc.), common causative agents like Streptococcus pneumoniae and viruses, the inflammatory response in the lungs, symptoms like fever and cough, diagnostic tests, treatments like antibiotics and breathing therapies, nursing interventions like positioning and coughing techniques, and risks such as respiratory failure.
Similar to pneumoniainchildren-151125034426-lva1-app6892.pdf (20)
A hydrocele is a collection of fluid within the processus vaginalis that causes swelling in the scrotum. It can be primary (idiopathic) or secondary to diseases like tuberculosis. The processus vaginalis normally closes after birth but failure of closure can lead to a communicating hydrocele. Surgery is usually not needed for small hydroceles in infants but may be required for larger or symptomatic hydroceles to prevent complications. Common surgical techniques include excision or plication of the hydrocele sac. Postoperative follow up is needed to ensure complete recovery. Recurrence after surgery is rare.
Urinary tract infections (UTIs) occur more commonly in girls than boys, with the highest rates in infants and during toilet training. In boys, most UTIs occur in the first year of life and are more common in uncircumcised boys. UTIs are usually caused by bacteria that enter the bladder from the gastrointestinal tract. The main types of UTIs are pyelonephritis, cystitis, and asymptomatic bacteriuria. Pyelonephritis involves the kidneys and can cause fever and other systemic symptoms, while cystitis only involves the bladder. Imaging studies like ultrasound and voiding cystourethrogram help identify anatomical abnormalities and assess renal involvement and function in children with UTIs.
1. Acute glomerulonephritis is a common kidney disease in children that often presents with red urine caused by blood in the urine. It typically results from a prior streptococcal infection of the throat or skin.
2. The disease is characterized by sudden onset of hematuria, decreased urine output, edema, and high blood pressure. It involves inflammation of the capillary loops in the kidneys caused by antigen-antibody complexes depositing in the glomeruli.
3. Treatment focuses on monitoring for hematuria, edema, and hypertension. Fluid intake is restricted if urine output decreases significantly. Antibiotics may be given if a streptococcal infection preceded the acute glomerulone
Hemophilia is a group of hereditary bleeding disorders caused by deficiencies in clotting factors VIII or IX. The main types are hemophilia A (factor VIII deficiency) and hemophilia B (factor IX deficiency). Symptoms include prolonged or excessive bleeding from minor injuries, bleeding into joints, muscles or internal organs. Treatment involves replacing the missing clotting factor through infusions or injections. Nursing care focuses on preventing and controlling bleeding episodes, limiting joint damage, managing pain, providing education and emotional support to patients and families.
This document discusses heart failure in children, including its definition, types, causes, symptoms, diagnosis, complications, and management. Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. In children, common causes include congenital heart disease, rheumatic heart disease, and cardiomyopathy. Symptoms vary by age but may include feeding issues, sweating, edema, fast breathing, and fatigue. Diagnosis involves exams, chest x-rays, electrocardiograms, and echocardiograms. Complications can include arrhythmias, infections, and organ dysfunction. Treatment focuses on supportive care, medications to improve heart function, and treating the underlying cause. Prognosis depends on the cause,
Leukemias are the most common cancers affecting children, with acute lymphoblastic leukemia (ALL) accounting for 73% of cases and acute myeloid leukemia (AML) accounting for 18% of cases. ALL incidence peaks between ages 2-5 years and accounts for 25-30% of all childhood cancers. Treatment involves induction, consolidation/intensification, and continuation phases using chemotherapy, immunotherapy, stem cell transplantation, and supportive care. The goal is to achieve remission and prevent relapse through risk stratification and tailored therapy.
This document discusses pediatric cardiac disorders, including:
1. Congenital heart defects (CHDs) are the most common birth defects and cause of infant mortality. CHDs can be acyanotic (left-to-right shunts) or cyanotic (right-to-left shunts). Common defects include atrial and ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and transposition of the great arteries.
2. Assessment of suspected CHD involves history, physical exam including pulse oximetry, chest x-ray, EKG, and echocardiogram. Major signs are systolic murmurs, diastolic murmurs, cyan
This document provides guidance on conducting a pediatric history and physical examination. It outlines the key components of the history, including the chief complaint, history of present illness, past medical history, nutrition, development, immunizations, family history, and review of systems. It then describes conducting a physical exam, including vital signs, general appearance, and examination of the head, eyes, ears, nose, throat, and other body systems. The goal is to obtain all relevant information from the child's history and perform an thorough physical exam to make an accurate diagnosis.
This document outlines a lecture on neonatal care. It begins with defining terms like newborn and neonate. It then discusses the objectives of the session which are to define terms, explain neonatal physiology and assessments, classify newborns, and discuss common problems and their management. The document covers classifications of newborns, essential newborn care steps, neonatal assessments including physical exams of different body systems, and common neonatal problems.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
pneumoniainchildren-151125034426-lva1-app6892.pdf
1.
2. Pneumonia
• Pneumonia is an infection of the lower respiratory
tract that involves the airways and parenchyma with
consolidation of the alveolar spaces.
• The term lower respiratory tract infection is often
used to encompass bronchitis, bronchiolitis, or
pneumonia or any combination of the three, which
may be difficult to distinguish clinically.
• Pneumonitis is a general term for lung inflammation
that may or may not be associated with consolidation.
3. Important notes??
• Lobar pneumonia describes "typical" pneumonia localized
to one or more lobes of the lung in which the affected lobe
or lobes are completely consolidated.
• Bronchopneumonia refers to inflammation of the lung that
is centered in the bronchioles and leads to the production
of a mucopurulent exudate that obstructs some of these
small airways and causes patchy consolidation of the
adjacent lobules.
• Interstitial pneumonitis refers to inflammation of the
interstitium, which is composed of the walls of the alveoli,
the alveolar sacs and ducts, and the bronchioles. Interstitial
pneumonitis is characteristic of acute viral infections, but
also may be a chronic process.
4. Defense mechanism
• Lower airways and secretions are sterile as a result of a
multicomponent cleansing system.
• Airway contaminants are caught in the mucus secreted by
the goblet cells.
• Cilia on epithelial surfaces, composing the ciliary elevator
system, beat synchronously to move particles upward
toward the central airways and into the throat, where they
are swallowed or expectorated.
• Polymorphonuclear neutrophils from the blood and tissue
macrophages ingest and kill microorganisms.
• IgA secreted into the upper airway fluid protects against
invasive infections and facilitates viral neutralization.
5. Epidemiology
• Pneumonia is a substantial cause of morbidity and
mortality in childhood throughout the world,
• Immunizations have had a great impact on the incidence of
pneumonia caused by pertussis, diphtheria, measles, Hib,
and S. pneumoniae.
• Where used, bacille Calmette-Guérin (BCG) for tuberculosis
also has had a significant impact.
• More than 4 million deaths each year in developing
countries are due to acute respiratory tract infections.
• The incidence of pneumonia is more than 10-fold higher
and the number of childhood-related deaths due to
pneumonia ≈2000-fold higher, in developing than in
developed countries.
6. Risk factors
• Risk factors for lower respiratory tract infections
include:
• gastroesophageal reflux,
• neurologic impairment (aspiration),
• immunocompromised states,
• anatomic abnormalities of the respiratory tract,
• residence in residential care facilities for
handicapped children, and
• hospitalization, especially in an ICU or requiring
invasive procedures.
7. Etiology
Although most cases of pneumonia are
caused by microorganisms,(infectious)
noninfectious causes include:
• aspiration of food or gastric acid,
• foreign bodies,
• hydrocarbons, and lipoid substances,
• hypersensitivity reactions, and
• drug- or radiation-induced pneumonitis.
8. • The infectious agents that commonly cause
community-acquired pneumonia vary by age
• The most common causes are RSV in infants ,
• respiratory viruses (RSV, parain-fluenza viruses,
influenza viruses, adenoviruses) in children younger
than 5 years old, and
• M. pneumoniae and S. pneumoniae in children older
than age 5.
• M. pneumoniae and C. pneumoniae are the principal
causes of atypical pneumonia.
• Additional agents occasionally or rarely cause
pneumonia as hospital-acquired pneumonia, as
zoonotic infections, in endemic areas, or among
immunocompromised persons.
9. Etiology
AGE GROUP FREQUENT PATHOGENS (IN ORDER OF FREQUENCY)
Neonates (<3 wk)
Group B streptococcus, Escherichia coli, other gram-negative bacilli,
Streptococcus pneumoniae, Haemophilus influenzae (type b,* nontypable)
3 wk-3 mo
Respiratory syncytial virus, other respiratory viruses (parainfluenza viruses,
influenza viruses, adenovirus), S. pneumoniae, H. influenzae (type b,*
nontypable); if patient is afebrile, consider Chlamydia trachomatis
4 mo-4 yr
Respiratory syncytial virus, other respiratory viruses (parainfluenza viruses,
influenza viruses, adenovirus), S. pneumoniae, H. influenzae (type b,*
nontypable), Mycoplasma pneumoniae, group A streptococcus
≥5 yr
M. pneumoniae, S. pneumoniae, Chlamydophila pneumoniae, H. influenzae
(type b,* nontypable), influenza viruses, adenovirus, other respiratory
viruses, Legionella pneumophila
10. • Causes of pneumonia in immunocompromised
persons include:
• gram-negative enteric bacteria,
• mycobacteria (M. avium complex),
• fungi (aspergillosis, histoplasmosis),
• viruses (CMV), and
• Pneumocystis jirovecii (carinii).
• Pneumonia in patients with cystic fibrosis usually is
caused by:
• S. aureus in infancy and
• P. aeruginosa or Burkholderia cepacia in older patients.
11. CLINICAL MANIFESTATIONS
• Age is a determinant in the clinical manifestations of pneumonia.
• Neonates may have fever only with subtle or no physical findings of
pneumonia.
• The typical clinical patterns of viral and bacterial pneumonias
usually differ between older infants and children, although the
distinction is not always clear for a particular patient.
• Fever, chills,
• tachypnea,
• cough,
• malaise,
• pleuritic chest pain,
• retractions, and
• apprehension, because of difficulty breathing or shortness of
breath.
12. • Viral pneumonias are associated more often
with cough, wheezing, or stridor; fever is less
prominent than with bacterial pneumonia.
• The chest radiograph in viral pneumonia
shows diffuse, streaky infiltrates of
bronchopneumonia, and
• the WBC count often is normal or mildly
elevated, with a predominance of
lymphocytes.
CLINICAL MANIFESTATIONS
13. • Bacterial pneumonias typically are associated
with higher fever, chills, cough, dyspnea, and
auscultatory findings of lung consolidation.
• The chest radiograph often shows lobar
consolidation (or a round pneumonia) and
pleural effusion (10% to 30%).
• The WBC count is elevated (>20,000/mm3)
with a predominance of neutrophils.
CLINICAL MANIFESTATIONS
14. • Afebrile pneumonia in young infants is
characterized by tachypnea, cough, crackles
on auscultation, and often concomitant
chlamydial conjunctivitis.
• The WBC count typically shows mild
eosinophilia,
• and there is hyperinflation on chest
radiograph.
CLINICAL MANIFESTATIONS
15. Pneumonia History
Age
Presence of cough,
difficulty breathing,
shortness of breath, chest pain
Fever
Recent upper respiratory tract infections
Associated symptoms
Duration of symptoms
Immunizations status
TB exposure
Maternal Chlamydia,
Group B Strep status during pregnancy
Choking episodes
Previous episodes
Previous antibiotics
16. Recognition of Signs of Pneumonia
Tachypnea is the most sensitive and specific sign of
pneumonia
SIGNS Classify AS Treatment
•Tachypnea
•Lower chest wall
indrawing
•Stridor in a calm child
Severe Pneumonia •Refer urgently to hospital for injectable
antibiotics and oxygen if needed
•Give first dose of appropriate antibiotic
•Tachypnea Non-Severe Pneumonia •Prescribe appropriate antibiotic
•Advise caregiver of other supportive measure
and when to return for a follow-up visit
•Normal respiratory rate Other respiratory
illness
•Advise caregiver on other supportive measures
and when to return if symptoms persist or
worsen
17. Does this infant child have
pneumonia?
The Rational Clinical Exam, Journal of the American
Medical Association
Observation of the infant is the most important part of
the examination – does the child look sick?
Respiratory rate should be calculated over two thirty
second intervals, or one minute due to moment to
moment variability.
Auscultation is unreliable when examining
infants.
In older children, examination will show diminished
movements on affected side, dullness on percusion,
bronchial breathing. Moist rales on resolution.
18. Pneumonia Severity Assessment
Mild Severe
Infants Temperature <38.5 C
RR < 50 breaths/min
Mild recession
Taking full feeds
Temperature >38.5 C
RR > 70 breaths/min
Moderate to severe recession
Nasal Flaring
Cyanosis
Intermittent Apnea
Grunting Respirations
Not feeding
Older Children Temperature <38.5 C
RR < 50 breaths/min
Mild breathlessness
No vomiting
Temperature >38.5 C
RR > 50 breaths/min
Severe difficulty in breathing
Nasal Flaring
Cyanosis
Grunting Respirations
Signs of dehydration
19. Age Group Indications for Admission to Hospital
Infants Oxygen Saturation <= 92%, cyanosis
RR > 70 breaths /min
Difficulty in breathing
Intermittent apnea, grunting
Not feeding
Family not able to provide appropriate observation or supervision
Older Children Oxygen Saturation <= 92%, cyanosis
RR > 50 breaths /min
Difficulty in breathing
Grunting
Signs of Dehydration
Family not able to provide appropriate observation or supervision
Indications for Admission
20. LABORATORY AND IMAGING STUDIES
• The diagnosis of lower respiratory tract infections in
children is hampered by difficulty in obtaining material for
culture that truly represents the infected tissue.
• The upper respiratory tract bacterial flora is not an
accurate reflection of the causes of lower respiratory tract
infection, and good quality sputum is rarely obtainable
from children.
• In otherwise healthy children without life-threatening
disease, invasive procedures to obtain lower respiratory
tissue or secretions usually are not indicated.
• Serologic tests are not useful for the most common causes
of bacterial pneumonia.
21. • The WBC count with viral pneumonias is often
normal or mildly elevated, with a
predominance of lymphocytes,
• whereas with bacterial pneumonias the WBC
count is elevated (>20,000/mm3) with a
predominance of neutrophils.
• Mild eosinophilia is characteristic of infant C.
trachomatis pneumonia.
22. • Blood cultures should be performed to
attempt to diagnose a bacterial cause of
pneumonia.
• Blood cultures are positive in 10% to 20% of
bacterial pneumonia and are considered to be
confirmatory of the cause of pneumonia if
positive for a recognized respiratory pathogen.
• Urinary antigen tests are useful for L.
pneumophila (legionnaires' disease).
23. • A pneumolysin-based PCR test for pneumococcus is
available at some centers and may aid in the diagnosis
of pneumococcal pneumonia.
• CMV and enterovirus can be cultured from the
nasopharynx, urine, or bronchoalveolar lavage fluid.
• M. pneumoniae should be suspected if cold agglutinins
are present in peripheral blood samples; this may be
confirmed by Mycoplasma IgM or more specifically
PCR.
• The diagnosis of M. tuberculosis is established by TSTs
and analysis of sputum or gastric aspirates by culture,
antigen detection, or PCR.
24. • When there is effusion or empyema,
performing a thoracentesis to obtain pleural
fluid can be diagnostic and therapeutic.
25. • The need to establish an etiologic diagnosis of pneumonia
is greater for patients who are:
• ill enough to require hospitalization,
• immunocompromised patients (persons with HIV infection,
cancer or transplant therapies, congenital
immunodeficiencies),
• patients with recurrent pneumonia, or
• patients with pneumonia unresponsive to empirical
therapy.
• For these patients, bronchoscopy with bronchoalveolar
lavage and brush mucosal biopsy, needle aspiration of the
lung, and open lung biopsy are methods of obtaining
material for microbiologic diagnosis.
26. • Frontal and lateral radiographs are required to localize the
diseased segments and to visualize adequately infiltrates
behind the heart or the diaphragmatic leaflets.
• There are characteristic radiographic findings of
pneumonia, although there is much overlap that precludes
definitive diagnosis by radiography alone.
• Bacterial pneumonia characteristically shows lobar
consolidation, or a round pneumonia, with pleural effusion
in 10% to 30% of cases.
• Viral pneumonia characteristically shows diffuse, streaky
infiltrates of bronchopneumonia.
• Atypical pneumonia, such as with M. pneumoniae and C.
pneumoniae, shows increased interstitial markings or
bronchopneumonia.
IMAGING STUDIES
27. Chest X-ray
• Consider if available and:
Infection is severe
Diagnosis is otherwise inconclusive
To exclude other causes of shortness of
breath (e.g.. foreign body, heart failure)
To look for complications of pneumonia
unresponsive to treatment (e.g.. empyema,
pleural effusion)
To exclude pneumonia in an infant less than
three months with fever.
28. • The chest radiograph may be normal in early pneumonia,
with appearance of an infiltrate during the treatment phase
of the disease when edema fluid is greater.
• Hilar lymphadenopathy is uncommon with bacterial
pneumonia, but may be a sign of tuberculosis,
histoplasmosis, or an underlying malignant neoplasm.
• Lung abscesses, pneumatoceles, and empyema all require
special management.
• ultrasound should be used to assess size of pleural
effusions and whether they are freely mobile.
• CT is used to evaluate serious disease, pleural abscesses,
bronchiectasis, and delineating effusions.
IMAGING STUDIES
29. • The various types of pneumonia-lobar pneumonia,
bronchopneumonia, interstitial and alveolar pneumonias-need to
be differentiated on the basis of radiologic or pathologic diagnosis.
• Pneumonia must be differentiated from other acute lung diseases,
including:
• lung edema caused by heart failure,
• allergic pneumonitis, and
• aspiration, and
• autoimmune diseases, such as rheumatoid disease and systemic
lupus erythematosus.
• Radiographically, pneumonia must be differentiated from lung
trauma and contusion, hemorrhage, foreign body obstruction, and
irritation from subdiaphragmatic inflammation.
DIFFERENTIAL DIAGNOSIS
30. TREATMENT
• Therapy for pneumonia includes :
• supportive and specific treatment.
• The appropriate treatment plan depends on the degree of
illness, complications, and knowledge of the infectious
agent or of the agent that is likely causing the pneumonia.
• Age, severity of the illness, complications noted on the
chest radiograph, degree of respiratory distress, and ability
of the family to care for the child and to assess the
progression of the symptoms all must be taken into
consideration in the choice of ambulatory treatment over
hospitalization.
• Most cases of pneumonia in healthy children can be
managed on an outpatient basis.
31. • Although viruses cause most community-acquired pneumonias in
young children, in most situations experts recommend empirical
treatment for the most probable treatable causes.
• Treatment recommendations are based on the age of the child,
severity of the pneumonia, and antimicrobial activity of agents
against the expected pathogens that cause pneumonia at different
ages.
• High-dose amoxicillin is used as a first-line agent for children with
uncomplicated community-acquired pneumonia. third-generation
cephalosporins and macrolide antibiotics such as azithromycin are
acceptable alternatives. Combination therapy (ampicillin and either
gentamicin or cefotaxime) is typically used in the initial treatment
of newborns and young infants.
• Hospitalized patients can also usually be treated with ampicillin.
The choice of agent and dosing may vary based on local resistance
rates. In areas where resistance is very high, a third-generation
cephalosporin might be indicated instead. Older children, in
addition, may receive a macrolide to cover for atypical infections.
32. • Pneumonia caused by S. pneumoniae presents a
problem because of increasing antibiotic
resistance.
• In contrast to pneumococcal meningitis,
presumed pneumococcal pneumonia can be
treated with high-dose penicillin or cephalosporin
therapy, even with high-level penicillin resistance.
• Vancomycin can be used if the isolate shows
high-level resistance and the patient is severely
ill.
33. • Empirical antibiotic treatment is sufficient for management
of pneumonia in children, unless there is an exceptional
need to know the pathogen to guide management.
• Such exceptional situations include:
• lack of response to empirical therapy,
• unusually severe presentations,
• nosocomial pneumonia, and
• immunocompromised children susceptible to infections
with opportunistic pathogens.
• Infants 4 to 18 weeks old with afebrile pneumonia most
likely have infection with C. trachomatis, and erythromycin
is the recommended treatment.
34. Antimicrobial Therapy for Pneumonia Caused by Specific Pathogens*
Pathogen Recommended Treatment Alternative Treatment
Streptococcus pneumoniae† Ceftriaxone, cefotaxime, penicillin
G, or penicillin V
Cefuroxime axetil, erythromycin, or
vancomycin
Group A streptococcus Penicillin G Cefuroxime, cefuroxime axetil, or
erythromycin
Group B streptococcus Penicillin G
Haemophilus influenzae type b Ceftriaxone, cefotaxime, amoxicillin,
or ampicillin
Cefuroxime or cefuroxime axetil
Mycoplasma pneumoniae Erythromycin, azithromycin, or
clarithromycin
Doxycycline (if >9 years old) or a
respiratory fluoroquinolone (if ≥18 years
old)‡
Gram-negative aerobic bacilli
(except Pseudomonas aeruginosa)
Cefotaxime (or ceftriaxone) with or
without an aminoglycoside§
Piperacillin-tazobactam plus an
aminoglycoside§
P. aeruginosa Ceftazidime with or without an
aminoglycoside§
Piperacillin-tazobactam plus an
aminoglycoside§
Staphylococcus aureus Nafcillin or oxacillin Vancomycin
Chlamydophila pneumoniae Erythromycin, azithromycin, or
clarithromycin
Doxycycline(if >9 years old) or a
respiratory fluoroquinolone (if ≥18 years
old)‡
Chlamydia trachomatis (afebrile
pneumonia in infants)
Erythromycin, azithromycin, or
clarithromycin
TMP-SMZ
Herpes simplex virus Acyclovir
36. PROGNOSIS
• Most children recover from pneumonia rapidly and
completely.
• The radiographic abnormalities may take 6 to 8 weeks
to return to normal.
• In a few children, pneumonia may persist longer than 1
month or may be recurrent. In such cases, the
possibility of underlying disease must be investigated
further, such as with TST, sweat chloride determination
for cystic fibrosis, serum immunoglobulin and IgG
subclass determinations, bronchoscopy to identify
anatomic abnormalities or foreign body, and barium
swallow for gastroesophageal reflux.
37. PREVENTION
• Immunizations have had a great impact on reducing the incidence
of vaccine-preventable causes of pneumonia.
• Zinc supplementation
• RSV infections can be reduced in severity by use of palivizumab .
• Reducing the length of mechanical ventilation and using antibiotic
treatment only when necessary can reduce ventilator-associated
pneumonias.
• Hand washing before and after every patient contact and use of
gloves for invasive procedures are important measures to prevent
nosocomial transmission of infections.
• Hospital staff with respiratory illnesses or who are carriers of
certain organisms, such as methicillin-resistant S. aureus, should
use masks or be reassigned to non-patient care duties.