Overview

• Viral cause more common in young children → GBS in neonates, RSV in infants.

• Bacterial cause in older children → S.pneumoniae is most common.

  <aside> 💡 Bacterial Infection → raised inflammatory markers and lobar consolidation on CXR. S.pneumoniae is the most likely causative agent.

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Making Diagnosis

Clinical Features

• Fever, Cough, SOB.
• O/E → COARSE crackles.

Investigations

• Basic Obs → temperature, O2 saturations, RR.
• CXR.

Management Plan

• Immediately refer to hospital if → peristent O2 <92% on air, grunting, RR >60/min, cyanosis, temperature >38 in child <3 months.
  • Give controlled supplemental oxygen if O2 <92%.
  • For children who are not admitted to hospital, parents should be advised to seek medical advice if there are signs of respiratory distress, fluid intake is reduced to less than 75% of normal, the child becomes less responsive or the fever does not settle within 48 hours of commencing antibiotics.
• Management at Home ⇒
  • Difficult to distinguish between bacterial and viral, therefore all children should be given antibiotics.
  • First Line (Low-Moderate Severity) → amoxicillin for 5 days. (Clarithromycin if penicillin allergic).
    • If mycoplasma (atypical) → give macrolide (erythromycin).
  • High Severity (if pneumonia associated with influenza) → co-amoxiclav.

Complications →

Prognosis →