Other common respiratory viruses include influenza virus, coronavirus (including SARS-CoV-2, which causes COVID-19), human rhinovirus, human metapneumovirus, and adenovirus. Respiratory syncytial virus is the most common pathogen overall, particularly in children younger than two years. population of 2,638 patients younger than 18 years hospitalized with CAP, a viral pathogen was more likely than a bacterial pathogen (66% compared with 8%, respectively 7% of patients had both viral and bacterial pathogens no pathogen was identified in 19%). High-quality cohort studies showing improved morbidity Systematic review showing improved patient-oriented outcomesĬhildhood and maternal immunizations against bacterial and viral pathogens decrease the risk of pneumonia. 14Īmoxicillin is the treatment of choice for community-acquired pneumonia in school-aged children in the outpatient setting. 11Ĭhest ultrasonography can be used in place of chest radiography for accurate diagnosis of pneumonia in children. Prospective cohort study and a meta-analysis of diagnostic accuracy studiesĬhest radiography should be ordered if the diagnosis is uncertain, if patients have hypoxemia or significant respiratory distress, or if patients fail to show clinical improvement within 48 to 72 hours after initiation of antibiotic therapy. Signs and symptoms most strongly associated with pneumonia found on chest radiography are grunting, history of fever, retractions, crackles, and the overall clinical impression. pneumoniae, Haemophilus influenzae type b, Bordetella pertussis, and influenza virus are the key to prevention. Childhood and maternal immunizations against S. Patients requiring hospitalization and empiric parenteral therapy should be transitioned to oral antibiotics once they are clinically improving and able to tolerate oral intake. Amoxicillin is the first-line antibiotic with coverage for Streptococcus pneumoniae for school-aged children, and treatment should not exceed seven days. Outpatient management of community-acquired pneumonia is appropriate in patients without respiratory distress who can tolerate oral antibiotics. Chest radiography should be ordered if the diagnosis is uncertain, if patients have hypoxemia or significant respiratory distress, or if patients fail to show clinical improvement within 48 to 72 hours after initiation of antibiotic therapy. Findings most strongly associated with an infiltrate on chest radiography in children with clinically suspected pneumonia are grunting, history of fever, retractions, crackles, tachypnea, and the overall clinical impression. Typical presenting signs and symptoms include tachypnea, cough, fever, and anorexia. Even in hospitalized children, community-acquired pneumonia is most likely of viral etiology, with respiratory syncytial virus being the most common pathogen, especially in children younger than two years. In the United States, pneumonia is the most common cause of hospitalization in children.
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