Pediatric Community Acquired Pneumonia (PCAP)

Definition Pneumonia and other lower respiratory tract infections are the leading causes of death worldwide. Because pneumonia is common and is associated with significant morbidity and mortality, properly diagnosing pneumonia, correctly recognizing any complications or underlying conditions, and appropriately treating patients are important. Although in developed countries the diagnosis is usually made on the basis of radiographic findings, the World Health Organization (WHO) has defined pneumonia solely on the basis of clinical findings obtained by visual inspection and on timing of the respiratory rate. Community-acquired pneumonia. This refers to pneumonia you acquire in the course of your daily life at school and in the community Worldwide, it's a leading cause of death in children. There are many kinds of pneumonia ranging in seriousness from mild to life threatening. Although signs and symptoms vary, many cases of pneumonia develop suddenly, with chest pain, fever, chills, cough and shortness of breath. Infection often follows a cold or the flu, but it can also be associated with other illnesses or occur on its own. Although antibiotics can treat some of the most common forms of bacterial pneumonias, antibiotic-resistant strains are a growing problem. For that reason, and because the disease can be very serious, it's best to try to prevent infection in the first place.

Etiology Pneumonia can be caused by a myriad of microorganisms. Clinical suspicion of a particular offending agent is derived from clues obtained during the history and physical examination. While virtually any microorganism can lead to pneumonia, specific bacterial, viral, fungal, and mycobacterial infections are most common in previously healthy children. Community-acquired viral infections occur in newborns, although less commonly than in older infants. The most commonly isolated virus is respiratory syncytial virus (RSV). The transfer of maternal antibodies is important in protecting newborns and young infants from such infections, making premature infants (who may not have benefited from sufficient transfer of transplacental immunoglobulin [Ig] G]) especially vulnerable to lower-tract disease. In addition, premature infants may have chronic lung disease of prematurity, with associated hyperreactive airways, fewer functional alveoli, and baseline increased oxygen requirements. Young infants However, most bacterial pneumonia in this age group is community acquired and involves S pneumoniae, S aureus, and nontypeable H influenzae. Infants, toddlers, and preschool-aged children Viruses remain the most common cause of pneumonia in this age group, accounting for approximately 90% of all lower respiratory tract infections. Tsolia et al identified a viral infection among 65% of hospitalized children with community-acquired pneumonia.[13] School-aged children and young adolescents M pneumoniae is the most frequent cause of pneumonia among older children and adolescents. Mycoplasma accounts for 14-35% of pneumonia hospitalizations in this age group.[6, 13, 17] Children in homeless shelters and group homes and those with household contacts are at particular risk. Similarly, the diagnosis must be considered in immunocompromised children.. Chlamyophila pneumoniae also causes pneumonia. The related organism, C psittaci, is an unusual cause of pneumonia that occurs in people who work with and handle birds.

Risk Factors Newborns may also be affected by the bacteria and viruses that commonly cause infections in older infants and children. Risk factors for infection include older siblings, group daycare, and lack of immunization. Very young children, whose immune systems aren't fully developed, are at increased risk of pneumonia. You're also more likely to develop pneumonia if you: Are exposed to certain chemicals or pollutants. Your risk of developing some uncommon types of pneumonia may be increased if you work in agriculture, construction or around certain industrial chemicals or animals. Exposure to air pollution or toxic fumes can also contribute to lung inflammation, which makes it harder for the lungs to clear themselves. Have had surgery or experienced a traumatic injury. People who've had surgery or who are immobilized from a traumatic injury have a higher risk of pneumonia because surgery or serious injuries may make coughing which helps clear the lungs more difficult and lying flat can allow mucous to collect in your lungs, providing a breeding ground for bacteria.