Abstract
Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide in developing and developed countries, and its incidence is highest among children less than 5-y-old. Over the last five years, several international and local guidelines have been updated with new evidence concerning the epidemiology, etiology, pathogenesis, treatment and prevention of pediatric CAP, but there are still several major problems that need to be standardised. The aim of this review is to consider the available data concerning the termination, epidemiology, microbiology and pathogenesis, clinical features, diagnosis and differential diagnosis, treatment, and complications of pediatric CAP. There still are many unanswered questions concerning the management of CAP, including its definition, the difficulty to identify its etiological agents, the emergence of drug, and the lack of introduction of vaccines against respiratory pathogens in developing countries. More research is required in various areas (including therapy of atypical agents), and further efforts are needed to increase vaccination in order to reduce the incidence of the disease.
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Liu L, Johnson HL, Cousens S, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151–61.
Rudan I, Chan KY, Zhang JS, et al; WHO/UNICEF’s Child Health Epidemiology Reference Group (CHERG). Causes of deaths in children younger than 5 years in China in 2008. Lancet. 2010;375:1083–9.
Kliegman RM, Behrman RE, Jenson HB, et al. Nelson Textbook of Pediatrics. 18th ed. United States of America: Saunders; 2007.
Johnson J, Kline JA. Intraobserver and interobserver agreement of the interpretation of pediatric chest radiographs. Emerg Radiol. 2010;17:285–90.
Margolis P, Gadomski A. The rational clinical examination. Does this infant have pneumonia? JAMA. 1998;279:308–13.
Fiore AE, Shay DK, Broder K, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep. 2009;58:1–52.
Subspecialty Group of Respiratory Diseases, The Society of Pediatrics; Chinese Medical Association The Editorial Board, Chinese Journal of Pediatrics. Guidelines for management of community acquired pneumonia in children (2013 edition). Chin J Pediatr. 2013;10:745–52.
Harris M, Clark J, Coote N, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66:ii1.
Heiskanen-Kosma T, Korppi M, Leinonen M. Serologically indicated pneumococcal pneumonia in children: a population-based study in primary care settings. APMIS. 2003;111:945–50.
Korppi M, Heiskanen-Kosma T, Kleemola M. Incidence of community-acquired pneumonia in children caused by Mycoplasma pneumoniae: serological results of a prospective, population-based study in primary health care. Respirology. 2004;9:109–14.
Kurz H, Göpfrich H, Wabnegger L, Apfalter P. Role of Chlamydophila pneumoniae in children hospitalized for community-acquired pneumonia in Vienna, Austria. Pediatr Pulmonol. 2009;44:873–6.
Carrillo-Marquez MA, Hulten KG, Hammerman W, et al. Staphylococcus aureus pneumonia in children in the era of community-acquired methicillin-resistance at Texas Children’s Hospital. Pediatr Infect Dis J. 2011;30:545–50.
Schwartz KL, Nourse C. Panton-Valentine leukocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature. Eur J Pediatr. 2012;171:711–7.
Murphy CG, van de Pol AC, Harper MB, Bachur RG. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007;14:243–9.
Margolis P, Gadomski A. The rational clinical examination. Does this infant have pneumonia? JAMA. 1998;279:308–13.
Rambaud-Althaus C, Althaus F, Genton B, D’Acremont V. Clinical features for diagnosis of pneumonia in children younger than 5 years: a systematic review and meta-analysis. Lancet Infect Dis. 2015;15:439–50.
McIntosh K. Community-acquired pneumonia in children. N Engl J Med. 2002;346:429–37.
Gadomski AM, Khallaf N, el Ansary S, Black RE. Assessment of respiratory rate and chest indrawing in children with ARI by primary care physicians in Egypt. Bull World Health Organ. 1993;71:523–7.
Gadomski AM, Permutt T, Stanton B. Correcting respiratory rate for the presence of fever. J Clin Epidemiol. 1994;47:1043–9.
Lynch T, Platt R, Gouin S, et al. Can we predict which children with clinically suspected pneumonia will have the presence of focal infiltrates on chest radiographs? Pediatrics. 2004;113:e186–9.
Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:e25–76.
Skerrett SJ. Diagnostic testing for community-acquired pneumonia. Clin Chest Med. 1999;20:531–8.
Community acquired pneumonia Guideline Team, Cincinnati Children’s Hospital Medical Center. Evidence-based care guidelines for medical management of community acquired pneumonia in children 60 days to 17 years of age. Guideline 14. Available at http://www.cincinnatichildrens.org/svc/alpha/h/health-policy/ev-based/pneumonia.htm. Accessed on 22 Sep 22 2011.
Wingerter SL, Bachur RG, Monuteaux MC, Neuman MI. Application of the World Health Organization criteria to predict radiographic pneumonia in a US-based pediatric emergency department. Pediatr Infect Dis J. 2012;31:561–4.
Esposito S, Cohen R, Domingo JD, et al. Antibiotic therapy for pediatric community-acquired pneumonia: do we know when, what and for how long to treat? Pediatr Infect Dis J. 2012;31:e78–85.
Cardinale F, Cappiello AR, Mastrototaro MF, Pignatelli M, Esposito S. Community-acquired pneumonia in children. Early Hum Dev. 2013;89:S49–52.
Jaffé A, Balfour-Lynn IM. Management of empyema in children. Pediatr Pulmonol. 2005;40:148–56.
Balfour-Lynn IM, Abrahamson E, Cohen G, et al. BTS guidelines for the management of pleural infection in children. Thorax. 2005;60:i1–21.
Mani CS, Murray DL. Acute pneumonia and its complications. In: Long SS, Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious diseases. 4th ed. Edinburgh: Elsevier Saunders; 2012. p. 235.
Sawicki GS, Lu FL, Valim C, et al. Necrotising pneumonia is an increasingly detected complication of pneumonia in children. Eur Respir J. 2008;31:1285–91.
Miller MA, Ben-Ami T, Daum RS. Bacterial pneumonia in neonates and older children. In: Taussig LM, Landau LI, editors. Pediatric respiratory medicine. St. Louis: Mosby; 1999. p. 595.
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The authors appreciate the efforts of their colleagues in Respiratory Medicine Department of State Clinical Medical Research Center.
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Source of Funding
This study was supported by the grants from the State Key Clinical Department (of Pediatric Lung Diseases 2012) and BCH Young Investigator Program, BCHYIPA-2013-03.
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Qin, Q., Shen, Kl. Community-acquired Pneumonia and its Complications. Indian J Pediatr 82, 745–751 (2015). https://doi.org/10.1007/s12098-015-1785-4
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DOI: https://doi.org/10.1007/s12098-015-1785-4