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Strategies for recognizing pneumonia look-alikes

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Community-acquired pneumonia is a common diagnosis in children. Among the many children whose symptoms and/or chest X-ray is consistent with community-acquired pneumonia, it can be difficult to distinguish the rare cases of differential diagnoses that require specific management. The aim of this educational article is to provide clinicians with a series of questions to ask themselves in order to detect a possible differential diagnosis of pneumonia in children. The value of this approach is illustrated by 13 real clinical cases in which a child was misdiagnosed as having lobar pneumonia.

What is Known:

• When a lobar pneumonia is diagnosed, an appropriate antibiotic treatment leads to the resolution of the clinical signs in most cases.

• However, several diseases can be look-alikes for pneumonia and mislead the practitioner.

What is New:

• This article provides a new approach to identify differential diagnoses of pneumonia in children.

• It is illustrated by 13 real-life situations of children misdiagnosed as having pneumonia.

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Community-acquired pneumonia


Computed tomography


Chest X-ray


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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by Drummond, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to David Drummond.

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Communicated by Peter de Winter

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Drummond, D., Hadchouel, A., Petit, A. et al. Strategies for recognizing pneumonia look-alikes. Eur J Pediatr 181, 3565–3575 (2022).

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