Pneumonia (peds)

Revision as of 19:16, 19 June 2015 by Rossdonaldson1 (talk | contribs) (Disposition)


  • Most common site of infection in neonates
  • Fever and tachypnea are sensitive but not specific

Bugs by Age Group

Clinical Features

Differential Diagnosis

Pediatric fever


  • Absence of tachypnea, resp distress, and rales/decr BS rules-out with 100% sp
    • Productive cough is rarely seen before late childhood
  • Imaging
    • CXR is not the gold standard!
    • Cannot differentiate between viral and bact (but lobar infiltrate more often bacterial)
    • Consider for:
      • Age 0-3mo (part of w/u for sepsis)
      • <5yr w/ temp >102.2, WBC >20K and no clear source of infection
      • Ambiguous clinical findings
      • PNA that is prolonged or not responsive to abx
  • Consider rapid assays for RSV, influenza
  • Blood/nasal culture are low yield



1-3 Month

>3mo - 18 years


All Children less than 2 months should be hospitalized[2]

Consider Admission

  • Age: birth to 3 months old
  • History of severe or relevant congenital disorders
  • Immune suppression (HIV, SCD, malignancy)
  • Toxic appearance/respiratory distress
  • SpO2 <90-93%

See Also


  1. Sanford Guide to Antimicrobial Therapy 2014
  2. AAP. Management of Communty-Acquired Pneumonia in Infants and Children Older than 3 Months of Age. Pediatrics. Vol 128 No 6 December 1, 2011