Pneumonia in Child

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No Pneumonia	Pneumonia (P)	Severe	Very Severe
Only Cough and cold	Respiratory rate – high >60 : in < 2mnths >50 : in 2 – 12 mnths >40 : in 12 – 60 mnths	P + Chest indrawing	Severe + Cyanosis
T/t – Symptomatic	Cotrimoxazole	IV or IM Penicillin	IV Chloramphenicol

In Child, they are mostly Viral - RSV (MC)

other:
Parainfluenzae
Influenzae
Adenovirus

Chest X-Ray - B/L diffuse interstitial infiltrates.

Bacterial Pneumonia - Causes (Age wise)
In < 2 months	3 months – 3 years	>3 years
Klebsiella ( MC ) E.Coli Staph. Aureus	Pneumococci and Staph H.Influenzae ( Because of vaccination , its not MC now )	Pneumococcus and Staph.

 Drug of choice and MCQ points : 

1. Community Acquired Neonatal Pneumonia : DOC - Ampicillin + Gentamycin

2. Hospital Acquired Neonatal Pneumonia : DOC - Cefotaxime + Amikacin

3. Staph aureus : DOC - Cloxacillin { MRSA : DOC - Vancomycin }

• Can have empyema ( Staph is MC cause of empyema in child )
• Pneumatocele ( other cause - Kerosene oil poisoning )

4. Atypical Pneumonia

• Symptoms : Dry hacking cough
• Pathology : Interstitial (like Viral)
• Organism : Chlamydia , Mycoplasma
• Rare in child < 4 years
• DOC : Macrolides - Erythro , Azithro
• No cell wall in organism - thus Ceftriazone (acts on cell wall) not effective.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel