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Pneumonia, Pediatric, Emergency Medicine

Reviewed 06/2017



  • Mechanism is often unknown.

  • Source is oropharyngeal aspiration (most common) or hematogenous.

  • Distribution depends on the organism: Interstitial (Mycoplasma pneumoniae, virus), lobar (...


Signs and Symptoms

  • General (in all ages):

    • Cough

    • Rales

    • Fever

    • Hypoxia

    • Tachycardia

    • Tachypnea, retractions, grunting

    • Rash (up to 10% of cases); usually maculopapular

    • Nonspecific symptoms of toxicity

    • Pulmo...



  • Pulse oximetry

  • Administer high-flow oxygen for respiratory distress.

  • IV fluids (0.9% normal saline [NS] 20 mL/kg initial bolus) for volume depletion, hypotension

  • Support and intubat...



Admission Criteria

  • Toxic appearance

  • Respiratory distress or failure

  • Dehydration/vomiting

  • Apnea

  • Infants <2 mo

  • Infants <6 mo with lobar pneumonia

  • Hypoxia (O2 saturation <92% on ro...

Pearls and Pitfalls

  • Early, aggressive airway management for patients with severe sepsis and septic shock

  • Delays to antibiotic therapy should be avoided.

  • Discharged patients should have clear evidence of...

Additional Reading

  • Cevey-Macherel  M, Galetto-Lacour  A, Gervaix  A, et al. Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines. Eur J Pediatr.  200...



  • 483.0 Pneumonia due to mycoplasma pneumoniae

  • 486 Pneumonia, organism unspecified

  • 507.0 Pneumonitis due to inhalation of food or vomitus

  • 481 Pneumococcal pneumonia [Streptococcus pneumoniae pneu...

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