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    Pediatric Community Acquired Pneumonia

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    James Lagamayo Javier
    Pediatric Community Acquired Pneumonia is an infection that inflames the air sacs in one or both lungs. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae type B, Staphylococcus aureus, and Klebsiella pneumoniae. Diagnostics may include imaging, blood tests, and cultures. Treatment depends on severity and vaccination history, ranging from oral antibiotics at home to referral to a specialist or critical care unit. Preventive measures include vaccines, proper hygiene, and immune boosters like zinc.

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    Pediatric Community Acquired Pneumonia

    Uploaded by

    James Lagamayo Javier
    187 views24 pages
    Pediatric Community Acquired Pneumonia is an infection that inflames the air sacs in one or both lungs. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae type B, Staphylococcus aureus, and Klebsiella pneumoniae. Diagnostics may include imaging, blood tests, and cultures. Treatment depends on severity and vaccination history, ranging from oral antibiotics at home to referral to a specialist or critical care unit. Preventive measures include vaccines, proper hygiene, and immune boosters like zinc.

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    Pediatric Community Acquired Pneumonia is an infection that inflames the air sacs in one or both lungs. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae type B, Staphylococcus aureus, and Klebsiella pneumoniae. Diagnostics may include imaging, blood tests, and cultures. Treatment depends on severity and vaccination history, ranging from oral antibiotics at home to referral to a specialist or critical care unit. Preventive measures include vaccines, proper hygiene, and immune boosters like zinc.

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    187 views24 pages

    Pediatric Community Acquired Pneumonia

    Uploaded by

    James Lagamayo Javier
    Pediatric Community Acquired Pneumonia is an infection that inflames the air sacs in one or both lungs. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae type B, Staphylococcus aureus, and Klebsiella pneumoniae. Diagnostics may include imaging, blood tests, and cultures. Treatment depends on severity and vaccination history, ranging from oral antibiotics at home to referral to a specialist or critical care unit. Preventive measures include vaccines, proper hygiene, and immune boosters like zinc.

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    Pediatric Community

    Acquired Pneumonia

    Abner O. Ganaban M.D


    QMMC-PBRTP – 1st year resident
    Objectives:
     To be able to identify the etiology of the underlying cause of Pediatric Pneumonia

     To outline the management of Pediatric Pneumonia

     Preventions and Interventions Pediatric Pneumonia


    Case of:
    E.A.L
    7months old
    Female
    Child
    Roman Catholic
    Presently residing at Muntingdilaw, Antipolo, City
    Chief Complaint:

    Difficulty of breathing
    HPI:
     1 week PTA (+) cough
    (+) colds
    (+) Fever Tmax 38.c was given Tempra (Paracetamol)
    1 day PTA condition persisted consult at OPD
    (+) salbutamol nebulization q6 and Budesonide q12
    Few hours PTA (+) DOB with loss of appetite consult at ER hence Admitted
    PMH:
     No past medical history date. Mother denies any accidents and injuries. Mother has not
    established her Pediatrician.
     Surgical Hx none
     Immunization: BCG
    Hep B 1,2
    Dtap 1,2,3
     Medications: Ascorbic Acid drops 0.9ml OD
     Allergies no known allergies
    Family History:
    P/S Hx:
     Pt. lives with her unmarried mother and grandmother with her 7 months old baby in
    a apartment. Mother is a plain housewife. The pt.’s father is uninvolved with the
    care. Their residence contains no pets. No one in the home smokes.
     Diet Pt. was breast feed exclusively until prior to admission.
    Physical Examination:
     Vital signs HR 152 RR 60 temp 37.8c spo2 94-95% via NC Wt. 6.8kg
     Gen. survey Awake, irritable
     PPC, AS, (+) sunken eyeball and fontanelle, dry oral mucosa and lips
     ECE, (+) subcostal retractions, (+) crackles both lung fields
     AP, Tachycardic, regular rhythm, ( - ) murmur
     Flat, soft non tender
     GNE, FEP , ( - ) cyanosis
     Slightly poor skin turgor, CRT > 2 sec
    Salient features:
     1 week cough
     Difficulty of breathing
     Loss of appetite
     Moderate dehydration
     Intercostal retractions
     (+) crackles
     (+) wheezes
    Differential DX:
    Diagnostics:
     Complete blood count 02-11-2020
    HGB 121 HCT 0.34 RBC 3.89 WBC 12.09 PLT. CT 411
    Differential count: Neutrophils 71
    Lymphocytes 21
    Monocytes 8
    CXR APL VIEW : BRONCHOPNEUMONIA
    COURSE IN THE WARD
     1ST HD IVF were started at 6cc/kg/hour D5LR 1L. Pt. was place diet for age with strict
    aspiration precaution. Started with Ampicillin 340mg tiv q6, Paracetamol 70mg tiv q4
    later on shifted to oral paracetamol drops, 0.7ml q4 prn fever, Salbutamol 1 neb q4.
     2nd HD continued IVF at same rate, salbutamol nebulization was revised to q6. noted
    improvement with appetite, decreased in distress but still tachypniec, comfortable with
    sleep
     3rd HD IVF changed to D5IMB 500cc at 30cc/hr, cont. medication and physiotheraphy,
    pt still with retractions and tachypneic (40), (+) fine crackles
     4th HD Pt IV antibiotic shifted ampicillin to cefuroxime 225mg tiv q8,started
    budesonide nebulization at ½ neb q12, zinc so4 drops, 0.75ml OD.
     Pt still with subcostal retractions, fine crackles both LF, wheezes bilateral.
     5th HD continued medication and IVF
     Pt. was afebrile, good suck and activity.
     Occasional crackles, no wheezes and retraction.
     6th HD Pt was discharged.
     comfortable
     No dyspnea, tachypnea and retractions
    Pediatric Community Acquired Pneumonia

     Infection that inflames the air sacs in one or both


    lungs .
    Pathophysiology:
    PCAP up to 5years old
    ETIOLOGY Prefered Regimen Comments
    S. Pneumoniae in 30-50% PCAP A or B Equal efficacy between oral
    Hib 10-30% If with complete Hib vaccination: amoxicillin and IV penicillin if
    S. Aureus Amoxicillin 80-90 mg/kg/day q12 feeding is tolerated
    K. pneumoniae P.O x 5days

    If no Hib vaccination or
    incomplete or unknown history:
    Co amoxiclav 80-90mg/kg/day or
    cefuroxime
    Etiology Preferred Regimen Comments
    S. Pneumoniae in 30-50% PCAP C Switch from IV to oral form 2-3
    Hib 10-30% If with complete Hib vaccination days after initiation if treatment in
    S. Aureus Penicillin or ampicillin patient who are:
    K. pneumoniae
    No Hib vaccination Responding
    Cefuxime or ceftriaxone or Able to feed
    ampicillin- sulbactam Free fro pulmonary
    /extrapulomonary complications
    Etiology Preferred Regimen Comments
    S. Pneumoniae in 30-50% PCAP D:
    Hib 10-30% Referred to specialist
    S. Aureus Admit to Critical Care Unit
    K. pneumoniae
    Diagnostics
     Radiographic Imaging
     Blood test (CBC), ABG’s
     Blood cultures
     Sputum cultures
     Nasopharyngeal Swabs
     Pleural fluid
    Preventions:
     Immune boosters (ZINC)
     Vaccines
     Proper hygiene

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