In a study in primary pediatrics care in canada, as many as 64% of young children with. Recurrent pneumonia rp is defined as two or more episodes of pneumonia in 12 months or three episodes altogether with radiographic clearance in between 1,2. Both pharyngeal swallowing disorders, such as penetration and aspiration, and esophageal disorders and reflux may result in recurrent pneumonia in pediatric patients. Many children with rp do not need a thorough investigation, as pneumonia episodes are not frequent andor severe, or they stop recurring over time. Thus, all phases of deglutition should be considered and followed up during swallowing evaluation. Approximately 6% of infants experience at least one episode of pneumonia during the first two years of life. Underlying causes of persistent and recurrent pneumonia in. Causes of recurrent pneumonia in children in a general. How are children with recurrent pediatric pneumonia evaluated.
The majority of recurrent pneumonia causes in children have. Application of the world health organization criteria to predict radiographic pneumonia in a usbased pediatric emergency department. A boy with recurrent pneumonia european respiratory society. It should be differentiated from persistent pneumonia, which is defined as persistence of symptoms and radiological changes for 6 weeks or more despite treatment. Communityacquired pneumonia cap is a major cause of morbidity and mortality in developing and developed countries. Both pharyngeal and esophageal phases of swallowing are. These deaths occur almost exclusively in children with underlying conditions, such as chronic lung disease of prematurity, congenital heart disease, and immunosuppression. Chronic and recurrent pneumonia in children request pdf.
Underlying causes of recurrent pneumonia in children. This report describes a child with three episodes of pneumonia. There are multiples areas of treein bud bronchiolitis. It is often difficult to determine whether pneumonia is. Pneumonia is a frequent cause of hospitalization in children with childhood pneumonia rates reported as high as 74 in children aged 03 years 16 with approximately 4142% of children. Recurrent pneumonia and pulmonary vein stenosis in a child exposed to valproic acid in utero anuja bandyopadhyay, gregory s. Paediatric, pneumonia recurrent or persistent diagnostic. Recurrent pneumonia rp is one of the most frequent causes of pediatric noncystic fibrosis cf bronchiectasis be and a consequent accelerated decline in lung function. These studies demonstrate that the majority of children with recurrent pneumonia have an identifiable cause for their recurrent symptoms. Pneumonia can be a serious illness, recurrent pneumonia is a concerning and potentially dangerous condition in children. Chest radiograph showed a consolidation involving the lateral. A pediatric case series is also presented, in order to document a single centre experience of rp. The diagnosis and management of chronic and recurrent pneumonia in children may present a significant challenge for the primary care physician. Persistent pneumonia in an infant american academy of.
In most children with recurrent pneumonia, underlying illnesses are known prior to the first episode. Antibiotic coverage was broadened because of the concern for resistant organisms. Recurrent pneumonia rp is defined as at least two episodes of pneumonia in one year or. Recognize the major findings that distinguish children who have pneumonia from those who have other respiratory tract infections. Discuss the major pathogens of childhood pneumonia, including the usual age groups affected and clinical features. The aim of this study was to analyse the clinical records of children with rp in attempt to identify factors that may lead to an early suspicion of noncf be. Ebenroth, stacey petersoncarmichael, and rash in a patient with cftrrelated metabolic syndrome. Causes of recurrent pneumonia in children in a general hospital. Underlying causes of recurrent pneumonia in children asthma. Recurrent infectious wheezing was diagnosed in 1 cases 77. Recurrent pneumonia in children pediatric pulmonologists.
No areas of ground glass opacification are identified. Recurrent pneumonia rp is defined as at least two episodes of pneumonia in one year or three episodes ever, with intercritical radiographic. Outline the antibiotic regimens used to treat pneumonia in ambulatory children. We recorded the demographic and clinical data, and lung function. Most instances of recurrent pneumonia have a known underlying cause, namely oropharyngeal incoordination predisposing to aspiration. It is one of the common causes of admission to the paediatric ward. Children with recurrent chest infection can be a significant diagnostic challenge. Recurrent pneumonia is defined as 2 or more episodes of pneumonia in a year or 3 episodes ever separated by an asymptomatic period of a month or clear chest xrays.
In a 10year retrospective survey of almost 3000 children admitted to hospital with pneumonia, only 8% met the criteria for recurrent pneumonia 8. In addition, a manual search was conducted to evaluate references. Because the few previous studies on underlying causes of recurrent pneumonia in children have come from tertiary care referral centres where selection bias may be important, the aim of this study was to examine underlying causes of recurrent pneumonia in children in a general hospital. Recurrent pneumonia is defined in the literature as two episodes or more in one year or more than three episodes of pneumonia in a child at any. Recurrent pneumonia in children typically has underlying causes. In children without a known medical or anatomic condition who have recurrent pneumonia, bronchial asthma and gastroesophageal reflux should be ruled out as part of the evaluation.
In a 10year retrospective survey of almost 3000 children admitted to hospital with pneumonia, only 8%. A 4monthold boy with past medical history of eczema presented with fever and cough. The patient meets the criteria for recurrent pneumonia rp which is defined as. This underlying cause has tended to be ignored in previous studies of pediatric recurrent pneumonia. Recurrent pneumonia is still a diagnostic challenge in pediatrics. The most common cause, however, varies depending on the characteristics of the population of children studied, whether inpatient or outpatient, referred to a subspecialty or general pediatric service, or from. The purpose of this study is to describe the underlying illnesses of children with recurrent pneumonia hospitalized in a tertiary care pediatric hospital. A management algorithm for the approach to children with rp. Diagnosing the cause of recurrent and persistent pneumonia. Persistent pneumonia in an infant american academy of pediatrics. The united nations childrens fund unicef estimates that pediatric pneumonia kills 3 million children worldwide each year. The aim of this article is to provide a guide to a systemic approach for diagnosis and treatment of children with recurrent pneumonia while not over investigating those with common but usually unrecognised conditions such as asthma or recurrent simple viral infections.