Pneumonia in older children
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Pneumonia is an inflammation at the level of the respiratory bronchioles, alveolar spaces, and/or interstitium.
For more information see Pneumonia.Etiology of pneumonia in older children[edit | edit source]
- The most common agents in children over 5 years of age:
- rare agents:
- respiratory viruses: adenoviruses, influenza, parainfluenza, rhinovirus, RSV
- bacteria: Haemophilus influenzae, Mycobacterium tuberculosis, vzácně Staphylococcus aureus, Legionella pneumophila[1].
Clinical picture[edit | edit source]
Therapy[edit | edit source]
- Empirical antibiotic treatment of community-acquired pneumonia in older children:
- mild pneumonia - amoxicillin p.o. (50-90 mg / kg / day in 3 doses),
- severe pneumonia - penicillin G i.v. (100-200,000 IU / kg / day or more in 4-6 doses), in case of allergy, cephalosporin III. generation i.v can be used instead.[1]
- symptomatic treatment:
- expectorants, mucolytics, antitussives for irritating dry cough
- antipyretics
- oxygen therapy for respiratory insufficiency
- nebulization therapy
- regime measures:
- adequate supply of fluids, calories, vitamins
- respiratory rehabilitation
- Functional lung examination is indicated 6 weeks after the pneumonia has subsided[2].
Comparison table for typical and atypical pneumonia[edit | edit source]
| PARAMETER | TYPICAL PNEUMONIA | ATYPICAL PNEUMONIA |
|---|---|---|
| Basic characteristics | significant physical findings | poor physical findings |
| Agens | (extracellular)
Streptococcus pneumoniae, Haemophilus influenzae Haemophilus parainfluenzae, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli a Pseudomonas aeruginosa |
(intra / paracellular)
Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, Legionella pneumophila Coxiella burnetii, viruses - RSV, influenza, Pneumocystis carinii |
| Boarding | sudden | slow |
| Extrapulmonary symptoms | infrequent | common - headache and muscle pain, vomiting, diarrhea |
| Fever | febrile | subfebrile |
| Cough | productive | dry, irritating |
| Heart rate | possibly tachycardia | normal |
| The patient looks | sick | calm, unaffected |
| Physically | crepitus, tubular respiration | isolated rales |
| X-ray | segmental/lobar opacities (alveolar involvement) | Reticulonodulation (interstitial involvement) |
| Sedimentation | high | slightly increased |
| Inflammatory parameters | high | slightly increased |
| Blood count | leukocytosis | lymphocytosis |
| Therapy | penicillins | macrolides |
References[edit | edit source]
Related articles[edit | edit source]
- Pneumonia (pediatrics) • Infant pneumonia • Pneumonia
- Bacterial pneumonia • Atypical pneumonia • Abscessive pneumonia • Aspiration pneumonia
- X-ray examination in lower respiratory tract inflammation • Clinical evaluation of the severity of pneumonia
Citations[edit | edit source]
- ↑ a b LEBL, J, J JANDA a P POHUNEK. Praktická pediatrie : Obvyklé diagnostické a léčebné postupy na Pediatrické klinice v Motole. 1. vydání. Galén, 2008. 189 s. s. 28. ISBN 978-80-7262-578-9.
- ↑ BABÁČKOVÁ, P. Zdravotnické noviny : Pneumonie [online]. Mladá fronta a.s, ©2007. [cit. 2011-02-03]. <https://zdravi.euro.cz/clanek/priloha-lekarske-listy/pneumonie-287447>.
