Community-acquired pneumonia in children – problems and solutions

Abstract

Pneumonia in children remains one of the most serious diseases. Despite intensive study, the diagnosis and treatment still present a variety of problems. The article is aimed to identify these problems and show the ways of their solution.One of the criteria for the diagnosis of pneumonia is pulmonary infiltrate on the X-ray image. Community-acquired pneumonia is often caused by Pneumococci and mycoplasma; respiratory viruses, influenza usually serve as contributing factors for bacterial infection. The high level of hyperand underdiagnosis of community-acquired pneumonia is associated with its similarity with ARVI; the registration of general violations (signs of the severity of the disease) improves the quality of diagnosis. The clinical and radiological picture helps to distinguish pneumococcal pneumonia from pneumonia caused by mycoplasma. To improve the diagnosis of community-acquired pneumonia, it is necessary to study inflammation markers during the first examination of the patient, which is impossible in the conditions of home care. Due to the growth of resistance of pneumococci to macrolides a community-acquired pneumonia of pneumococcal (and unclear) etiology requires the use of amoxicillin in high doses and macrolides (in case of atypical pneumonia). Gentle therapy of destructive pneumonia, steroids for metapneumonic pleurisy allow avoiding invasive interventions and help to repair lung tissue.