Clinical features
Clinical diagnosis of pneumonia is based on:
- fever
- tachypnoea
- intercostal or subcostal recession
- nasal flaring
- expiratory grunting
- shortness of breath
- anxiety
- cyanosis
- respiratory failure
Note - in a previously healthy, immunocompetent child with non-severe symptoms, community-acquired pneumonia can be diagnosed clinically without the need for any blood tests, imaging, or microbiology investigations. (2,3)
Reference
- Shah SN, Bachur RG, Simel DL, et al. Does this child have pneumonia?: the rational clinical examination systematic review. JAMA. 2017 Aug 1;318(5):462-71.
- Chan SS, Kotecha MK, Rigsby CK, et al; Expert Panel on Pediatric Imaging. ACR appropriateness criteria®: pneumonia in the immunocompetent child. J Am Coll Radiol. 2020 May;17(5 Suppl):S215-25.
- Harris M, Clark J, Coote N, et al; British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66 Suppl 2:ii1-23.
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