Does This Child Have Pneumonia?

Shah, Sonal; Bachur, Richard G.; Simel, David L.; Neuman, Mark I.

doi:10.1001/jama.2017.9039

Cited by 165 publications

(91 citation statements)

References 71 publications

(274 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite known limitations of CXR, 23 it is still regarded as the reference standard for diagnosis in most studies and also in clinical practice. 23 , 25 However, this inclusion criterium may have led to the fact that we found no studies performed in a primary care setting that fulfilled our inclusion criteria. The studies that we did identify were all conducted in ambulatory settings but still prevalence of pneumonia varied greatly.…”

Section: Discussionmentioning

confidence: 99%

“…These reviews have all mainly focused on the objective to correctly identify the child who suffers from pneumonia. Rambaud-Althaus et al 48 and Shah et al 25 evaluated the diagnostic value of clinical features in younger children, also including children in low resource settings. Rambaud-Althaus et al 48 specifically examined studies in children aged <5 years.…”

Section: Discussionmentioning

confidence: 99%

“…Systematic reviews have reported separately on the diagnostic value of clinical features 5 , 25 and laboratory tests 26 to identify children with serious infections including pneumonia. These reviews identified shortness of breath, increased work of breathing, and hypoxemia as most important to identify the presence of pneumonia.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review

Schot

Dekker

Giorgi

et al. 2018

npj Prim Care Resp Med

View full text Add to dashboard Cite

Identifying a child with pneumonia in the large group of children with acute respiratory tract infections can be challenging for primary care physicians. Knowledge on the diagnostic value of specific signs and symptoms may guide future decision rules and guidelines for clinicians. We aimed to identify and systematically review available evidence for the diagnostic value of signs, symptoms, and additional tests to diagnose pneumonia in children in an ambulatory setting in developed countries. We conducted a systematic review, searching in the electronic databases of PubMed and Embase. Quality assessment of studies was done using the QUADAS-2 criteria. After data extraction from selected studies, we calculated and summarized test characteristics (sensitivity, specificity, negative and positive predictive values) of all available signs, symptoms, additional laboratory tests, and chest ultrasonography. The original search yielded 4665 records, of which 17 articles were eligible for analysis: 12 studies on signs and symptoms, 4 on additional laboratory tests, and 6 on ultrasonography. All included studies were performed in a secondary care setting. Risk of bias was present in the majority of studies in the domain of patient selection. Prevalence of pneumonia varied from 3.4% to 71.7%. The diagnostic value of the available 27 individual signs and symptoms to identify pneumonia was low. In a low prevalence setting, (4 studies, pneumonia prevalence <10%) clinically ill appearance of the child and oxygen saturation <94% can aid a physician. In a high prevalence setting (10 studies, pneumonia >10%), additional diagnostic tests such as oxygen saturation, C-reactive protein, and white blood cell count are more promising. Chest ultrasonography showed high diagnostic value in settings with higher prevalence of pneumonia. Single signs and symptoms from medical history and physical examination or individual additional diagnostic tests are insufficient to diagnose pneumonia in ambulant children. Very few diagnostic studies are conducted in settings with low prevalence of pneumonia. Future research in low prevalence settings should focus on the diagnostic value of the combination of clinical features and additional testing possibly using meta-analysis of individual data.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review

Schot

Dekker

Giorgi

et al. 2018

npj Prim Care Resp Med

View full text Add to dashboard Cite

show abstract

“…For the cases without chest radiography, a set of symptoms and laboratory findings were used to differentiate the two types of bacterial and viral pneumonia. These symptoms and findings included persistent or recurrent fever > 38.5°C, increased respiratory rate, chest indrawing, hypoxia, leukocytosis > 20,000, and neutrophilia, and most importantly, the clinical course of patients during admission and course of the disease (26,29).…”

Section: Methodsmentioning

confidence: 99%

Active form and Reservoir form of Vitamin D in Children with Acute Lower Respiratory Infections and Its Association with Severity of the Infection

Tavahen

Pourmoghaddas

Esteki

et al. 2019

Arch Pediatr Infect Dis

View full text Add to dashboard Cite

Background: Vitamin D plays an important role in regulating the immune system, calcium and phosphorus homeostasis, and bone formation. This micronutrient plays an important role in the incidence and severity of respiratory infections. Objectives: The aim of this study was to evaluate the vitamin D serum level in children with acute lower respiratory infections (ALRIs) and its association with the severity of infection with vitamin D serum level. Methods: This cross-sectional study was conducted on 99 children with ALRIs aged 20.13 ± 17.55 months who were selected with a simple random sampling technique. The children were examined and evaluated at the time of admission. Their data, including demographic characteristics and the findings of the physical examination and laboratory, were recorded in the questionnaires. Serum level of 1,25-dihydroxy vitamin D3 [1,25(OH)2D] and 25-hydroxyvitamin D3 [25(OH)D] were measured by HPLC method. Results: children with severe acute lower respiratory infection had a significant lower level of 25(OH) D (P = 0.02). Indeed, data analysis showed a level of 25(OH) D inversely associated with severity of acute lower respiratory infections in children (B =-0.7, P = 0.00). Conclusions: The severity of the lower respiratory tract infections was inversely proportional to the level of 25(OH)D, and it may be hoped that increasing 25(OH)D level may reduce the severity of ALRIs.

show abstract

“…In Brazil, although the reduction of the mortality rate is related to the improvement of the economic conditions of the population, to the access to health care and the national availability of antibiotics and vaccination policies, to the reduction of infections of the lower respiratory tract, especially pneumonia, it remains the third cause of mortality over the years, reaching a total of 75,602 deaths, which corresponds to 5.6% of the total deaths in the country (2) . For this reason, the interest remains in research with a focus on respiratory diseases (2)(3)(4) , with the acute diseases being a concern in nursing studies (4) in order to strengthen the provision of care so that it becomes more effective.…”

Section: Introductionmentioning

confidence: 99%

Funcionalidade do apoio à família da criança com pneumonia

Souza

Borges

et al. 2019

Rev. Gaúcha Enferm.

View full text Add to dashboard Cite

Resumo OBJETIVO Conhecer a composição e o funcionamento do apoio social utilizado pela família da criança adoecida por pneumonia. MÉTODO Pesquisa qualitativa, realizada com quatorze famílias de crianças menores de cinco anos internadas por pneumonia, provenientes de regiões de maior vulnerabilidade social de um município do interior paulista, no período de novembro de 2015 a maio de 2016. Utilizou-se como referencial teórico o Modelo Calgary de Avaliação Familiar, e a Análise de Conteúdo Temática de Bardin como método. RESULTADOS A família nuclear e a extensa constituem o apoio social utilizado; a rede de apoio acessada engloba a Atenção Primária de Saúde, Unidades de Pronto Atendimento e hospitais, observando falha na referência e contra-referência intersetoriais. CONSIDERAÇÕES FINAIS A reorganização familiar mostrou-se relevante e efetiva em períodos de crise; as famílias buscam no nível secundário de atenção à saúde a resolutividade para o adoecimento de seu filho.

show abstract

Does This Child Have Pneumonia?

Abstract: Although no single finding reliably differentiates pneumonia from other causes of childhood respiratory illness, hypoxia and increased work of breathing are more important than tachypnea and auscultatory findings.

Cited by 165 publications

References 71 publications

Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review

Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review

Active form and Reservoir form of Vitamin D in Children with Acute Lower Respiratory Infections and Its Association with Severity of the Infection

Funcionalidade do apoio à família da criança com pneumonia

Contact Info

Product

Resources

About