Evaluating the child with recurrent lower respiratory tract infections

Brand, Paul; Hoving, M.; Groot, Eric P. de

doi:10.1016/j.prrv.2011.02.005

Cited by 22 publications

(34 citation statements)

References 23 publications

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“…In the evaluation of children with RP, the first step is to distinguish between otherwise healthy “but unlucky” subjects, and those with an underlying disorder that requires further investigation [12]. A thorough diagnostic work-up is not required when: infections are self-limiting; other organs or systems are not involved; there are relatively long periods of clinical wellness, at least during the summer; the child has normal growth and a normal physical examination; the family history for genetic or infectious respiratory disorder is negative; there is a quick response to treatment and a complete recovery after the episode [12,13,14,15,16,17,18]. The presence of any risk factor for RP should be ruled out by a careful recording of the clinical history (Table 1), as cases presenting risk factors may experience earlier and more severe episodes.…”

Section: Which Children Should Undergo a Diagnostic Work-up?mentioning

confidence: 99%

Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience

Montella

Corcione

Santamaria

2017

IJMS

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Recurrent pneumonia (RP), i.e., at least two episodes of pneumonia in one year or three episodes ever with intercritical radiographic clearing of densities, occurs in 7.7%–9% of children with community-acquired pneumonia. In RP, the challenge is to discriminate between children with self-limiting or minor problems, that do not require a diagnostic work-up, and those with an underlying disease. The aim of the current review is to discuss a reasoned diagnostic approach to RP in childhood. Particular emphasis has been placed on which children should undergo a diagnostic work-up and which tests should be performed. A pediatric case series is also presented, in order to document a single centre experience of RP. A management algorithm for the approach to children with RP, based on the evidence from a literature review, is proposed. Like all algorithms, it is not meant to replace clinical judgment, but it should drive physicians to adopt a systematic approach to pediatric RP and provide a useful guide to the clinician.

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Section: Which Children Should Undergo a Diagnostic Work-up?mentioning

confidence: 99%

Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience

Montella

Corcione

Santamaria

2017

IJMS

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“…If a serious illness is suspected, refer the child to secondary care without delaying for a chest x ray 39Box 3. lists specific red flags that should prompt referral to secondary care.…”

Section: When Should a Child Be Referred?mentioning

confidence: 99%

Recurrent lower respiratory tract infections in children

Benedictis

Bush

2018

BMJ

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“…A subgroup of these children (up to 8%) suffers from recurrent pneumonia, related to an underlying illness that may be identified in the majority of them [2]. Pneumonias that occur in varied sites, or affect more than one lobe, suggest the presence of a more, often already known, generalized abnormality [3][4][5]. Examples include psychomotor retardation with feeding problems, swallow dysfunction or aspiration, congenital heart disease or severe immunodeficiencies [5].…”

Section: Introductionmentioning

confidence: 99%

“…Pneumonias that occur in varied sites, or affect more than one lobe, suggest the presence of a more, often already known, generalized abnormality [3][4][5]. Examples include psychomotor retardation with feeding problems, swallow dysfunction or aspiration, congenital heart disease or severe immunodeficiencies [5]. In such patients, there is often no need to pursue another underlying etiologic cause.…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, infiltrates that recur in a single lobe or segment of the lung may be caused by congenital or acquired airway obstruction or by anatomic abnormalities of the lung structures. In almost all these cases there is the need to proceed further, carefully selecting the investigations to be used in each individual, taking into account the morphology and the location of the pulmonary lesion [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of right lower lobe pneumonia 3 years after the first episode in an otherwise healthy 13-year-old girl

Capizzi¹,

Sacco²,

Rossi³

et al. 2017

Monaldi Arch Chest Dis

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Recurrent pneumonia is one of the most frequent reasons for referral to paediatric chest physicians. The diagnostic work-up is dependent on whether infection repeatedly occurs in the same lung lobe, or affects multiple lobes and/or different areas in different episodes. A 13-year-old girl was admitted with a second episode of right lower lobe pneumonia.The chest x-ray demonstrated an inhomogeneous opacity, without a clearly recognizable segmental distribution. A contrast-enhanced CT scan, was therefore performed that showed a polycyclic consolidation with blood supply from a systemic artery, originated from the thoracic aorta. A diagnosis of superinfection of an intralobar sequestration was made. The patient was treated with systemic antibiotics and, four weeks later, a segmental resection of the lesion was performed. The histological evaluation of the surgical specimen confirmed the diagnosis.

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Evaluating the child with recurrent lower respiratory tract infections

Cited by 22 publications

References 23 publications

Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience

Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience

Recurrent lower respiratory tract infections in children

Recurrence of right lower lobe pneumonia 3 years after the first episode in an otherwise healthy 13-year-old girl

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