Pneumonia in Normal and Immunocompromised Children: An Overview and Update

Abstract

Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia, and determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as effusion/empyema and suppurative lung changes. The overarching goal of this article is to review cause, role of imaging, imaging techniques, and the spectrum of acute and chronic pneumonias in children. Pneumonia in the neonate and immunocompromised host is also discussed.

Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan: A nationwide surveillance

“…Based on the consensus of interpretation, 13 the area and distribution of the lung parenchyma and the abnormality of the pleura were evaluated. Patients with segmental or lobar pneumonia and complete clinical information were included.…”

Cystic Lung Lesions in Newborns and Young Children: Differential Considerations and Imaging

“…Differential diagnosis of cavitary lesions in an infant with clinical features suggesting infection also include infected BPM, necrotic or infected neoplasm, and in older children, vasculitic lesions such as granulomatosis with polyangiitis (Wegener granulomatosis). 18 US imaging is very helpful in evaluating pulmonary infection, particularly in determining if effusion is simple or complex. Fluid may be anechoic or echogenic.…”

“…US may also identify fluid-filled cystic changes in the lung as well as consolidated lung and mediastinal lesions including adenopathy. 18,19 CT is useful for evaluating the extent and nature of suppurative complications of infection, especially in case of a poor response to antibiotic treatment, complex x-ray findings, or an immunocompromised child (Fig. 9).…”

“…10). 18,22 Cavitary consolidation is more common after primary TB with reinfection or reactivation of previously sensitized patients and is less often Figure 9 Lung abscess-angioinvasive aspergillosis. A 6-month-old girl with acute myelogenous leukemia on induction chemotherapy.…”

Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency

“…Opportunistic pathogens may lead to rapidly progressive, fatal interstitial pneumonitis accompanied by hyperinflation resulting from small airway obstruction or to persistent bronchiolitic presentation. Apart from pyogenic bacteria, such as Pseudomonas aeruginosa , Stenotrophomonas spp, Burkholderia spp, as well as Mycobacteria and fungi, in particular Pneumocystis jiroveci , respiratory viruses like respiratory syncytial virus (RSV), adenovirus, parainfluenza virus, human metapneumovirus (hMPV) and other viruses – cytomegalovirus (CMV), varicella–zoster virus (VZV), and Epstein–Barr virus (EBV) are associated with severe pneumonia in SCID children 2 . Human coronaviruses (HCoV) HCoV‐229E and HCoV‐OC43 and related new strains HCoV‐NL63 and HCoV‐HKU1, identified after the epidemic outbreak of severe acquired respiratory syndrome (SARS) coronavirus, are likely to be common respiratory viruses in otherwise healthy children and were not implicated in severe lung infections in immunocompromised patients thus far 3 .…”