Differential Diagnosis of Pediatric Pneumonia
Childhood pneumonia needs to be differentiated from other respiratory diseases such as bronchial foreign bodies, bronchial asthma, and pulmonary tuberculosis. A bronchial foreign body generally has a history of inhalation of foreign objects, sudden choking coughs, and a chest X-ray might indicate atelectasis or pulmonary emphysema. If the foreign body has been present for a long time, the disease course is prolonged and may lead to secondary infections, similar to pneumonia or concurrent with pneumonia. The differentiation of bronchial foreign body involves detailed medical history inquiries to check for inhaled foreign objects, then using symptoms and auxiliary examinations like chest X-rays for confirmation. Bronchial asthma, especially in children, might not always present with obvious wheezing attacks but rather persistent coughing. The X-ray might show increased and disordered lung markings and pulmonary emphysema, which can easily be confused with pneumonia. Typically, children with bronchial asthma have an allergic constitution and generally require pulmonary function tests and other auxiliary examinations to differentiate from pneumonia. Pulmonary tuberculosis generally occurs in those with a history of contact with tuberculosis patients. Their tuberculin skin test is positive, and X-rays may show features of tuberculosis lesions in the lungs, which can be used to differentiate from pneumonia.