Differential Diagnosis of Pediatric Pneumonia

Written by Li Jiao Yan
Neonatology
Updated on September 06, 2024
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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.

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Written by Li Jiao Yan
Neonatology
1min 38sec home-news-image

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.

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Written by Yan Xin Liang
Pediatrics
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What should a child with pneumonia eat?

Childhood pneumonia is an infectious disease that not only presents symptoms related to the respiratory system but also may include symptoms from the gastrointestinal tract, such as vomiting, diarrhea, loss of appetite, and abdominal distension. Therefore, the diet for pneumonia must be light and easy to digest. For instance, if the child is breastfed, the mother should consume a light and digestible diet. If the child is fed with cow's milk, the milk can be diluted appropriately to aid digestion. Supplementary foods can generally include thin porridge, noodles, rice paste, vegetables, and fruits, as well as a moderate amount of lean meat and eggs, but not in excess. Oily and spicy foods should not be included.

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Written by Yang Feng
Pulmonology
39sec home-news-image

Symptoms of pneumonia in infants

Pneumonia is a particularly common infectious disease of the respiratory system. In infants and young children with pneumonia, the main clinical symptoms include fever, crying, vomiting, and so forth. Since infants cannot express their discomfort, it is difficult to make a diagnosis. However, when a patient presents with fever, we first need to consider the possibility of a lung infection. We can determine whether there is an infection of the lungs through listening to the chest, routine blood tests, imaging examinations, etc., and then treat the pneumonia with effective anti-inflammatory therapy.

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Written by Wang Xiang Yu
Pulmonology
57sec home-news-image

What department should I go to for pneumonia?

Pneumonia, as the name suggests, is inflammation of the lungs and belongs to the category of respiratory diseases. Therefore, the primary department to consult is Respiratory Medicine. In places where there is no Respiratory Medicine department, such as community health service centers or township health clinics, patients would have to consult the general internal medicine department instead. Of course, if the symptoms of pneumonia are severe and the condition is critical, and it happens outside of regular outpatient hours, then the patient must be seen by the emergency medicine department. The emergency medicine department will manage and triage pneumonia patients, and then decide their next steps, such as whether to transfer them to the ICU, a regular Respiratory Medicine department, or keep them for observation in the emergency department.

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Written by Li Jiao Yan
Neonatology
55sec home-news-image

How many doses are there for the pneumonia vaccine?

Currently, there are two types of vaccines commonly used to prevent pneumococcal diseases. One type is the 23-valent polysaccharide vaccine, suitable for high-risk populations over two years old. The other type includes the 7-valent or 13-valent conjugate vaccines, used for vaccinating infants under two years old. The vaccination schedule for the 7-valent or 13-valent vaccines follows a "three plus one" program, which means three primary immunization doses with at least one month between each dose, followed by a booster dose. For the 23-valent vaccine, high-risk individuals over two years old generally require only a single dose; however, immunocompromised patients may need a booster shot, typically recommended five years after the initial vaccination.