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

Int J Mol Sci. 2017 Jan 29;18(2):296. doi: 10.3390/ijms18020296.

Abstract

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.

Keywords: children; community-acquired pneumonia; diagnosis; lower respiratory tract infections; recurrent pneumonia.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / etiology
  • Comorbidity
  • Disease Management
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Italy / epidemiology
  • Male
  • Pneumonia / diagnosis*
  • Pneumonia / epidemiology*
  • Pneumonia / etiology
  • Recurrence
  • Risk Factors