September 2017

Does This Child Have Pneumonia?

No clinical criteria were powerful diagnostic discriminators of the presence or absence of pneumonia in children, though some were fair.  When in doubt, a CXR is probably warranted, with the exceptions of obvious bronchiolitis or asthma.  Low SpO2 (</= 95 to 96%) or increased work of breathing were the best predictors of radiographic pneumonia in children; auscultatory findings and tachypnea were poor.  You don’t need a CXR if no cough, no fever, no tachypnea, and normal SpO2.

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