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# Mometrix ## Pneumonia - Erythematous rash and pharyngitis - Pneumonia presents as interstitial infiltrates on x-ray - Complications include myocarditis, endocarditis, aseptic meningitis, and encephalitis - Most infections clear without sequelae - **Treatment includes:** - Antibiotic therapy: E...

# Mometrix ## Pneumonia - Erythematous rash and pharyngitis - Pneumonia presents as interstitial infiltrates on x-ray - Complications include myocarditis, endocarditis, aseptic meningitis, and encephalitis - Most infections clear without sequelae - **Treatment includes:** - Antibiotic therapy: Erythromycin, tetracycline, macrolide, or fluoroquinolone - Symptomatic support: Antidiarrheals, antipyretics, and analgesics ## HAP - Hospital-acquired pneumonias (HAP) are far more lethal than community-acquired pneumonias (CAP) - HAP death rates are 20-40% and up to 90% if the child is on mechanical ventilation - _Pseudomonas aeruginosa_ is one of the most lethal (40-60% mortality) because it can invade blood vessels - Most infections are spread by contact with contaminated hands of healthcare staff or from invasive devices - Children with cystic fibrosis (CF) are at particular risk - Symptoms include fever, cough, bradycardia, and elevated WBC counts - **Treatment includes:** - Antibiotic therapy: Usually combinations of 2 antibiotics are given, such as piperacillin or ceftazidime AND gentamicin or ciprofloxacin (based on cultures) - Vancomycin is generally avoided because of the rise of vancomycin-resistant organisms - Isolation: Isolating infected and coughing CF children from others - Preventive measures: Maintaining ventilated children in 30° upright positions, universal precautions, and changing ventilator circuits as per protocol ## Aspiration Pneumonia - Aspiration pneumonia may occur as a result of any type of aspiration, including foreign objects. - The aspirated material creates an inflammatory response, with the irritated mucous membrane at high risk for bacterial infection secondary to the aspiration. - The most common causes of aspiration pneumonia are fluids or foods - Children with respiratory stress or crying during feeding can easily aspirate - Toddlers and young children may aspirate lighter fluids or other hydrocarbon liquids - Symptoms are similar to other pneumonia, depending upon the site of inflammation - Cough - Dyspnea, respiratory distress - Cyanosis - **Treatment includes:** - Removal of foreign object if indicated (laryngoscopy/bronchoscopy) - Antibiotic therapy as indicated - Symptomatic respiratory support - Preventive methods to avoid aspiration, such as careful feeding and positioning child on the right side after feeding ## Bronchiolitis (RSV) - Bronchiolitis is inflammation of the bronchiolar level and is usually caused by the respiratory syncytial virus (RSV) - Adenoviruses, parainfluenza and M. pneumoniae have also been implicated