Pediatria pre prax 2/2024

Complications of pneumonia in children

Pneumonia is one of the leading causes of morbidity and mortality in children worldwide, with an increasing number of complicated pneumonias. Complications are divided into pulmonary – fluidothorax, empyema, abscess and necrosis and extrapulmonary – bacteraemia and sepsis, multiorgan failure or disseminated intravascular coagulopathy. Complicated pneumonia often affects otherwise healthy children without comorbidities. Clinically, it manifests as severe respiratory infection with febrilities, cough and significantly increased inflammatory activity. Complicated pneumonia should be ruled out in any child with pneumonia who fails to improve after 48 to 72 hours on conventional treatment. Imaging modalities such as chest X-ray as well as chest ultrasound and HRCT are used in both diagnosis and follow-up. Antibiotic treatment of complicated pneumonia is often combined, initially with parenteral administration, and in indicated cases surgical intervention is also necessary. A total of 86 paediatric patients with severe community-acquired pneumonia (49 girls), with a mean age of 5 years, were admitted to the Department of Paediatric Pneumology and Phtisiology in Bratislava between September 2021 and June 2023. Pulmonary complications occurred in 25 cases and surgical treatment was required in 9 patients with complicated community-acquired pneumonia. Our follow-up confirms the relatively frequent occurrence of pneumonia complications in childhood.

Keywords: pneumonia, complications, children