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Community-acquired pneumonia in children: Clinical features and diagnosis

William J Barson, MD
Section Editors
Sheldon L Kaplan, MD
George B Mallory, MD
Deputy Editor
Mary M Torchia, MD


Community-acquired pneumonia (CAP) is defined as signs and symptoms of an acute infection of the pulmonary parenchyma in an individual who acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia [1,2]. CAP is a common and potentially serious illness with considerable morbidity.

The clinical features and diagnosis of CAP in children will be reviewed here. The epidemiology, pathogenesis, and treatment of pneumonia in children are discussed separately. (See "Pneumonia in children: Epidemiology, pathogenesis, and etiology" and "Community-acquired pneumonia in children: Outpatient treatment" and "Pneumonia in children: Inpatient treatment".)


The clinical presentation of childhood pneumonia varies depending upon the responsible pathogen, the particular host, and the severity. The presenting signs and symptoms are nonspecific; no single symptom or sign is pathognomonic for pneumonia in children [3].

Symptoms and signs of pneumonia may be subtle, particularly in infants and young children. The combination of fever and cough is suggestive of pneumonia; other respiratory findings (eg, tachypnea, increased work of breathing) may precede the cough. Cough may not be a feature initially since the alveoli have few cough receptors. Cough begins when the products of infection irritate cough receptors in the airways. The longer fever, cough, and respiratory findings are present, the greater the likelihood of pneumonia [4].

Neonates and young infants may present with difficulty feeding, restlessness, or fussiness rather than with cough and/or abnormal breath sounds [5]. Neonates, young infants, and young children (ie, <5 to 10 years of age) may present only with fever and leukocytosis [4,6].

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Literature review current through: Nov 2017. | This topic last updated: Oct 24, 2017.
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