Recurrent or Persistent Pneumonia

What is pneumonia?
Pneumonia is an infection of the lungs. It can be due to various types of disease causing organisms. The symptoms include fever, cough, rapid or laboured breathing, loss of appetite, etc. Pneumonia usually clears up rapidly with usual antibiotics and would not occur again.

When does pneumonia need to be investigated further?
Repeated episodes of pneumonia or a single episode not clearing up raises a red flag that an underlying disease process may be present. Hence all children with recurrent or persistent pneumonia would need further evaluation.

What are the causes of recurrent or persistent pneumonia?
Some of the common conditions are

  • Tuberculosis
  • Cystic fibrosis
  • Immune system disorder
  • Congenital cardiac defects
  • Recurrent aspiration
  • Bronchiectasis
  • Gastroesophageal reflux disease
  • Foreign body in child’s airway
  • Asthma
  • Abnormal airway anatomy like tracheomalacia, bronchomalacia etc

How would we evaluate a child with recurrent or persistent pneumonia?

  • We would first take a history and examine your child in detail. All outside chest X-rays if they are available would be reviewed and a new chest x-ray if indicated would be obtained.
  • Investigations are decided on a case-to-case basis after looking at the child’s history, examination, old records and xrays.
  • Further investigations might be required like a CT Scan of the chest; a flexible bronchoscopy, studies for gastro-esophageal reflux, sweat chloride, swallow study, etc. Blood samples for immune deficiency work-up might be needed.

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