Recurrent or Persistent Pneumonia

What is a pneumonia?

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

What is a Recurrent pneumonia?

Children who have more than two episodes of pneumonia which has been confirmed by a chest xray.

What is a Persistent pneumonia?

Pneumonia that has failed to clear after 4 weeks of treatment with an appropriate antibiotic.

When does a pneumonia needs 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 a recurrent or persistent pneumonia would need further evaluation.

What are the causes of a recurrent or persistent pneumonia?

The list of causes is very long. Some of the more common conditions are

  • Tuberculosis
  • Abnormal airway anatomy like bronchomalacia etc
  • Gastroesophageal reflux disease
  • Immune system disorder
  • Congenital cardiac defects
  • Recurrent aspiration
  • Asthma

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.
  • All children would not need all the mentioned investigations. They 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, swallow study, etc. Blood samples for immune deficiency work-up might be needed.