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Clinical signs of pneumonia in children

M Harari1, F Shann, V Spooner

  • 1Goroka Base Hospital, Papua New Guinea.

Lancet (London, England)
|October 12, 1991
PubMed

Insights

Simple clinical signs like rapid breathing or chest indrawing accurately indicate pneumonia in young children. These findings are crucial for diagnosing childhood pneumonia in outpatient settings.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Radiology

Background:

  • Pneumonia is a leading cause of child mortality globally.
  • Accurate and timely diagnosis is essential for effective treatment.
  • Clinical signs are often used to diagnose pneumonia in resource-limited settings.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of clinical signs for pneumonia in children.
  • To assess the utility of specific respiratory rate thresholds and chest indrawing for pneumonia diagnosis.

Main Methods:

  • Prospective study of 185 children aged 8 weeks to 6 years with cough.
  • Exclusion of children with wheeze, stridor, measles, or pertussis.
  • Recording of clinical findings and chest radiography.

Main Results:

  • 30% of children had radiological evidence of pneumonia.
  • Respiratory rate >= 50/min or chest indrawing showed 46% positive predictive value and 83% negative predictive value.
  • A more complex tachypnoea definition offered minimal additional diagnostic benefit.

Conclusions:

  • Simple clinical signs (tachypnoea, chest indrawing) are valuable for diagnosing childhood pneumonia.
  • These signs are particularly useful in outpatient settings in resource-limited areas.
  • Complex tachypnoea definitions do not significantly improve diagnostic accuracy over simpler criteria.

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