[Pneumonia in childhood and adolescence]

Pneumonia plays a significant clinical and epidemiological role in childhood and adolescence. The most common form is community-acquired pneumonia ("pCAP"). However, pneumonia that arises due to immunodeficiency-such as that caused by chemotherapy or pre-existing, mostly congenital, underlying diseases-must be distinguished.

The aim of this work is to present the value of various radiological methods for diagnosing pneumonia in children and adolescents.

The advantages and disadvantages of radiological methods (X-ray, ultrasound, computed tomography [CT], and magnetic resonance imaging [MRI]) for diagnostic use in the three classic forms of pneumonia and their typical complications are presented. Age-specific characteristics in childhood and adolescence and their implications for imaging are discussed, with particular attention to pneumonia under immunosuppression.

Most patients with pneumonia in childhood and adolescence, especially those with pCAP, do not initially require radiological imaging. Imaging becomes necessary in patients who lack clinical improvement or complications are suspected. Chest X‑ray remains the first-line method due to its ease of use, widespread availability, and relatively low radiation dose, and is complemented by ultrasound. CT is indicated in cases of severe complications of pCAP. In pneumonia associated with immunosuppression, CT is often the first-line method, as it is significantly more sensitive than X‑ray and permits better characterization of the type of pneumonia and possible complications.