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Severe pneumonia in childhood.

Severe pneumonia in childhood. Robert Gie Department Paediatrics and Child Health Stellenbosch University. 3 month old infant Doing well after birth Onset of cough and fast breathing Severely hypoxic with rapid progression of disease Started on PJP treatment HIV infected

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Severe pneumonia in childhood.

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  1. Severe pneumonia in childhood. Robert Gie Department Paediatrics and Child Health Stellenbosch University.

  2. 3 month old infant Doing well after birth Onset of cough and fast breathing Severely hypoxic with rapid progression of disease Started on PJP treatment HIV infected Proven PJ pneumonia Initially improves then deteriorates Proven CMV co-infection

  3. 2 month old ex-premature Presented with cough and progessive respiratory distress Required ventilatory support Due to hypercarbia Culture proven PTB. Source case CXR:

  4. 10 year old child Previous well Develops the symptoms of an influenza like disease Rapid progression of respiratory failure H1N1 proven

  5. P Enarson 2010

  6. Table 3 WHO standard antibiotic regimens for low and high HIV prevalent settings [1] World Health Organisation.Management of Children with Pneumonia and HIV in low-resource settings. Report of a consultative meeting. Harare, Zimbabwe,Jan 30–31, 2003. Geneva: World Health Organisation/Boston University, 2004.)

  7. Further adaptation: Consider PJP CMV co-infection in infants Less than 6 months Add Gancyclovir for 21 days

  8. Surgical enucleation of obstructing glands. Indication: hypercapnea and not able to wean

  9. Micronutrients Zinc supplementation 10mg/day

  10. Predicting for failure

  11. Child lung Health Project:Malawi • In 5 years 48702 in hospital children treated for pneumonia • Age • 52% 2-11 months • 37% 12-59 months • Severity of disease • 62.8% severe pneumonia • 25.2% very severe pneumonia • Mortality • Decreased from 18.6% to 8.4% P Enarson

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