Community-acquired pneumonia in children: what to do when there is no response to standard empirical treatment?

SS (registrar) and AC (resident) A 5-year-old female presents to a tertiary paediatric hospital in Australia with a 2-day history of fever, vomiting and abdominal pain. Her past history consists of three episodes of otitis media in the preceding 12 months, all resulting in tympanic membrane perforation. Her parents report an ‘innocent heart murmur’ diagnosed by a paediatric cardiologist. There is no history of travel or animal exposure. With regard to family history, she is the child of non-consanguineous Caucasian parents, and her father has Crohn's disease. On examination, she is febrile (40.0°C) and tachypnoeic (45 breaths/min) with normal oxygen saturations (99% room air). Bronchial breath sounds are auscultated posteriorly in the left lower zone. She has a 3/6 systolic murmur heard at the apex and lower left sternal edge with no radiation. Her first full blood examination showed a neutrophilia (13.9x109/L, normal <8.5x109/L) and mild lymphopenia (1.9x109/L, normal...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Lung abscess, Drugs: infectious diseases, Pneumonia (infectious disease), TB and other respiratory infections, Inflammation, Pneumonia (respiratory medicine), Radiology (diagnostics), Ear, nose and throat/otolaryngology Chest clinic Source Type: research