Hospitalization is usual for pneumonia in infants < 6 months of age; immunocompromised children; children who appear toxic, have respiratory distress, or require supplemental oxygen; and children with pneumonia for whom outpatient treatment has failed. Chest X-ray findings on hospital admission are related to clinical outcomes and can assist in predicting disease severity. In developed countries, diagnosis is made based on respiratory manifestations and radiographic findings; if X-ray equipment is not available, pneumonia is diagnosed based on clinical findings alone.