Basic Concepts on Community-Acquired Bacterial Pneumonia in Pediatrics
Abstract
Community-acquired pneumonia (CAP) is a common
disease in infancy, requiring several pediatric ƐƉĞcŝĂůƟĞƐ
for its diagnosis and treatment. Establishing the causal
agent of pneumonia is ĞƐƐĞnƟĂů to guarantee the most
appropriate and ĞīĞcƟvĞ therapy and is pivotal to the
development of ƚŚĞrĂƉĞƵƟc and ƉrĞvĞnƟvĞ strategies.
However, determining the ĞƟŽůŽŐy of pneumonia is ƐƟůů a
challenge due to the rĞůĂƟvĞ inaccessibility of infected
ƟƐƐƵĞ and the ĚŝĸcƵůƚy in obtaining non-contaminated
samples of the upper airway. Broncho alveolar lavage
(BAL) yields adequate samples, but should be reserved for
severe cases with poor outcome. Blood cultures should be
obtained in all children in whom bacterial pneumonia is
suspected. Serum samples should be collected during the
acute phase and during convalescence as a ƉrĞvĞnƟvĞ
measure in case a microbiological diagnosis is not
established during the acute period of the disease. Recent
ĚŝĂŐnŽƐƟc advances have introduced the polymerase
chain rĞĂcƟŽn (PCR), which in great measure has
increased the ability to ŝĚĞnƟĨy airway pathogens.
Immunological markers provide ŝnĨŽrmĂƟŽn
cŽmƉůĞmĞnƟnŐ clinical ĮnĚŝnŐƐ͘ New and more ƐĞnƐŝƟvĞ
techniques should be evaluated to detect the ĞƟŽůŽŐŝcĂů
agents of severe pneumonia in children, ƉĂrƟcƵůĂrůy in
developing countries.