Professor, Departments of Emergency Medicine and Pediatrics, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, CA.
Associate Professor, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Pediatr Emerg Care. 2023 Dec 1;39(12):968-976. doi: 10.1097/PEC.0000000000003070.
Community-acquired pneumonia (CAP) is the most common cause of childhood mortality globally. In the United States, CAP is a leading cause of pediatric hospitalization and antibiotic use and is associated with substantial morbidity. There has been a dramatic shift in microbiological etiologies for CAP in children over time as pneumococcal pneumonia has become less common and viral etiologies have become predominant. There is no commonly agreed on approach to the diagnosis of CAP in children. When indicated, antimicrobial treatment should consist of narrow-spectrum antibiotics. In this article, we will describe the current understanding of the microbiological etiologies, clinical presentation, diagnostic approach, risk factors, treatment, and future directions in the diagnosis and management of pediatric CAP.
社区获得性肺炎(CAP)是全球儿童死亡的最常见原因。在美国,CAP 是导致儿童住院和抗生素使用的主要原因,并且与大量发病率相关。随着时间的推移,儿童 CAP 的微生物病因已经发生了巨大变化,肺炎球菌肺炎变得不那么常见,而病毒性病因则成为主要病因。目前对于儿童 CAP 的诊断还没有一个普遍认同的方法。在有指征的情况下,抗菌治疗应该采用窄谱抗生素。本文将描述当前对儿童 CAP 的微生物病因、临床表现、诊断方法、危险因素、治疗和未来诊断和管理方向的理解。