CT Chest There is no relevant literature to support the use of CT as the initial imaging study in this clinical scenario. Pneumonia in the Immunocompetent Child MRI Chest There is no relevant literature to support the use of MRI as the initial imaging study in this clinical scenario. Variant 2: Child. 3 months of age and older. Immunocompetent. Community-acquired pneumonia that does not respond to initial outpatient treatment or requires hospital admission. Initial imaging. Radiography Chest Radiographs can be used to document the presence, size, and character of parenchymal infiltrates as well as to identify complications of pneumonia that may lead to interventions beyond antimicrobial agents and supportive medical therapy [3,24]. Frontal and lateral views of the chest are appropriate when evaluating for pneumonia in children with significant respiratory distress, hypoxemia, and failed antibiotic therapy, as suggested by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America [3,24,30]. Chest radiographs should be performed in select patients with prolonged fever and cough even in the absence of tachypnea or respiratory distress [3]. CT Chest There is no relevant literature to support the use of CT as the initial imaging study in this clinical scenario. MRI Chest There is no relevant literature to support the use of MRI as the initial imaging study in this clinical scenario. Variant 3: Child. 3 months of age and older. Immunocompetent. Suspected hospital-acquired pneumonia. Initial imaging. Radiography Chest Findings of new or progressive lung opacity support the diagnosis of hospital-acquired pneumonia in the appropriate clinical circumstances [10]. However, a new lung opacity in an inpatient with fever, leukocytosis, or leukopenia and purulent secretions is neither highly sensitive nor specific for hospital-acquired pneumonia [10,11].
Pneumonia in the Immunocompetent Child. CT Chest There is no relevant literature to support the use of CT as the initial imaging study in this clinical scenario. Pneumonia in the Immunocompetent Child MRI Chest There is no relevant literature to support the use of MRI as the initial imaging study in this clinical scenario. Variant 2: Child. 3 months of age and older. Immunocompetent. Community-acquired pneumonia that does not respond to initial outpatient treatment or requires hospital admission. Initial imaging. Radiography Chest Radiographs can be used to document the presence, size, and character of parenchymal infiltrates as well as to identify complications of pneumonia that may lead to interventions beyond antimicrobial agents and supportive medical therapy [3,24]. Frontal and lateral views of the chest are appropriate when evaluating for pneumonia in children with significant respiratory distress, hypoxemia, and failed antibiotic therapy, as suggested by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America [3,24,30]. Chest radiographs should be performed in select patients with prolonged fever and cough even in the absence of tachypnea or respiratory distress [3]. CT Chest There is no relevant literature to support the use of CT as the initial imaging study in this clinical scenario. MRI Chest There is no relevant literature to support the use of MRI as the initial imaging study in this clinical scenario. Variant 3: Child. 3 months of age and older. Immunocompetent. Suspected hospital-acquired pneumonia. Initial imaging. Radiography Chest Findings of new or progressive lung opacity support the diagnosis of hospital-acquired pneumonia in the appropriate clinical circumstances [10]. However, a new lung opacity in an inpatient with fever, leukocytosis, or leukopenia and purulent secretions is neither highly sensitive nor specific for hospital-acquired pneumonia [10,11].