Pediatric Community-Acquired Pneumonia in the United States: Changing Epidemiology, Diagnostic and Therapeutic Challenges, and Areas for Future Research

Abstract

Community-acquired pneumonia (CAP) is one of the most common serious infections in childhood. This review focuses on pediatric CAP in the United States and other industrialized nations, specifically highlighting the changing epidemiology of CAP, diagnostic and therapeutic challenges, and areas for further research.

Keywords: Community-acquired pneumonia; Epidemiology; Pediatric.

Fig. 1

Radiographic imaging in cavitating pneumonia. (A) Chest radiograph demonstrating a complex air space opacity in the left upper lobe with central lucency consistent with cavitating pneumonia. (B) CT of the same lesion demonstrates a large cavity with central necrosis and multiple air fluid levels occupying most of the left upper lobe.

Fig. 2

Pathogens detected in US children with CAP requiring hospitalization, detection according to age group. Darker shading in the bar graph in panel B indicates that only the single pathogen was detected, and lighter shading indicates the pathogen was detected in combination with at least one other pathogen. Panel A shows the proportion of pathogen types among 2222 hospitalized children in the CDC EPIC study. A total of 4 patients had more than one bacterial pathogen without a virus detected. Panel C shows the proportions of pathogens detected, according to age group. AdV, denotes adenovirus; CoV, coronavirus; Flu, influenza A or B virus; HMPV, human metapneumovirus; HRV, human rhinovirus; PIV, parainfluenza virus.