Severe or Life-Threatening CAP
ÎThe clinician should obtain tracheal aspirates for Gram stain and culture, as well as clinically- and epidemiologically-guided testing for viral pathogens, including influenza virus, at the time of initial endotracheal tube placement in children requiring mechanical ventilation. (SR-L)
ÎBronchoscopic or blind protected specimen brush sampling, bronchoalveolar lavage (BAL), percutaneous lung aspiration, or open lung biopsy should be reserved for the immunocompetent child with severe CAP if initial diagnostic tests are not positive. (WR-L)
Table 1. Complications Associated With CAP Pulmonary
Pleural effusion/empyema Pneumothorax Lung abscess Bronchopleural fistula Necrotizing pneumonia Acute respiratory failure
Metastatic
Meningitis Central nervous system abscess Pericarditis Endocarditis Osteomyelitis Septic arthritis
Systemic
Systemic inflammatory response syndrome/sepsis Hemolytic uremic syndrome
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