Strategies for recognizing pneumonia look-alikes

Eur J Pediatr. 2022 Oct;181(10):3565-3575. doi: 10.1007/s00431-022-04575-9. Epub 2022 Jul 30.

Abstract

Community-acquired pneumonia is a common diagnosis in children. Among the many children whose symptoms and/or chest X-ray is consistent with community-acquired pneumonia, it can be difficult to distinguish the rare cases of differential diagnoses that require specific management. The aim of this educational article is to provide clinicians with a series of questions to ask themselves in order to detect a possible differential diagnosis of pneumonia in children. The value of this approach is illustrated by 13 real clinical cases in which a child was misdiagnosed as having lobar pneumonia. What is Known: • When a lobar pneumonia is diagnosed, an appropriate antibiotic treatment leads to the resolution of the clinical signs in most cases. • However, several diseases can be look-alikes for pneumonia and mislead the practitioner. What is New: • This article provides a new approach to identify differential diagnoses of pneumonia in children. • It is illustrated by 13 real-life situations of children misdiagnosed as having pneumonia.

Keywords: Chest radiograph; Mediastinal mass; Pediatrics; Pneumonia; Radiological consolidation.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Community-Acquired Infections* / diagnosis
  • Diagnosis, Differential
  • Humans
  • Pneumonia* / diagnostic imaging
  • Pneumonia* / drug therapy
  • Pneumonia, Pneumococcal* / diagnosis
  • Radiography

Substances

  • Anti-Bacterial Agents