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Severe pneumonia in childhood. Robert Gie Department Paediatrics and Child Health Stellenbosch University. 3 month old infant Doing well after birth Onset of cough and fast breathing Severely hypoxic with rapid progression of disease Started on PJP treatment HIV infected

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severe pneumonia in childhood

Severe pneumonia in childhood.

Robert Gie

Department Paediatrics and Child Health

Stellenbosch University.

slide2

3 month old infant

Doing well after birth

Onset of cough and fast

breathing

Severely hypoxic with rapid

progression of disease

Started on PJP treatment

HIV infected

Proven PJ pneumonia

Initially improves then

deteriorates

Proven CMV co-infection

slide4

2 month old ex-premature

Presented with cough and

progessive respiratory distress

Required ventilatory support

Due to hypercarbia

Culture proven PTB.

Source case CXR:

slide7

10 year old child

Previous well

Develops the symptoms

of an influenza like disease

Rapid progression of

respiratory failure

H1N1 proven

slide24

Table 3 WHO standard antibiotic regimens for low and high HIV prevalent settings

[1] World Health Organisation.Management of Children with Pneumonia and HIV in low-resource settings.

Report of a consultative meeting. Harare, Zimbabwe,Jan 30–31, 2003.

Geneva: World Health Organisation/Boston University, 2004.)

slide26

Further adaptation:

Consider PJP CMV

co-infection in infants

Less than 6 months

Add Gancyclovir for

21 days

slide28

Surgical enucleation

of obstructing glands.

Indication: hypercapnea

and not able to wean

slide31

Micronutrients

Zinc supplementation

10mg/day

child lung health project malawi
Child lung Health Project:Malawi
  • In 5 years 48702 in hospital children treated for pneumonia
  • Age
    • 52% 2-11 months
    • 37% 12-59 months
  • Severity of disease
    • 62.8% severe pneumonia
    • 25.2% very severe pneumonia
  • Mortality
    • Decreased from 18.6% to 8.4%

P Enarson