The paediatric chest x-ray: is it really infection? Mimics of pneumonia in children

Pneumonia is a significant cause of morbidity and mortality in children. The chest radiograph (CXR) is a widely used diagnostic tool in ensuring early diagnosis of pneumonia in order to optimise management. The pattern of findings seen on a CXR in pneumonia will vary depending on the complexity of the disease process. Features of lobar […]Pneumonia is a significant cause of morbidity and mortality in children. The chest radiograph (CXR) is a widely used diagnostic tool in ensuring early diagnosis of pneumonia in order to optimise management. The pattern of findings seen on a CXR in pneumonia will vary depending on the complexity of the disease process. Features of lobar pneumonia include homogenous consolidation with air bronchograms typically affecting a single lobe; however, multilobar consolidation may occur in more pronounced disease. Confluent bronchopulmonary pneumonia may be indistinguishable from a lobar pneumonia; however, mild disease may show features of peribronchial cuffing and patchy ill-defined opacities. Viral pneumonia continues to be difficult to differentiate from bacterial pneumonia clinically, presenting similarly with cough and tachypnoea. Radiographic appearance of viral infections include interstitial disease, lobar consolidation, and patchy or diffuse areas of consolidation. Radiography cannot reliably differentiate viral from bacterial pneumonia. It is also important to be aware of the multitude of conditions that may be identified on a CXR which can mimic pneumonia and it is imperative to be able to differentiate between these conditions.

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