AFEBRILE PNEUMONIA IN INFANTS - 11/09/11

Doi : 10.1016/S0095-4543(05)70366-3

Gregory P. DeMuri, MD ^{^{*
From the Divisions of General Pediatrics and Adolescent Medicine and Infectious Diseases, Department of Pediatrics, University of Wisconsin Medical School, Madison, Wisconsin}}

Résumé

The syndrome of afebrile pneumonitis in infants is a relatively common disease that has gone by myriad names in the medical literature. Appellations for this clinical syndrome have included atypical pneumonia, infantile pneumonitis, interstitial pneumonia, viral pneumonia, or nonbacterial pneumonia.^{5 Boyer K.M., Cherry J.D. Non-bacterial pneumonia Pediatric Infectious Diseases Philadelphia: WB Saunders (1992).
254-264

Cliquez ici pour aller à la section Références} Despite this confusion of names, most clinicians are familiar with the clinical picture of a patient with a pneumonia that is not a typical lobar or lobular process as seen with pyogenic bacteria such a Streptococcus pneumoniae. For this article, afebrile pneumonia is defined as a pneumonitis with the following:

1	Acute or subacute onset
2	Lack of fever or low-grade fever (< 102°F)
3	Clinical signs suggestive of a pulmonary process such as cough, tachypnea, or mild to moderate respiratory distress
4	Infiltrates on chest radiographs such as perihilar or interstitial infiltrates
5	Lack of evidence of on acute pyogenic bacterial process such as a normal or only mildly elevated white blood cell count and no response to -lactam antibiotics such as amoxicillin or cephalosporins.^{24 Moffet H.L. Atypical pneumonia syndromes Pediatric Infectious Diseases: A Problem Oriented Approach Philadelphia: JB Lippincott (1989). 159-166 Cliquez ici pour aller à la section Références}

This definition is intended to apply to the majority of children, but clearly there are exceptions. For instance, some infants with an atypical pneumonia present with fever. Terms that imply a etiologic agent such as nonbacterial pneumonia should be avoided because bacterial agents are actually common causes of afebrile pneumonia, as is discussed. This article focuses mainly on afebrile pneumonia in infants, in particular, those younger than 6 months of age. Comparison are made to pneumonia in older children. Etiologic agents are discussed as well as the clinical presentations, diagnosis, and treatment of afebrile pneumonia in infancy.

Le texte complet de cet article est disponible en PDF.

Plan

CAUSE AND CLINICAL MANIFESTATIONS

Chlamydia trachomatis

Viral Pneumonia

Pneumocystis carinii

Ureaplasma and Mycoplasma hominis

Other Agents

DIAGNOSIS

THERAPY AND PREVENTION

CONCLUSION

Address reprint requests to Gregory P. DeMuri, MD, Department of Pediatrics, University of Wisconsin Medical School, 600 Highland Avenue H6/440, Madison, WI 537924116