Pneumonia, Viral Infection
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: J12.9 DESCRIPTION The commonest cause of pneumonia in children is viral infection. Respiratory syncyctial virus, adenovirus, cytomegalovirus, influenza, parainfluenza, adenovirus, herpes, human metapneumovirus and measles are the common viruses responsible for infections of the respirato
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
ICD-10 code: J12.9
DESCRIPTION
The commonest cause of pneumonia in children is viral infection. Respiratory syncyctial virus, adenovirus, cytomegalovirus, influenza, parainfluenza, adenovirus, herpes, human metapneumovirus and measles are the common viruses responsible for infections of the respiratory tract, Children present with fever, cough, rhinorrhea and chest indrawing. Scattered fine crackles may also occur.
Common viral causes in infancy and early childhood include:
- influenza virus,
- para-influenza virus,
- measles virus,
- respiratory syncytial virus,
- cytomegalovirus,
- adenovirus.
Measles is recognized by the typical features of cough, coryza, koplik spots, a maculopapular rash and its other systemic manifestations.
DIAGNOSTIC CRITERIA
- As for pneumonia, See: Pneumonia.
- It is not possible to discriminate viral from bacterial pneumonia on clinical or radiological grounds,
- Chest X-ray is not routinely indicated.
GENERAL AND SUPPORTIVE MEASURES
- Maintain nutrition.
- Maintain hydration.
MEDICINE TREATMENT
Only if saturation < 92%:
- Oxygen, humidified, 1–2 L/min via nasal prongs or nasal cannula.
To relieve discomfort:
- Paracetamol, oral, 15 mg/kg/dose 6 hourly.
There is no role for routine antiviral therapy.
For Measles Pneumonia:
Treat as severe pneumonia, and refer to: Measles.
Complications
Monitor for secondary bacterial infection and institute empiric antibiotics for pneumonia if suspected. Do a blood culture.
REFERRAL
- Patients not improving within 48-72 hours of admission should be discussed with a paediatrician.
- For possible ICU care if not maintaining saturations in normal range on oxygen or if clinical features of fatigue are present.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 15: Respiratory System, 15.1 Cough With Predominant Fever And Tachypnoea, 15.1.1 Pneumonia, 15.1.1.1 Pneumonia, Viral Infection