Paediatrics: Bronchopneumonia vs Lobar pneumonia
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1. Bronchopneumonia 2. Lobar pneumonia | K, 5 years old girl p/w rapid breathing for 1/7 a/w fever, chesty cough, coryza 2/7 active, no loss of appetite no whooping cough, no barking cough, no post tussive vomiting no noisy breathing, no chest indrawing no chest pain, palpitation differential dx? |
Right lobar pneumonia | Ix results wbc - 17 crp - 45.1 rp - normal blood c+s - pending cxr - right middle zone consolidation dx? |
1. high grade fever 2. infants - irritability, toddler - pleuritic chest pain 3. sometimes no cough present 4. common cause: strep pneumoniae | Criteria of lobar pneumonia (according to Prof K) |
Ddx 1. aspiration pneumonia - bronchoscopy since cxr cannot visualise the obstruction 2. atypical pneumonia - change abx to macrolides 3. tb - tb work up - mantoux test, sputum AFB 4. congenital malformation | If still persistent consolidation despite 1 week abx, what is the ddx? what's next plan? |