Viral Pneumonia
I just attended the Pediatric Infectious Disease Specialist (PIDSP) postgraduate course held at Conrad Hotel in Manila. All the topics presented and reviewed were relevant to us Pediatricians to better care for the Filipino children.
In this issue, i wish to echo the lecture on Viral Pneumonia by Dr Cesar Ong, a pediatric pulmonologist.
Dr. Ong stressed that the importance of the topic includes the following:
1. To directly determine the decision of management
2. To prevent antibiotic overuse and resistance
3. To improve patient safety
4. To reduce unnecessary diagnostic investigation
5. To sharpen knowledge on viral pneumonia will influence prognosis and counselling
Viral pneumonia is common among the infants and children below 5 years of age. The onset is gradual, patient will have low grade fever, mild respiratory distress and wheezing upon auscultation is prominent.
Comparing to bacterial pneumonia, which will affect all age group, the onset is sudden with high grade fever, the respiratory distress is prominent and wheezing maybe present or not. If an infant hsas wheezing and chest xray findings leading to interstitial pneumonia, then most likely it is viral. However, if presented with a toxic child with focal findings and lobar chest xray findings then it could be bacterial pneumonia.
The common familiar foes in viral pneumonias are:
1. RSV
2. Influenza
3. Adenovirus
Common viruses are considered emerging because of improved diagnostic tools and that burden is getting higher because of malnutrition that could blunt immune response; overcrowding that may cause higher viral loads and co-infection; and, delayed care that may result to more severe at presentation.
Dr. Cesar Ong further stressed that management of Viral Pneumonia is primarily supportive. Majority will recover with supportive care. Dr Ong said and i quote, “Viral Pneumonia remains a familiar foe and evolving challenge to all medical doctors.”