Imaging community-acquired pneumonia in children

Excerpt

Community-acquired pneumonia in children is common in all parts of the world and it remains the major single cause of death in children outside the neonatal period. The presentation and natural progression of pneumonia is constantly changing with the use of new vaccines, and clinicians must adapt to these changes. This issue’s minisymposium on imaging of pneumonia starts with a review by Le Roux and Zar [1], who report, for example, that there have been more empyemas since the introduction of pneumococcal conjugate vaccine. This change in disease profile might change the likelihood of a clinician requesting an imaging study. On the other hand, the choice of which imaging modality to use is also evolving with advances in technology and with emerging knowledge regarding diagnostic imaging. Both clinicians and radiologists are involved in making the diagnosis of pneumonia, and these groups need clarity on their respective roles. Mahommed and colleagues [2] describe one environment where clinicians and radiologists are engaging in discussions through the World Health Organization Chest Radiography in Epidemiological Studies project and where definitions of chest radiograph findings representing pneumonia are being revised for vaccine trials. This process has come about because of criticism and dissatisfaction with the previous radiographic World Health Organization definitions for pneumonia. The World Health Organization has grappled with definitions that now include some size specifications but has continued to embrace chest radiography as the primary diagnostic imaging tool for confirming the presence of pneumonia. …