Severe Pneumonia
Lower chest wall indrawing
- Problems in recognizing children who should be urgently referred
- “Retractions” suggested as indication of severe disease but multiple definitions existed
- Studies found lower chest wall indrawing best identified children who required assessment or admission
- must be definite, present all the time
Recognition
- Urgently refer children with Cough or difficult breathing AND
- Lower chest wall indrawing OR
- Stridor when calm OR
- Any general danger sign
Clinical signs
+ = always present += Present sometimes
A combination of clinical signs indicates need for referral and further assessment
Identification of potentially life threatening diseases must be made by a proper physical examination at a higher level facility
Antibiotics
- Invasive bacterial organisms warrant injectable antibiotics
- Delivered to the blood and/or meninges
- Incessant vomiting or shock prohibit oral antibiotics
- Penicillin –IM
- Inexpensive
- Widely available
- Limited organisms treated
- Poor CSF penetration