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Pcap

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DIFFERENTIAL DIAGNOSIS

• ASTHMA
RULE IN RULE OUT
cough no wheezing
colds no shortness of breath
no chest tightness/pain
no dry cough

• PULMONARY FIBROSIS
RULE IN RULE OUT
Cough no dry cough
poor appetite no dyspnea
crackles on both lung fields no chest discomfort
no fatigue
no muscle/joint pain
no clubbing
• TUBERCULOSIS
RULE IN RULE OUT
Productive cough no chest pain
poor appetite no fatigue
fever no night sweats
submandibular lymphadenopatahy no hemoptysis
crackles on both lung fields

• ACUTE BRONCHITIS
RULE IN RULE OUT
fever no chest tightness
productive cough no shortness of breath
colds no fatigue
crackles
• PNEUMONIA

RULE IN RULE OUT


productive cough can't be completely ruled out
colds
fever
crackles on both lung fields
past medical history: (+) pneumonia
PNEUMONIA
• Is an inflammation of the parenchyma of the lungs
• Most cases of pneumonia are caused by microorganism
• Non infectious causes:
aspiration of food or gastric acid; foreign bodies; hydrocarbons;
hypersensitivity reactions and drug or radiation-induced pneumonitis.
SPECIFIC RISK FACTORS:
lung disease
anatomic problems
gastroesophageal reflux disease with aspiration
• neurologic disorders that interfere with protection of the airway or
compromise clearing f the airway
• disease that alter the immune system, such as immunodeficiency
diseases or hemoglobinopathies.
ETIOLOGY:
viral: peak attack is between 2-3 years old
S.pneumoniae, M.pneumoniae- older than 5 years old
other bacterial causes: group A streptococcus, S. pyogenes,
staphylococcus aureus, hemophillus influenzae type b
DIAGNOSTICS
No diagnostic aids are initially requestyed for a patient classified as
PCAP A or B who is being managed in an ambulatoy setting
Recommendations for PCAP Cand D
chest Xray PAL
WBC count
Culture and sensitivity of blood, pleural fluid, tracheal aspirate for PCAP
D, sputum for older children
The following should not be requested:
ESR
C-reactive protein

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