Should all children with pneumonia have chest X-rays?

A routine chest X-ray need not be taken in all children suspected of having pneumonia. However, if facilities are available, it should be done where:

  • Complications are expected (e.g. pneumothorax).
  • The diagnosis of tuberculosis is suspected.
  • The pneumonia is severe or does not respond to treatment after 2 days.

The diagnosis of pneumonia in a child is usually made on general examination rather than by listening to the chest.

Bronchopneumonia is common in small children while lobar pneumonia is often seen in older children. Always look for a pleural effusion or other signs of tuberculosis.

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