Suggested criteria for admission of children with pneumonia include hypoxia (oxygen saturation £90 percent), respiratory distress, a history of apneic episodes or cyanosis, toxic appearance, dehydration, age less than 3 months, impaired immune function, and infections unresponsive to oral therapy. The presence of underlying disease and the ability of the care givers should also be considered. The finding of a pleural effusion or pneumatocele or findings suggestive of a bacterial infection in a child less than 1 year of age suggest a pathogen other than S. pneumoniae (particularly HIB or S. aureus). Since such infections can progress rapidly and are not well tolerated, hospitalization is generally required. Infants with suspected B. pertussis or M. tuberculosis should be admitted. Children with moderate or severe complications from pneumonia should be hospitalized. Indications for admitting patients with RSV pneumonia are the same as for RSV bronchiolitis.
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