Epidemiology

Pneumonia is defined pathologically as an inflammation of lower tract lung tissue. Clinically, pneumonia is defined by the presence of pulmonary infiltrates on a chest radiograph, usually associated with a combination of clinical signs, such as cough, fever, chest pain, tachypnea, and a variety of abnormal auscultatory findings. Most commonly, pneumonia is caused by an infectious agent, although aspiration of irritants and interstitial inflammation are also referred to as such.

Pneumonia develops more often in early childhood than at any other age. The incidence of pneumonia in children decreases as a function of age. In North America it has been estimated at 40 per 1000 in preschool children and approximately 9 per 1000 in 10-year-olds. 12 Infectious causes often display seasonal variation. Parainfluenza occurs predominantly in the fall, respiratory syncytial virus (RSV) in the winter, and influenza in the spring. Bacterial pneumonia is more common in the winter, when indoor crowding promotes respiratory transmission of microbes. Several risk factors increase the incidence or severity of pneumonia: prematurity, malnutrition, low socioeconomic status, passive exposure to smoke, and attendance at day-care centers. The mortality rate of childhood pneumonia is less than 1 percent in industrialized nations, but pneumonia accounts for up to 5 million deaths annually in children less than 5 years of age in developing countries. 3

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