Significant clinical features in pediatric pneumonia

Main Article Content

Wisman Dalimunthe
Rini S Daulay
Ridwan M Daulay


Background Pneumonia is the leading cause of childhood mortality
in the world. Although WHO develops an algorithm for
diagnosing pneumonia, many clinicians still under or overdiagnose
this disease.
Objective To assess associations of cough, tachypnea, fever, and
chest indrawing with pneumonia in children.
Methods This cross-sectional study was conducted using medical
records of children aged less than 5 year old with one or more clinical
signs of pneumonia such as cough, fever, tachypnea, and chest
indrawing in Haji Adam Malik Hospital, Medan from January
2009 to December 2011. Pneumonia was diagnosed by pediatric
respirologists based on history-taking, and physical, laboratory
and radiology examinations. Patients with incomplete data
were excluded. Data was analyzed by bivariate and multivariate
Results Of 420 subjects, the majority were aged 3 to 23 months
and there were more boys than girls. Clinical signs assessed for
were cough (82.9%), tachypnea (31 %), fever (79.3%), and chest
indrawing (40.2%). Age < 24 months (OR 2.563; 95% CI 1.497
to 4.387), cough (OR 2.274; 95% CI 1.042 to 4.960), tachypnea
(OR 2.249; 95% CI 1.282 to 3.947), and chest indrawing (OR
6.993; 95% CI 4.017 to 12.173) were significant predictors for
Conclusion Age less than 24 months, cough, tachypnea, and
chest indrawing are significantly associated with pneumonia.

Article Details

How to Cite
Dalimunthe W, Daulay R, Daulay R. Significant clinical features in pediatric pneumonia. PI [Internet]. 28Feb.2013 [cited 24Jan.2020];53(1):37-1. Available from:
Received 2016-08-18
Accepted 2016-08-18
Published 2013-02-28


1. Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H,
WHO Child Health Epidemiology Reference Group. Global
estimate of the incidence of clinical pneumonia among
children under five years of age. Bull World Health Organ.
2. Ebell MH. Clinical diagnosis of pneumonia in children. Am
Fam Physician. 2010;82: 192-3
3. UNICEF/WHO. Pneumonia: the forgotten killer of children.
[cited 2012 June]. Available from:
publications/2006/9280640489 eng.pdf
4. Badan Penelitian dan Pengembangan Kesehatan Departemen
Kesehatan RI. Riset Kesehatan Dasar 2007. [cited 2012
June]. Available from: http: //www.riskesdas.litbang.depkes.
5. Crowe JE. Viral pneumonia. In: Chernick V, Boat TF, Wilmott
RW, Bush A, editors. Kendig's disorders of the respiratory
tract in children. Philadelphia: Saunders Elsevier; 2006. p.
6. Mower WR, Sachs C, Niklin EL, Baraff LJ. Pulse oximetry
as a fifth pediatric vital sign. Pediatrics. 1997;99:681-6.
7. Kisworini P, Setyati A, Sutaryo. Mortality predictors of
pneumonia in children. Paediatr Indones. 2010;50: 149-53.
8. Palafox M, Guiscrafe H, Reyes H, Munoz 0 , Martinez H.
Diagnostic value of tachypnoea in pneumonia defined
radiologically. Arch Dis Child. 2000;82:41-5.
9. Neuman MI, Monuteaux MC, Scully KJ, Bachur RG.
Prediction of pneumonia in a pediatric emergency department. Pediatrics. 2011;128;246-53.
10. Jadavji T, Law B, Lebel MH, Kennedy WA, Gold R, Wang
EEL. A practical guide for the diagnosis and treatment of
pediatric pneumonia. Can Med Assoc J. 1997;156:S703-
11. Bakes K. Tachypnea is a poor predictor of pneumonia in
children. Journal Watch Emergency Med. 2010;14:14.
12. Kandi S. Diagnosis of community acquired pneumonia
[supplement]. J Assoc Physicians India. 2012;60: 17-20.
13. Lozano JM, Steinhoff M, Ruiz JG, Mesa ML, Martinez
N, Dussan B. Clinical predictors of acute radiological
pneumonia and hypoxaemia at high altitude. Arch Dis Child.
14. Hazir T, Qazi S, Nisar YB, Ansari S, Maqbool S, Randhawa
S, et al. Assessment and management of children aged 1-59
months presenting with wheeze, fast breathing, and/or lower
chest indrawing; results of a multicentre descriptive study in
Pakistan. Arch Dis Child. 2004;89: 1049-54.
15. Kollef MH, Shorr A, Tabak YP, Gupta V, Liu LZ, Johannes
RS. Epidemiology and outcomes of health-care-associated
pneumonia: results from a large US database of culturepositive
pneumonia. Chest. 2005;128:3854-62.