Here is a summary of clinical prediction models in pediatric community acquired pneumonia and the signs and symptoms most suggestive of pneumonia. The take home point is that there is such a wide variability that you should only test/treat if your clinical suspicion is high. All four of these articles are worth a look.
Lynch et al. – Pediatrics 2004
- Fever
- Decreased breath sounds
- Crackles
- Tachypnea
Mahabee Gittens et al – Clinical Pediatrics, 2005
- Age <12mos
- Tachypnea
- O2 sat ≤96%
- Nasal flaring in infants
Bilkis et al – Pediatric Emergency Care, 2010
- Decreased breath sounds
- Rales
- Tachypnea
Neumann et al – Pediatrics, 2011
- O2 sat ≤92%
- Chest pain
- Focal rales
- Fever ≥72h
- Fever at triage
