Lower respiratory tract infection in children : when are further investigations warranted?

Abstract

The substantial decline in the burden of childhood community acquired lower respiratory tract infections (LRTI) over the last decades is associated with improvements in immunization, nutrition, socioeconomic, and control of the HIV epidemic (1). However, LRTI remains the commonest cause of under-5 mortality outside the neonatal period (1). Although most children with LRTI fully recover, a proportion develop chronic respiratory symptoms and/or sequelae; reasons include host factors (immunosuppression, poor secretion clearance, airway abnormalities or genetic factors), infectious causes (TB or adenovirus), and/or adverse environmental factors. Early identification and management of children at-risk of respiratory sequelae may help to preserve long-term lung health. However, knowing who and when to investigate is challenging as there is little high-level evidence to support the timing and extent of investigations required.