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Epilogue
Answers to Epilogue questions: A pneumonia that does not improve
  1. Samuele Naviglio1,
  2. Matteo Chinello1,
  3. Alessandro Ventura1,2
  1. 1University of Trieste, Trieste, Italy
  2. 2Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy
  1. Correspondence to Dr Samuele Naviglio, University of Trieste, via dell'Istria 65/1, Trieste 34137, Italy; samuele.naviglio{at}gmail.com

https://doi.org/10.1136/archdischild-2014-306343a

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    Answers

    From questions on page 18.

    1. Children with community-acquired bacterial pneumonia usually improve within 48–72 h from the start of appropriate antibiotic therapy. When improvement is not apparent, several conditions should be considered (box 1). In our patient, respiratory symptoms persisted well beyond the improvement of fever and general conditions, therefore prompting further investigations, the first of which should always be a chest radiography.

    2. Chest radiography showed right deviation of the trachea and hyperlucency of the left lung, suggesting the presence of air trapping in the left lung. While the opposite interpretation (ie, a hypolucent right lung, with the left one being considered ‘normal’) may be mistakenly considered, it should …

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    Footnotes

    • Contributors SN and MC cared for the patient and wrote the manuscript. AV cared for the patient and critically revised the manuscript.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.