Some children may have pneumonia without all of the clinical findings usually expected with a lower respiratory tract infection.
(1) fever (> 39°C), which may be prolonged (> 5 days)
(2) variable cough, which may be prolonged (> 5 days)
(3) absence of tachypnea
(4) absence of hypoxemia or respiratory distress
(1) leukocytosis, with white blood cell count >= 20,000 per µL
A chest X-ray may show a lung infiltrate, which supports the diagnosis of occult pneumonia.
Imaging studies should be performed in pediatric patients who have these findings if there are clinical suspicions for the diagnosis. The risk appears to be greater in children who have not been fully immunized.
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