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Recurrent Pneumonia Workup — RACP Paediatrics MCQ

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ModerateRespiratoryRecurrent Pneumonia WorkupRACP Paediatrics

A 4-year-old Aboriginal child in a remote community presents with a 12-week moist cough. He has had 3 previous hospitalisations for pneumonia. CXR shows peribronchial thickening. Sweat chloride and immunoglobulins are normal. What structured approach should be followed to investigate recurrent lower respiratory tract infections?

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Correct answer: D — Systematic workup: immune function (FBC, Ig, vaccine responses), CF (sweat test), ciliary function (nasal NO), aspiration assessment, and HRCT

Recurrent LRTI requires a systematic approach: exclude immune deficiency (Ig levels, vaccine responses, HIV), CF (sweat chloride), PCD (nasal NO, cilia biopsy), structural anomalies (CT), aspiration (swallow study), and environmental factors. In Aboriginal children, bronchiectasis screening with HRCT is indicated early.

Reference: Thoracic Society of Australia and New Zealand – 2024 – Recurrent Pneumonia in Children