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Community-acquired pneumonia in child — RACGP Fellowship MCQ

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HardPaediatrics and adolescentCommunity-acquired pneumonia in childRACGP Fellowship

A 5-year-old child presents with fever, cough and tachypnoea. Temperature is 38.9°C, respiratory rate is 42/min, oxygen saturation is 93% on room air, and focal crackles are auscultated at the right lung base. The child is drinking less than usual but passing urine. What is the most appropriate initial management?

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Correct answer: C — Assess clinical severity and arrange hospital assessment given hypoxia and consolidation signs

This patient meets criteria indicating the need for hospital-level care: respiratory compromise (tachypnoea), borderline hypoxia (SpO₂ 93% ≤92‑93% threshold), and focal consolidation. Option C directs appropriate severity assessment and referral. Option D inappropriately dismisses likely pneumonia. Option B targets bronchospasm, not consolidation. Option A delays empiric antibiotic treatment, risking progression. Option E uses a contraindicated medication (codeine) in children. Severity-based triage is central in Australian and pediatric CAP management.

Reference: Guidelines for the Management of Community Acquired Pneumonia in Children and Adolescents (DGPI, 2020); RACP/TSANZ paediatric oxygen supplementation guidance (2026), https://pubmed.ncbi.nlm.nih.gov/32823360/