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Staphylococcal pneumonia — RACP Paediatrics MCQ

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HardRespiratoryStaphylococcal pneumoniaRACP Paediatrics

A 4-year-old has influenza followed by recurrent fever, toxicity and pleuritic pain. Chest radiograph shows multilobar consolidation with pneumatoceles and a small effusion; neutrophils are high. What is the most likely diagnosis?

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Correct answer: E — Staphylococcus aureus pneumonia

Post-influenza deterioration with severe pneumonia, pneumatoceles and effusion is highly suggestive of Staphylococcus aureus pneumonia. Mycoplasma can cause pneumonia in older children but usually does not produce this toxic pneumatocoele pattern. The pearl is to consider staphylococcal coverage in severe post-influenza paediatric pneumonia.

Reference: Therapeutic Guidelines (eTG): Antibiotic; RCH Clinical Practice Guidelines: Pneumonia