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A lower respiratory tract infection (LRI) develops in one in three children in the first year of life. Twenty nine percent of these children develop pneumonia, 15% develop croup, 34% tracheobronchitis, and 29% bronchiolitis.

consists of an invasion of the lung by an infectious agent, resulting in an acute inflammatory response and consolidation of the affected lobe.

Clinical Evaluation

Cough. Pneumonia usually causes cough that persists day and night. Patients who cough spontaneously throughout the office visit are likely to have lower respiratory tract disease. The cough often is productive.

Grunting occurs in 20% of infants who have pneumonia. Grunting is produced by approximation of the vocal cords, which prevents collapse of narrowed airways and improves oxygenation.

Chest Pain. The disorder may cause chest pain when the infection develops near the pleura. that involves the diaphragmatic pleura may present as abdominal pain. Older children may complain of diffuse chest or abdominal pain, which is caused by persistent cough and repeated muscle contraction.

Tachypnea. Increased respiratory rate is one of the earliest and most consistent signs of lower respiratory tract pulmonia


Retractions of the intercostal spaces are caused by decreased compliance or increased