Influenza-Associated Pneumonia in Children: Limitations of Current Diagnostics

S.O. Mokiia-Serbina, D.I. Shulha, А.M. Hryhorenko, A.A. Hordieieva


This article is based on the analysis of current domestic and foreign literature and deals with the problem of diagnostics of influenza-associated pneumonia in children. Clinical features of primary viral and viral-bacterial pneumonia are described. We presented a critical characteristic of laboratory and imaging methods for the diagnosis of influenza-associated pneumonia, we justified the possibility and the feasibility of their use in pediatric practice, depending on the purpose of the study and the stage of monitoring.


influenza-associated pneumonia; children; diagnostics


Zajcev AA. Treatment of acute respiratory viral infections. Lechashchij vrach. 2008;8:42-45. (Russian)

Ivanova LA. Diagnostic value of clinical and paraclinical indicators in verification of bacterial pneumonia in infants. The Eurpean Association of pedagogues and psychologists “Science” “The unity of science” January, 2015 Direction 3: «Medical sciences»:134-136. (Russian)

Bakradze MD, Chashchina IV, Tatochenko VK, Mityushin IL. How to distinguish bacterial infection from viral and how to treat it. Pediatricheskaya farmakologiya. 2013;10(4):139-144. (Russian)

Laboratory diagnostics of community-acquired pneumonia. Clinical practice guidelines. Association of professionals and organizations of laboratory services "Federation of laboratory medicine". Moskva; 2016. 36 p. (Russian)

Mavrodij V, Artemenko V. Virus-associated pneumonia. Ukraїns'kij terapevtichnij zhurnal. 2015;1:95-101. (Russian)

Beloborodova N, Dmitrieva I, Chernevskaya E, dr i. Monitoring of the current biomarkers of infectious complications in child 1.5 months old with high risk of postoperative sepsis. Pediatriya. 2016;95(1):130-136. (Russian)

Rekalova EM. Lung disease during a pandemic swine influenza A(H1N1) 2009-2010 Klinicheskaya immunologiya Allergologiya Infektologiya. 2010;3:42-48. (Russian)

Kim SS, Spichak TV, Yacyshina CB. The role of viruses in community-acquired pneumonia in children. Voprosy diagnostiki v pediatrii. 2012;4(4):21-25. (Russian)

Spichak TV, Kim SS, Katosova LK. Diagnostic criteria and compliance of the treatment of community-acquired pneumonia in children to modern standards. Voprosy diagnostiki v pediatrii. 2010;2(6):31-34. (Russian)

Hodosh EM, Efremova OA, Horoshun DA. The symptom of "Matte glass": clinical and radiological parallel. Nauchnye vedomosti BelGU Seriya: Medicina Farmaciya [Internet]. 2014;18(189). Available from: (Russian)

Sluijs K, Poll T, Lutter R, Juffermans N, Schultz M. Bench-to-bedside review: Bacterial pneumonia with influenza - pathogenesis and clinical implications. Critical Care. 2010;14(2):219–227. doi:10.1186/cc8893.

Cillóniz C, Ewig S, Menéndez R, Ferrer M, Polverino E, Reyes S, Gabarrús A, Marcos M, Cordoba J, Mensa J, Torres A. Bacterial co-infection with H1N1 infection in patients admitted with community acquired pneumonia. Journal of Infection. 2012;65(3):223-230. neumonia / Cillóniz, Catia et al. // Journal of Infection. – 2012. – №65(3). – P. 223–230. doi:

Cobo F, Cabezas-Fernández M, Cabeza-Barrera M. Streptococcus pneumoniae bacteremia: clinical and microbiological epidemiology in a health area of Southern Spain. Infect Dis Rep. 2012;4(2):29. doi: 10.4081/idr.2012.e29

Naucler P, Darenberg J, Morfeldt E, Ortqvist A, Henriques Normark B. Contribution of host, bacterial factors and antibiotic treatment to mortality in adult patients with bacteraemic pneumococcal pneumonia. Thorax. 2013;68(6):571-579. doi: 10.1136/thoraxjnl-2012-203106

Elemraid M, Rushton S, Thomas M, Spencer D, Gennery A, Clark J. Utility of inflammatory markers in predicting the aetiology of pneumonia in children. Diagnostic Microbiology and Infectious Disease. 2014;79(4):458-462. doi: 16/j.diagmicrobio.2014.04.006

Metersky M, Masterton R, Lode H, File T, Babinchak T. Epidemiology, microbiology, and treatment considerations for bacterial pneumonia complicating influenza. International Journal of Infectious Diseases. 2012;16(5):e321-e331. doi: 10.1016/j.ijid.2012.01.003

Kash J, Taubenberger J. The Role of Viral, Host, and Secondary Bacterial Factors in Influenza Pathogenesis. The American Journal of Pathology. 2015;185(6):1528-1536. doi: 10.1016/j.ajpath.2014.08.030

Kloth C, Forler S, Gatidis S, Beck R, Spira D, Nikolaou K, Horger M. Comparison of chest-CT findings of Influenza virus-associated pneumonia in immunocompetent vs. immunocompromised patients. European Journal of Radiology. 2015;84(6):1177-1183. doi: 5.02.014

Lee K, Rhim J, Kang J. Hyperactive immune cells (T cells) may be responsible for acute lung injury in influenza virus infections: A need for early immune-modulators for severe cases. Medical Hypotheses. 2011;76(1):64-69.. doi: 0.08.032

Catalano D, Trovato G, Sperandeo M, Sacco M. Lung ultrasound in pediatric pneumonia. The persistent need of chest X-rays. Pediatric Pulmonology. 2013;49(6):617-618. PMID: 24178894

Modi P, Mark Munyaneza R, Goldberg E, Choy G, Shailam R, Sagar P, Westra S, Nyakubyara S, Gakwerere M, Wolfman V, Vinograd A, Moore M, Levine A. Oxygen Saturation Can Predict Pediatric Pneumonia in a Resource-Limited Setting. The Journal of Emergency Medicine. 2013;45(5):752-760. doi: 10.1016/j.jemermed.2013.04.041

Hasegawa M, Okada T, Sakata H, Nakayama E, Fuchigami T, Inamo Y, Mugishima H, Tajima T, Iwata S, Morozumi M, Ubukata K, Watanabe H, Takahashi T. Pandemic (H1N1) 2009–associated Pneumonia in Children, Japan. Emerg Infect Dis. 2011;17(2):279-282. doi:10.3201/eid1702.091904.

Boyd M, Clezy K, Lindley R, Pearce R. Pandemic influenza: clinical issues. Med J Aust. 2006;185:844-847. PMID: 17115951

Picard C. Invasive pneumococcal disease in children: a primary immunodeficiency?. Sbornik tezisov II Vserossijskoj shkoly po klinicheskoj immunologii. SPb: RAKI; 2011.

Pierce R, Bigham M, Giuliano J. Use of procalcitonin for the prediction and treatment of acute bacterial infection in children. Current Opinion in Pediatrics. 2014;26(3):292-298. doi: 10.1097/MOP.0000000000000092.

Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernandez M, Quiñon844-847es-Falconi F, Bautista E, Ramirez-Venegas A, Rojas-Serrano J, Ormsby C, Corrales A, Higuera A, Mondragon E, Cordova-Villalobos J. Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico. New England Journal of Medicine. 2009;361(7):680-689. doi:10.1056/NEJMoa0904252

Trautner B, Caviness A, Gerlacher G, Demmler G, Macias C. Prospective Evaluation of the Risk of Serious Bacterial Infection in Children Who Present to the Emergency Department With Hyperpyrexia (Temperature of 106 F or Higher). PEDIATRICS. 2006;118(1):34-40. doi: 10.1542/peds.2005-2823

Sherman J, Abo A. Evaluation of Pulmonary Emergencies Using Point-Of-Care Ultrasound in the Pediatric Emergency Department: A Review. Clinical Pediatric Emergency Medicine. 2015;16(4):244-255. doi: 5.11.006

Schuetz P, Raad I, Amin D. Using procalcitonin-guided algorithms to improve antimicrobial therapy in ICU patients with respiratory infections and sepsis. Current Opinion in Critical Care. 2013;19(5):453-460. doi: 10.1097/MCC.0b013 e328363bd38

Craig J, Williams G, Jones M, Codarini M, Macaskill P, Hayen A, Irwig L, Fitzgerald D, Isaacs D, McCaskill M. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses. BMJ. 2010;340(apr19 2):c1594-c1594. doi:

Vareille M, Kieninger E, Edwards M, Regamey N. The Airway Epithelium: Soldier in the Fight against Respiratory Viruses. Clinical Microbiology Reviews. 2011;24(1):210-229. doi:10.1128/CMR.00014-10.

Bradley J, Byington C, Shah S, Alverson B, Carter E, Harrison C, Kaplan S, Mace S, McCracken G, Moore M, St Peter S, Stockwell J, Swanson J. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clinical Infectious Diseases. 2011;53(7):e25-e76. doi: 10.1093/cid/cir531

Kuhns L, Oliver W, Christodoulou E, Goodsitt M. The Predicted Increased Cancer Risk Associated With a Single Computed Tomography Examination for Calculus Detection in Pediatric Patients Compared With the Natural Cancer Incidence. Pediatric Emergency Care. 2011;27(4):345-350. doi: 10.1097/PEC.0b013e3182132016

Sabroe I, Read R, Whyte M, Dockrell D, Vogel S, Dower S. Toll-Like Receptors in Health and Disease: Complex Questions Remain. The Journal of Immunology. 2003;171(4):1630-1635. PMID:12902458

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