Other conditions:
Pleural fluid: A diagnostic thoracocentesis, is indicated initially for cultures and other microbiologic tests, cell count and chemical tests (protein,

glucose, pH). Therapeutic drainage is indicated in empyema.

Supportive care:

• Maintenance of adequate oxygenation

• Hydration

• Acid-base balance

• Respiratory failure necessitates intubation and mechanical ventilation

• Symptomatic therapy with antipyretics and nebulization with salbutamol.

Tuberculin test:
The possibility of Tuberculosis should always be considered in a child with pneumonia. Mantoux test is indicated if the child does not respond to initial antibiotic therapy as expected or if there is a history of possible exposure to a person with tuberculosis.

Second chest Roentgenogram:
If a normal child with pneumonia responds promptly to antibiotic therapy, is clinically well and has normal physical findings at follow-up, another chest roentgenogram at 6 weeks is optional. However, if child continues to be symptomatic, has signs of pneumonia or if foreign body aspiration or congenital malformation is suspected chest x-ray has to be repeated.

Conclusion:
Pediatric pneumonia remains an important public health problem in children globally. Much of this could be reduced by recognizing the disease early and by instituting early antibiotic therapy.