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A prospective multicenter study that compared physical examination findings in children with community-acquired pneumonia (CAP) found that 2 clinicians examining the same patient may not always agree on whether certain physical findings are or are not present during an exam. The study, published in JAMA Network Open, included 252 patients aged 3 months–17 years with CAP evaluated at 7 pediatric emergency departments. Two clinicians independently examined each patient within 60 minutes. After the exam findings were recorded, researchers found the 2 clinicians did not agree consistently enough about whether any particular physical exam finding was present to meet the study’s threshold for reliability. Wheezing and retractions had the highest reliability, while decreased breath sounds, crackles or rales, and rhonchi or coarse breath sounds were among the findings with the least reliability among the providers. The authors conclude that findings such as crackles, rhonchi, or decreased breath sounds can vary between clinicians and should not be the sole factor to determine a diagnosis of pediatric CAP.
More kids with pneumonia: The United States appears to be experiencing a rise in Mycoplasma pneumoniae cases among young children. Read more about the increase in radiographically confirmed pneumonia over a 2‑year period across 3 urgent cares from the JUCM archive: Increased Incidence of Pneumonia in Pediatric Urgent Care