Polmonite acquisita in comunità: quali novità?

Community-acquired pneumonia (CAP) is still the leading cause of death in children aged <5 in developing countries and one of the most common causes of hospitalization in children in industrialized countries. Despite the frequency of this pathology, many children do not receive early diagnosis and/or adequate treatments. As for the diagnosis, chest radiography should only be used in the most severe cases to rule out complications. Lung ultrasound can help confirming the diagnosis and, despite many limitations, is a useful tool during the follow-up as well as in identifying prognostic indexes. Among the biomarkers, procalcitonin remains the only parameter that can guide the clinician on the etiology of CAP. In the last twenty years molecular techniques applied to upper airway samples have showed us that viruses are the main cause of CAP, as opposed to what was believed in the past. However, these methods do not allow to distinguish acute infections from colonization of the upper airways, but in the near future transcriptomics will clarify these aspects. To date, considering the reduced prevalence of penicillin-resistant pneumococcal serotypes, international guidelines, although based on poor quality evidence, remain the best option for the treatment of CAP in childhood.