| Table. Characteristics Distinguishing Lower Respiratory Tract Infections | ||||
| Localization of infection | Clinical syndrome | Age | Important causes | Epidemiologic features |
| Tracheobronchial tree | Tracheobronchitis | Any | Respiratory viruses: Parainfluenza virus Adenovirus Influenza virus Rhinovirus RSV | • Sick contacts |
| Any | Bordetella pertussis | • Incomplete immunization against pertussis • Exposure to contact with > 2 wk cough and lack of Tdap booster | ||
| Bronchiole | Bronchiolitis | 3 wk to 2 y (80% are < 1 y | Respiratory viruses: | • Seasonal peak Nov-April • Prematurity, cardiac disease, and tobacco smoke exposure are associated with more severe disease |
| Lung parenchyma | CAP | Neonate | Group B streptococcus Enteric organisms Cytomegalovirus | • Perinatally or nosocomially acquired infection |
| 3 wk to 3 mo | RSV S pneumoniae | • Sick contacts • Prevalence 4% to 40% across all age groups | ||
| C trachomatis B pertussis | • Maternal history of STI • Exposure to contact with > 2 wk cough and lack of Tdap booster | |||
| 4 mo to 4 y | Respiratory viruses: RSV Adenovirus Metapneumo- virus Bocavirus Influenza virus Parainfluenza virus | • Viruses cause up to 80% of CAP at age 2 to 3 y (prevalence decreases thereafter) | ||
| S pneumoniae | • Prevalence 4% to 40% across all age groups | |||
| S aureus | • Maternal breast abscess, close contact with SSTI | |||
| M pneumoniae | • Up to 18% of CAP in this age group1 | |||
| 5 to 15 y | M pneumoniae | • 50% of CAP in children aged ≥ 5 y; prevalence increases with age | ||
| S pneumoniae | • Less frequent than M pneumoniae as a cause of outpatient CAP; causes 20% to 40% of hospitalized CAP | |||
| C pneumoniae | • 13% of CAP in children aged 5 to 10 y; 35% of CAP in those ≥ 10 y old2 | |||
RSV, respiratory syncytial virus; CAP, community-acquired pneumonia; STI, sexually transmitted infections; SSTI, skin and soft tissue infection. | ||||
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