Clinical, laboratory, and radiological information in the diagnosis of pneumonia in children

The relative importance of clinical, laboratory, and radiological information in the diagnosis of pneumonia in children has not been extensively studied. In our study clinicians recorded clinical impressions and anticipated management prior to obtaining a chest radiograph and laboratory tests for 155 children in whom the diagnosis of pneumonia was being considered. This information was compared with the final diagnosis and management plans instituted after obtaining the radiograph and laboratory tests. Agreement occurred with the actual post-radiograph plans in 78% of treatment decisions and in 88% of disposition plans made prior to obtaining the radiograph. The overall clinical impression was more important than individual signs, symptoms, or laboratory data in predicting the radiological diagnosis. No consistent pattern of signs, symptoms, and laboratory tests was found to be useful in making the diagnosis of pneumonia.