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This was a retrospective study at a tertiary pediatric emergency department over a 10 year period. Authors sought to determine the number of patients who developed radiographic pneumonia after an initial normal CXR.
9957 patients with suspected pneumonia were included. 240 had an additional CXR within 14 days and 27 (11% of those with a 2nd CXR) had developed PNA on the CXR. Overall, the rate was 1/370 children went on to have radiographic PNA in the next 14 days after an initial CXR. Tachypnea, hypoxia and dehydration at the initial visit were shown to be associated with later development of PNA on CXR.
References
Hirsch AW, Wagner A, Lipsett SC, Monuteaux MC, Neuman MI. Risk of Subsequent Pneumonia After a Negative Chest Radiograph in the ED. Pediatrics. 2025 May 1;155(5):e2024069829. doi: 10.1542/peds.2024-069829. PMID: 40189217.