Evidence behind the WHO Guidelines: Hospital Care for Children * What are the Clinical Indicators of PCP?

Abstract

The World Health Organization has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO’s recommendations. The WHO guidelines, and more reviews are available at http://www.ichrc.org The WHO Pocketbook of Hospital Care for Children recommends that PCP should be presumptively diagnosed in any child who has severe or very severe pneumonia and bilateral interstitial infiltrates on chest X-ray. Consider the possibility of pneumocystis pneumonia in children, known or suspected to have HIV, whose ordinary pneumonia does not respond to treatment. Pneumocystis pneumonia occurs most frequently in infants and is often associated with hypoxia. Fast breathing is the most common presenting sign, respiratory distress is out of proportion with chest findings, fever is often mild. Peak age is 4–6 months.