2026 Volume 42 Issue 1 Pages 13-19
Pediatric lower respiratory tract infections are among the most common conditions encountered in pediatric practice. Clinical decision-making often focuses on the presence of pneumonia, evaluation of the causative pathogen, and the appropriateness of antibiotic therapy. Routine chest radiography for pediatric lower respiratory tract infections is not recommended by the World Health Organization or other international guidelines, but imaging findings can provide valuable pathophysiological information in selected clinical settings. In this review, pediatric community-acquired lower respiratory tract infections are broadly categorized into viral and bacterial infections, and the relationships between characteristic disease processes and chest radiographic findings are summarized. Typical imaging features of bronchiolitis, viral interstitial pneumonia, alveolar (lobar) pneumonia, bronchopneumonia, round pneumonia, necrotizing pneumonia, and Mycoplasma pneumonia are described with reference to their pathological backgrounds. Chest imaging should not be regarded as a tool for identifying specific causative pathogens, but rather as a modality for understanding the underlying disease processes occurring in the lungs. Appropriate interpretation of imaging findings requires integration with patient age, epidemiological trends, and clinical course.
