Table 1

Criteria used in developing and developed countries to define the severity of community-acquired pneumonia (CAP)

Developing countries
Severe CAPIn children with CAP diagnosed on the basis of fast breathing and on possible evidence of lower respiratory tract involvement, severe cases are identified in the presence of cough or difficult breathing plus at least one of the following signs:

  • lower chest wall indrawing

  • nasal flaring

  • grunting (in young infants)

Very severe CAPIn children with a diagnosis of CAP or severe CAP, a diagnosis of very severe CAP is based on the presence of at least one of the following:

  • central cyanosis

  • inability to breastfeed or drink, or vomiting everything

  • convulsions, lethargy or unconsciousness

  • severe respiratory distress

Developed countries
Severe CAP
 InfantsTemperature >38.5°C
Respiratory rate >70 breaths/min
Moderate to severe recession
Nasal flaring
Cyanosis
Grunting respiration
Not feeding
Sao2 <92%
 Older childrenTemperature >38.5°C
Respiratory rate >50 breaths/min
Severe difficulty in breathing
Nasal flaring
Cyanosis
Grunting respiration
Signs of dehydration
Sao2 <92%

  • Adapted from the World Health Organization11 and the British Thoracic Society.7

  • Sao2, arterial oxygen saturation.