What is the most common causative organism of typical pneumonia in a child aged 6 or 9 years?

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Most Common Causative Organism of Typical Pneumonia in Children Aged 6-9 Years

Streptococcus pneumoniae (Option C) is the correct answer and the most common causative organism of typical pneumonia in children aged 6 or 9 years. 1

Age-Specific Pathogen Distribution

Streptococcus pneumoniae remains the most common bacterial cause of community-acquired pneumonia across all pediatric age groups, including school-aged children. 1, 2 The British Thoracic Society guidelines explicitly state this as a key point, emphasizing that the incidence of S. pneumoniae is less influenced by age compared to other pathogens. 1

Why the Other Options Are Incorrect:

  • Respiratory syncytial virus (Option A) is predominantly found in younger children, particularly those under 2 years of age, not in the 6-9 year age group. 1, 3 While viruses account for 14-35% of childhood CAP overall, RSV specifically targets infants and toddlers. 1, 2

  • Group B Streptococcus (Option B) is a neonatal pathogen causing early-onset sepsis and pneumonia in the first days to weeks of life, and is not a typical cause of community-acquired pneumonia in school-aged children. 4

Clinical Context for This Age Group

In children aged 6-9 years presenting with typical pneumonia (characterized by lobar consolidation, productive cough, and acute onset):

  • S. pneumoniae accounts for 16-37% of cases when serological testing is used, though blood cultures are positive in only 5-10% of cases. 1

  • Mycoplasma pneumoniae becomes increasingly common in children over 5 years (accounting for 4-39% of cases), but this typically presents as atypical pneumonia with gradual onset, nonproductive cough, and bilateral interstitial infiltrates—not the typical pneumonia pattern described in the question. 1, 5

  • Chlamydia pneumoniae is responsible for 0-20% of cases in older children but also presents as atypical pneumonia. 1

Important Clinical Pitfall

Do not confuse the overall epidemiology of CAP with the specific presentation of "typical pneumonia." While atypical organisms like Mycoplasma become more prevalent in school-aged children, the question specifically asks about typical pneumonia, which by definition points to S. pneumoniae as the causative organism. 4, 6 Typical bacterial pneumonia is characterized by lobar consolidation, air bronchograms on chest X-ray, and acute presentation with high fever—all hallmarks of pneumococcal infection. 4

Mixed viral-bacterial infections occur in 8-40% of cases, so co-infection is possible, but S. pneumoniae remains the primary bacterial pathogen to consider. 1, 2, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Common Infections in Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Causative Organism of Community-Acquired Pneumonia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Community-Acquired Pneumonia in Adolescents

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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