High-Altitude Lung Edema Can Mimic Pneumonia in Kids, Even Without Travel

By Rob Goodier

August 09, 2016

NEW YORK (Reuters Health) - What looks like pneumonia in children living at high elevations may actually be high-altitude pulmonary edema (HAPE), even if the patient has not traveled, new research suggests.

HAPE is known to affect children and adults who gain elevation, either by visiting or returning home after a trip, but resident form of the condition might exist that can strike children who live at high elevation and contract a respiratory tract infection, according to findings presented August 3 at the World Congress of Mountain and Wilderness Medicine in Telluride, Colorado.

"Health providers should advise patients who live at or travel to high altitude to have a pulse oximeter and check their oxygen levels if they are unwell," the study's author, Dr. Christine Ebert-Santos at the Ebert Family Clinic in Frisco, Colorado, told Reuters Health by email.

The children who visit the Ebert Family Clinic live at 2440 - 3500m (about 8000 - 11,500 feet). Dr. Ebert-Santos reviewed the charts of 38 children at the clinic with suspected HAPE. Of those, 28 had not traveled and had resident HAPE, Dr. Ebert-Santos says. Two of the patients had re-entry and five had classic HAPE, while the remaining three had pneumonia.

The HAPE patients recovered after oxygen treatment with no need for antibiotics, Dr. Ebert-Santos wrote in her presentation.

Dr. Ebert-Santos acknowledges that HAPE without travel is a radical proposal.

"But many providers working above 2800m have told me they also see this. Calling it pulmonary edema is the stickler, but as we discuss this and do more studies I am confident that my observations will be confirmed," Dr. Ebert-Santos says.

She will include these findings in a paper for publication in the Journal of High Altitude medicine and Biology, Dr. Ebert-Santos says.

This work is raising awareness among the communities living at high altitudes, says Dr. Peter Hackett, an altitude medicine specialist at the University of Colorado Denver School of Medicine who was not involved in the research.

"We used to think that it only happened when kids went to a lower altitude and back up to higher altitude - reentry HAPE. But now it happens when kids get chest infections," Dr. Hackett says. "It's helping doctors to realize that there are special circumstances at high altitudes in kids that they don't see at low altitude."

SOURCE: http://bit.ly/2aMkwRO

World Congress of Mountain and Wilderness Medicine 2016.