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To the Editor.—Drs Margolis and Gadomski¹ state, "Textbooks do not recommend percussion of the chest in infants because it is difficult to get infants to cooperate with this maneuver."¹ However, we believe that chest percussion is helpful in the diagnosis of pneumonia, and we regularly demonstrate to colleagues, students, and residents the value of percussion in examining an infant's chest.²

Chest percussion requires no greater cooperation from the patient than does auscultation. Rather than discourage the use of percussion, pediatric textbooks specifically describe the utility and limitations of this method in infantile pneumonia, emphasizing that both auscultation and percussion may fail to elicit abnormalities in infants with pneumonia^3-4 and that when localized dullness is detected in infants, pleural effusion or empyema should be suspected.⁴ Textbook authors appear to encourage chest percussion in the examination of older children. Finally, while the article's title refers to infants, the text frequently refers . . . [Full Text of this Article]

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Does This Infant Have Pneumonia?
Peter Margolis and Anne Gadomski
JAMA. 1998;279(4):308-313.
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