Clinical Features Fever, cough breathlessness and lethargy following an upper respiratory tract infection are the usual presenting symptoms Breathing is rapid shallow and gives the impression that the child is afraid to breathe deepl Pleuritic chest pain, neck stiffness and abdominal pain may be present if there is pleural inflammationClinical Features ◼ Fever, cough breathlessness and lethargy following an upper respiratory tract infection are the usual presenting symptoms. ◼ Breathing is rapid, shallow and gives the impression that the child is afraid to breathe deeply. ◼ Pleuritic chest pain, neck stiffness and abdominal pain may be present if there is pleural inflammation