Table 3 Possible underlying causes for recurrent pneumonia and first-line investigations
CauseInvestigation
Aspiration (silent)Video fluoroscopy
Gastro-oesophageal reflux diseasepH/impedance study with or without milk scan
BronchiectasisHigh-resolution chest CT with or without contrast
ImmunodeficiencyImmunoglobulins and vaccine responses
Cystic fibrosisSweat test and genetic analysis
Primary ciliary dyskinesiaNasal nitric oxide ± ciliary brushings
Congenital heart diseaseEchocardiogram