Introduction: Acute respiratory infections (ARI) are one of the commonest causes of death in children in developing countries. It is responsible for an estimated 4 million deaths worldwide. Almost all ARI deaths in young children are due to acute lower respiratory tract infections (ALRTI), mostly pneumonia. Methodology: Children in the age group of one month to 5 years with clinical features of severe pneumonia as per WHO recommendations for the control ARI were included. A detailed examination of each child including anthropometry was carried out. During the general physical examination, emphasis was laid on assessing general condition of the child, respiratory rate (counted over 1 minute), presence of fever and other signs such as cyanosis and pallor. Results: In the present study, radiological findings were present in 80.66% of cases. Bacterial pneumonia was detected in 62.67%, viral pneumonia in 14%. Among bacterial pneumonia, consolidation was seen in 18%, alveolar infiltrate in 24.67% and complications of pneumonia in Complications include empyema, pleural effusion, collapse, and pneumothorax. Chest X –ray was normal in 8 cases. Conclusion: Routine hematological investigations and blood culture will not give much information regarding severity or etiology of illness.

Keywords: Acute Respiratory Infections; Pneumonia; Bacteriology