Pneumonia, defined as infection of lung parenchyma, is associated with severe complications especially in the very young and old patients. It is the world's leading cause of childhood mortality. The World Health Organization (WHO) classification and guidelines are commonly used in Sudan in the diagnosis and management of pneumonia patients. A group of 224 patients at Gaafar Ibn Oaf Children's Hospital and Omdurman Children's Hospital were assessed and managed for severe presentation of pneumonia. The data collected showed that most of the patients were of low socioeconomic class families. The vast majority (99%) of patients had chronic exposure to tobacco smoke at home. Female patients (52.7%) were more than males, with 42% of the presenting patients in the less than 12 months age group. Pneumonia is a dangerous childhood menace that is associated with severe presentations. Public health community outreach programs should be put in place to raise awareness. The case fatality rate during the study period was 4%.
Key words: Severe pneumonia; Sudan; Under-five children