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Radiographic findings among children hospitalized with severe community-acquired pneumonia.

Abstract：

BACKGROUND:Community-acquired pneumonia (CAP) is a leading cause of childhood death. There are few published reports of radiographic findings among children with severe CAP. OBJECTIVE:To describe chest X-ray (CXR) findings and assess association between these radiographic findings and pneumococcal isolation in children with severe CAP. METHODS:A prospective, multicenter, observational study was conducted in 12 centers in Argentina, Brazil, and the Dominican Republic. Children aged 3-59 months, hospitalized with severe pneumonia, were included. On admission, blood and pleural effusion cultures were performed. Streptococcus pneumoniae was identified according to standard procedures in the respective national reference laboratory. Chest X-rays were taken on admission and read before the culture results were reported. RESULTS:Out of 2,536 enrolled patients, 283 (11.2%) had S. pneumoniae isolated, in 181 cases (7.1%) from blood. The follow radiographic patterns were observed: alveolar infiltrate (75.2%), pleural effusion (15.6%), and interstitial infiltrate (9.2%). Overall, pleural effusion was associated with pneumococcal isolation and pneumococcal bacteremia (P < 0.001). Infiltrates were unilateral (78.7%) or bilateral (21.3%), right-sided (76%) or left-sided (24%), in the lower lobe (53.6%) or the upper lobe (46.4%). Multivariate analysis including patients with affection of only one lobe showed that upper lobe affection and pleural effusion were associated with pneumococcal isolation (OR 1.8, 95% CI, 1.3-2.7; OR 11.0, 95% CI, 4.6-26.8, respectively) and with pneumococcal bacteremia (OR 1.7, 95% CI, 1.2-2.6; OR 3.1, 95% CI, 1.2-8.0, respectively). CONCLUSIONS:Three-quarters of the patients studied had alveolar infiltrates. Upper lobe compromising and pleural effusion were associated with pneumococcal invasive disease.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Ferrero F,Nascimento-Carvalho CM,Cardoso MR,Camargos P,March MF,Berezin E,Ruvinsky R,Sant'Anna C,Feris-Iglesias J,Maggi R,Benguigui Y,CARIBE group.

doi

10.1002/ppul.21287

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

1009-13

issue

eissn

8755-6863

issn

1099-0496

journal_volume

pub_type

临床试验,杂志文章,多中心研究

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Radiographic findings among children hospitalized with severe community-acquired pneumonia.