In:
Pediatric Pulmonology, Wiley, Vol. 45, No. 10 ( 2010-10), p. 1009-1013
Abstract:
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. Pediatr Pulmonol. 2010; 45:1009–1013. © 2010 Wiley‐Liss, Inc.
Type of Medium:
Online Resource
ISSN:
8755-6863
,
1099-0496
Language:
English
Publisher:
Wiley
Publication Date:
2010
detail.hit.zdb_id:
1491904-7
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