Radiographic Findings Among Children Hospitalized With Severe Community-Acquired Pneumonia


Autoria(s): FERRERO, F.; NASCIMENTO-CARVALHO, C. M.; CARDOSO, M. -R.; CAMARGOS, P.; MARCH, M. -F. P.; BEREZIN, E.; RUVINSKY, R.; SANT`ANNA, C.; FERIS-IGLESIAS, J.; MAGGI, R.; BENGUIGUI, Y.; CARIBE Grp
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

19/10/2012

19/10/2012

2010

Resumo

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. Pediatr Pulmonol. 2010; 45:1009-1013. (C) 2010 Wiley-Liss, Inc.

Identificador

PEDIATRIC PULMONOLOGY, v.45, n.10, p.1009-1013, 2010

8755-6863

http://producao.usp.br/handle/BDPI/26520

10.1002/ppul.21287

http://dx.doi.org/10.1002/ppul.21287

Idioma(s)

eng

Publicador

WILEY-LISS

Relação

Pediatric Pulmonology

Direitos

restrictedAccess

Copyright WILEY-LISS

Palavras-Chave #bacteremia #chest X-ray #pleural effusion #respiratory tract infection #Streptococcus pneumoniae #CHEST RADIOGRAPHS #STANDARDIZED INTERPRETATION #Pediatrics #Respiratory System
Tipo

article

original article

publishedVersion