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 Vol. 12 No. 3, September 2004
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AAP Grand Rounds 12:28-29 (2004)
© 2004 American Academy of Pediatrics

HOSPITAL CARE

Etiology of Community-Acquired Pneumonia in Hospitalized Pediatric Patients

Source: Michelow IC, Olsen K, Lozano J, et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatrics. 2004;113:701–707.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

The precise etiology of lower respiratory infections (LRIs) in children remains poorly defined because efforts to identify the causative agent in LRIs among children have produced inconsistent results. The authors from the University of Texas Southwestern in Dallas, the University of Alabama in Birmingham, and the National Public Health Institute in Helsinki, Finland, conducted a prospective study of community-acquired pneumonia (CAP) among 184 consecutive children hospitalized for LRI over a 14-month period at a single Dallas children’s hospital. Children were eligible for enrollment if they were immunocompetent, 6 weeks to 18 years of age, had preceding fever, and had clinical (tachypnea, chest retractions, or abnormal auscultatory findings on chest exam) and radiologic evidence of LRI. Children with uncomplicated bronchiolitis were excluded. No child had received pneumococcal conjugate or polysaccharide vaccines.

One hundred fifty-four children were evaluated. Radiographic interpretation was blinded to clinical and laboratory findings. Microbiologic laboratory evaluation included blood culture (89%), pleural fluid culture (21%), naso- and oropharyngeal viral culture (88%), Mantoux skin test, and serological immunoassay for Chlamydia trachomatis, C pneumoniae, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), adenovirus, parainfluenza, and influenza. In addition, white blood cell count (WBC) and serum procalcitonin concentrations were measured in 90% and 97% of children, respectively. All patients were treated with antibiotics.

At . . . [Full Text of this Article]

Brian M. Pate, MD, FAAP1 and Mary Anne Jackson, MD, FAAP2
1 Hospitalist Services, Children’s Mercy Hospital, Kansas City, MO
2 Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO