The Association of Positive Chest Radiograph and Laboratory Parameters with Community Acquired Pneumonia in Children

Abstract

Context: This study was designed to compare the sensitivities of different investigations for the diagnosis of Community Acquired Pneumonia (CAP). A prospective study was carried out which compared the sensitivities of the chest radiographs, CRP, TLC, ESR and the blood cultures in sixty-six patients who were diagnosed with WHO defined CAP. Material and Methods:The chest radiographs, serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total leucocyte count (TLC) and blood cultures were determined in sixty-six patients who were amongst the age group of one month to five years of age, who were diagnosed with WHO defined CAP.Statistical Analysis: It was carried out by calculating the proportion, mean, standard deviation (SD) and the sensitivity of the test. Results:The chest radiographs were found to be positive in 93.9% (n=62) patients, CRP was positive in 90.9% (n=60) patients, ESR was positive in 72.7% (n=42) patients, TLC was positive in 48.5% (n=38) patients and the blood cultures were positive in 6.1% (n=4) patients. Hence, the sensitivity of the chest radiograph, CRP, ESR, TLC and the blood culture in the diagnosis of CAP were 93.9%, 90.9%, 72.7%, 48.5% and 6.1%. Conclusion:In view of the high sensitivity of CRP, which is almost similar to that of chest X-Ray in detecting CAP, CRP can be used as an alternative test to the chest radiographs at peripheral centres, where X-ray machines are not available.

Blood Culture in Evaluation of Pediatric Community-Acquired Pneumonia: A Systematic Review and Meta-analysis

“…The highest yield of positive BCs in studies were from patients who were manifestly sick, 34,42 and severe CAP was the only subgroup that had a signifi cant effect on prevalence in the meta-regression model. However, we were unable to determine the benefi t of BC collection in cases of presumed moderate CAP, as is suggested by the current guidelines, because the majority of studies did not stratify patients by severity of illness.…”

“…57 Several studies used World Health Organization criteria that defi nes mild to moderate CAP based on cough and tachypnea. 32,34 This defi nition is clearly limited because it is nonspecifi c for all types of lower respiratory tract disease. Other studies did not provide a case defi nition of CAP, although this was implied by their inclusion criteria and thus were included in the review.…”

“…Six studies were assessed as good, 36,37,39-42 11 were fair, 23,24,[26][27][28][30][31][32]34,35,38 and 4 were poor. 22,25,29,33 Poorly rated studies suffered from outcomes that were not clearly described, omission of followup of participants, and lack of adequate adjustment of confounding in the analyses.…”

Accuracy of Ultrasound Determination of Estimated Fetal Weight in Small for Gestational Age Pregnancies

“…According to WHO, presence of cough and tachypnea is the criteria that defines mild to moderate community acquired pneumonia. 17,18 But this criteria is of limited use as the symptoms are consistent with most of the lower respiratory tract infections. There have been numerous reports on the presence of false positive cultures, which have ranged from 0.7% to 8.1%.…”

Etiologic diagnosis of communityacquired pneumonia in children

“…Так, по данным K. Loens et al (2009), бактериологическое исследова ние крови высокоспецифично, но положительный результат отмечается в небольшом числе случаев (4-18 %) [16]. В работе D.Lakhani и P.Muley (2013) гемокультуры были выделены у 6,1 % детей, посту пивших в стационар по поводу тяжелой ВП [15].…”