title: Etiological diagnosis of childhood pneumonia by use of transthoracic needle aspiration and modern microbiological methods.
abstract: Childhood pneumonia is usually treated without determining its etiology. The causative organism can be isolated from specimens of blood, empyema fluid, or lung aspirate, but this is rarely done. The potential of transthoracic needle aspiration for identification of causative agents was tested with use of modern microbiological methods. Aspiration was performed for 34 children who had radiological signs compatible with community-acquired pneumonia and had alveolar consolidation. In addition to bacterial and viral cultures and viral antigen detection, nucleic acid detection for common respiratory pathogens was performed on aspirate specimens. Aspiration disclosed the etiology in 20 (59%) of 34 cases overall and in 18 (69%) of 26 patients from whom a representative specimen was obtained. Aspiration's advantages are high microbiological yield and a relatively low risk of a clinically significant adverse event. Aspiration should be used if identification of the causative agent outweighs the modest risk of the procedure.
authors.affiliation: Hospital for Children and Adolescents, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland. elina.vuori@hus.fi
authors.forename: Elina
authors.initials: E
authors.lastname: Vuori-Holopainen
authors.forename: Eeva
authors.initials: E
authors.lastname: Salo
authors.forename: Harri
authors.initials: H
authors.lastname: Saxén
authors.forename: Klaus
authors.initials: K
authors.lastname: Hedman
authors.forename: Timo
authors.initials: T
authors.lastname: Hyypiä
authors.forename: Raija
authors.initials: R
authors.lastname: Lahdenperä
authors.forename: Maija
authors.initials: M
authors.lastname: Leinonen
authors.forename: Eveliina
authors.initials: E
authors.lastname: Tarkka
authors.forename: Martti
authors.initials: M
authors.lastname: Vaara
authors.forename: Heikki
authors.initials: H
authors.lastname: Peltola
mesh_terms: D000293:Adolescent; D001431:Bacteriological Techniques; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification