Signs and symptoms indicative of community-acquired pneumonia in infants under six months.
OBJECTIVE
Evaluation of the clinical signs and symptoms predicting bacterial and viral pneumonia, in accordance with the Brazilian National Control Program for Acute Respiratory (ARI).


METHODS
Observational prospective study. Seventy-six children from birth to six months of age who had pneumonia were studied in the emergency room. The patients were subdivided into two groups, based on radiological findings (gold-standard): 47 had bacterial pneumonia, and 29 had viral pneumonia. The frequencies, sensitivities, and specificities of the signs and symptoms were evaluated.


RESULTS
The sensibilities and sensitivities of general findings in bacterial pneumonia were, respectively: fever 53.2%/40.0%; hypoactivity 68.4%/55.6% and prostration detected by the doctor 72.7%/55.0%. The same findings in viral pneumonias showed, respectively: 37.9%/40.0%, 66.7%/55.6% and 66.7%/55.6%. The sensibilities and sensitivities of respiratory findings in bacterial pneumonia were, respectively: coughing 66.0/38.1%, Respiratory rate = 50 ripm 76.6%/38.1%, altered respiratory auscultation 91.3%/10.5%, and chest indrawing 46.7%/80.0%. The same findings in viral pneumonias were, respectively: 69.0%/38.1%, 86.2%/38.1%, 85.7%/10.5% and 44.8%/80.0%.


CONCLUSIONS
Analysis of signs and symptoms in each group did not distinguish bacterial from viral pneumonia. Our findings reinforce the adequacy of the ARI program in Brazil, which gives an early diagnosis of pneumonia, independent of its etiology.
March
Maria de Fátima Bazhuni Pombo
Mde F
Martagão Gesteira Pediatric Institute, Dept. of Pediatrics, Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Sant'Anna
Clemax Couto
CC
D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D016001:Confidence Intervals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity