[Utility of chest x-ray like approach to etiology of community acquired pneumonia in children].
BACKGROUND
Chest X-ray (CR) utility to predict etiology in community-acquired pneumonia (CAP), in children has been controversial. Nevertheless, some authors propose the use of well standardized radiological patterns.


OBJECTIVE
To evaluate usefulness of modified Swischuk's radiological patterns (RaP) to determine probable etiology in children hospitalized with CAP.


METHODS
Eighty children were studied using 6 standardized RaP. The RaP were blindly and individually analyzed by 9 pneumologists, who registered the results (stage 1). Thereafter, (stage 2) a second evaluation adding clinical information was performed. Then, the patients complementary examinations and clinical evolution were included (stage 3). The reference standard (RS) was generated from a blind consensus. Every result was compared with the RS using Student test.


RESULTS
According to RS, children were classified as having a virus-like pneumonia in 63% of cases, bacterial in 13%, mixed in 16%, atypical in 5% and ADV in 3%. The agreement of stage 1 and 2 with RS was 64 and 77%, respectively. Virus and bacterial RaP agreement increased from 66 to 82 % (p < 0.001) and from 82 to 90% (p < 0.05), respectively after incorporating clinical parameters.


CONCLUSIONS
Modified Swischuk's RaP used in association with clinical elements allows a quite satisfactory approach to etiologic diagnosis of CAP.
Zenteno A
Daniel
D
Hospital de Niños Dr. Exequiel González Cortés, Santiago, Chile. danielzenteno@gmail.com
Girardi B
Guido
G
Fuentes O
Luis
L
Pérez H
M Angélica
MA
González V
Ramiro
R
Abara E
Selim
S
Díaz G
J Pablo
JP
Kogan A
Ricardo
R
Maggiolo M
Julio
J
Parietti B
Mónica
M
Pavón T
Dolores
D
Rubilar O
Lilian
L
D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012015:Reference Standards