title: [Utility of chest x-ray like approach to etiology of community acquired pneumonia in children].
abstract: 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.
authors.affiliation: Hospital de Niños Dr. Exequiel González Cortés, Santiago, Chile. danielzenteno@gmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Zenteno A
authors.forename: Guido
authors.initials: G
authors.lastname: Girardi B
authors.forename: Luis
authors.initials: L
authors.lastname: Fuentes O
authors.forename: M Angélica
authors.initials: MA
authors.lastname: Pérez H
authors.forename: Ramiro
authors.initials: R
authors.lastname: González V
authors.forename: Selim
authors.initials: S
authors.lastname: Abara E
authors.forename: J Pablo
authors.initials: JP
authors.lastname: Díaz G
authors.forename: Ricardo
authors.initials: R
authors.lastname: Kogan A
authors.forename: Julio
authors.initials: J
authors.lastname: Maggiolo M
authors.forename: Mónica
authors.initials: M
authors.lastname: Parietti B
authors.forename: Dolores
authors.initials: D
authors.lastname: Pavón T
authors.forename: Lilian
authors.initials: L
authors.lastname: Rubilar O
mesh_terms: 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