title: Severity of childhood community-acquired pneumonia and chest radiographic findings.
abstract: To assess if chest radiographic findings present on admission are associated with severity of childhood community-acquired pneumonia (CAP), a total of 161 children hospitalized with pulmonary infiltrate were enrolled in the study; 48 (30%) patients were excluded because of presence of bilateral chest radiographic alterations (33; 20%) and presence of underlying diseases (15; 9%). According to WHO and BTS criteria, severe CAP was present in 57 (50%) and in 96 (85%) cases, respectively; 29 (26%) were aged less than 1 year. The median age (months) was 22 (mean 24 +/- 14, range 2-58). Overall, radiographic finding was right-sided in 77 (68%) cases and the upper lobe was compromised in 36 (32%) cases. By analyzing data stratified to age, the frequency of upper lobe involvement was significantly higher among severe cases (WHO criteria) only for those patients aged > or =1 year (13/35 [37%] vs. 7/45 [16%], P = 0.03, OR [95% CI] 3.2 [1.1-9.2]). The specificity and positive predictive value of upper lobe involvement for severity among the latter group of patients were 84% (95% CI 70-93%) and 65% (95% CI 41-84%), respectively. No association was found by using the BTS criteria. The admission chest radiography was useful to predict severity of children aged > or =1 year hospitalized with CAP.
authors.affiliation: Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil.
authors.forename: Ng
authors.initials: N
authors.lastname: Kin Key
authors.forename: César Augusto
authors.initials: CA
authors.lastname: Araújo-Neto
authors.forename: Cristiana Maria
authors.initials: CM
authors.lastname: Nascimento-Carvalho
mesh_terms: D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index