title: Association between radiological findings and severity of community-acquired pneumonia in children.
abstract: BACKGROUND
  There are few published data concerning radiological findings and their relationship with community-acquired pneumonia (CAP) severity. The aim if this study was to assess radiographic findings in children with CAP of different severity in order to evaluate whether some parameters are associated with severe CAP.
  
  
  METHODS
  We analysed the characteristics of parenchymal densities in 335 chest radiographs of otherwise healthy children (173 males; mean age ± standard deviation, 7.5 ± 4.5 years) admitted to our Emergency Room for CAP. Upon admission, chest radiographs were obtained in the two standard projections, and the children with severe or mild/moderate CAP were compared in order to identify any correlations between CAP severity and the radiological findings.
  
  
  RESULTS
  Seventy-six of the 335 enrolled children (22.7%) fulfilled the criteria for severe CAP. In comparison with the children with mild/moderate CAP, in severe CAP there was a significantly greater frequency of a bilateral multifocal distribution (p = 0.01), the simultaneous involvement of ≥ 3 sites (p = 0.007), and the involvement of the right hilum (p = 0.02). The same results were confirmed in the multiple logistic regression model.
  
  
  CONCLUSIONS
  This study shows that radiological findings such as a multifocal bilateral distribution, the simultaneous involvement of at least three sites, and right hilar consolidation are associated with severe CAP in otherwise healthy children, and could be considered markers of disease severity in children with CAP.
authors.affiliation: Pediatric Clinic 1, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. susanna.esposito@unimi.it.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Patria
authors.forename: Benedetta
authors.initials: B
authors.lastname: Longhi
authors.forename: Mara
authors.initials: M
authors.lastname: Lelii
authors.forename: Carlotta
authors.initials: C
authors.lastname: Galeone
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Pavesi
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
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