Investigation of the Chest Radiograph Findings in Children with Pneumonia Hospitalized in a Children's Hospital, Tabriz, Iran

Document Type : Original Article

Authors

1 Department of radiology, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Pediatrics, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction:
Pneumonia has been regarded as the leading cause of death among the elderly, very young children, and those who suffer from chronic diseases. Among the underlying causes, viral infections have been addressed as the most frequent cause of pneumonia in children.
Materials and Methods:
This study investigated a total of 300 subjects with pneumonia hospitalized in Tabriz Children's Hospital, Tabriz, Iran. Moreover, a comparison was made between the type of pneumonia and associated radiologic features. Age, gender, performed laboratory tests, symptoms, and final interpretations of the chest x-ray (CXR) images were included in the checklist.
Results:
The mean age of the patients was 6.09 2.45 years. Moreover, the mean erythrocyte sedimentation rate was estimated at 27.86±22.73 mm/h. In this study, 174 (58%), 57 (19%), 50 (16.7%), and 19 (6.3%) patients were C-reactive protein (CRP) negative, CRP (+), CRP (++), and CRP (+++), respectively. Furthermore, in 238 (79.3%) patients, white blood cell (WBC) count in serum was within the normal range, whereas high WBC count was reported in 62 individuals (20.7%). In addition, four positive blood cultures as well as 27 (9%) cases with pleural effusion were identified in this study. Reticulonodular involvement was recognized in up to 246 (82%) subjects. It should be noted that 63 (21%) and 237 (79%) patients showed unilateral and bilateral involvement in chest radiography, respectively. Regarding the frequency of radiographic evidence, the most common patterns of involvement in descending frequencies were reticulonodular and lobar alveolar.
Conclusion:
The most common pattern of involvement in children's CXRs with pneumonia is a reticulonodular pattern associated with bilateral peribronchial cuffing.

Keywords

References

1.            Marcdante K, Kliegman RM. Nelson Essentials of Pediatrics E-Book. 8 ed: Elsevier Health Sciences; 2018. 788 p.
2.            Kyu HH, Pinho C, Wagner JA, Brown JC, Bertozzi-Villa A, Charlson FJ, et al. Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study. JAMA pediatrics. 2016; 170(3): 267-87.
3.            Wang L, Song W, Wang Y, Han J, Lv K. Lung ultrasonography versus chest radiography for the diagnosis of pediatric community acquired pneumonia in emergency department: a meta-analysis. Journal of thoracic disease. 2019;11(12):5107-14.
4.            Wilmott RW. The Pediatric Lung: Birkhäuser Basel; 2012. 1118 p.
5.            Virkki R, Rikalainen H, Svedström E, Juven T, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. 2002;57(5):438-41.
6.            Taussig LM, Landau LI, Souëf PNL. Pediatric Respiratory Medicine. illustrated ed: Mosby/Elsevier; 2008. 1118 p.
7.            Su G, Ding L, Zhang Z. The Effect of lnterleukin-6 Gene Polymorphism on Pediatric Pneumonia. Iranian journal of public health. 2019; 48(11):2035-40.
8.            Shah SN, Bachur RG, Simel DL, Neuman MI. Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review. Jama. 2017;318(5):462-71.
9.            Grunebaum M. Pediatric Radiological Signs: iUniverse; 2005.
10.          Nelson KA, Morrow C, Wingerter SL, Bachur RG, Neuman MI. Impact of Chest Radiography on Antibiotic Treatment for Children With Suspected Pneumonia. Pediatr Emerg Care. 2016;32(8):514-9.
11.          Andrade DC, Nascimento-Carvalho CM. Radiologic scales as a tool for the etiologic diagnosis of pediatric community-acquired pneumonia. Jornal de pediatria. 2018;94(6):690-1.
12.          Florin TA, Gerber JS. Sticking by an Imperfect Standard: Chest Radiography for Pediatric Community-Acquired Pneumonia. Pediatrics. 2020.
13.     Korppi M, Kiekara O, Heiskanen‐Kosma T, Soimakallio S. Comparison of radiological findings and microbial aetiology of childhood pneumonia. Acta paediatrica. 1993 Apr;82(4):360-3
14.          Lipsett SC, Monuteaux MC, Bachur RG, Finn N, Neuman MI. Negative Chest Radiography and Risk of Pneumonia. Pediatrics. 2018;142(3):e20180236.
15.          Correa M, Zimic M, Barrientos F, Barrientos R, Roman-Gonzalez A, Pajuelo MJ, et al. Automatic classification of pediatric pneumonia based on lung ultrasound pattern recognition. PloS one. 2018;13(12):e0206410.
16.          Levine OS, O'Brien KL, Deloria-Knoll M, Murdoch DR, Feikin DR, DeLuca AN, et al. The Pneumonia Etiology Research for Child Health Project: a 21st century childhood pneumonia etiology study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2012;54 Suppl 2(Suppl 2):S93-101.
17.          Lee E, Kim CH, Lee YJ, Kim HB, Kim BS, Kim HY, et al. Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea. BMC infectious diseases. 2020;20(1):132.
18.          Garcia-Garcia ML, Calvo C, Pozo F, Villadangos PA, Perez-Brena P, Casas I. Spectrum of respiratory viruses in children with community-acquired pneumonia. The Pediatric infectious disease journal. 2012;31(8):808-13.
19.          John SD, Ramanathan J, Swischuk LE. Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia. Radiographics : a review publication of the Radiological Society of North America, Inc. 2001;21(1):121-31.
20.          Falup-Pecurariu OG, Diez-Domingo J, Esposito S, Finn A, Rodrigues F, Spoulou V, et al. Clinical and laboratory features of children with community-acquired pneumonia are associated with distinct radiographic presentations. 2018;177(7):1111-20.
21.          Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Comparison of radiological findings and microbial aetiology of childhood pneumonia. Acta paediatrica (Oslo, Norway : 1992). 1993;82(4):360-3.
22.          Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children. The Pediatric infectious disease journal. 1995;14(6):484-90.
23.          Andrade DC, Borges IC, Vilas-Boas AL, Fontoura MSH, Araujo-Neto CA, Andrade SC, et al. Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia. Jornal de pediatria. 2018; 94(1): 23-30.
24.          Hazir T, Nisar YB, Qazi SA, Khan SF, Raza M, Zameer S, et al. Chest radiography in children aged 2-59 months diagnosed with non-severe pneumonia as defined by World Health Organization: descriptive multicentre study in Pakistan. BMJ (Clinical research ed). 2006; 333 (7569):629.
25.          Kiekara O, Korppi M, Tanska S, Soimakallio S. Radiological diagnosis of pneumonia in children. Annals of medicine. 1996 Jan 1; 28(1):69-72.
 
 
Journal of Patient Safety & Quality Improvement
Volume 8, Issue 2
April 2020
Pages 93-98

Files

Share

How to cite

Statistics