Complicated community acquired pneumonia in childhood: Different types, clinical course, and outcome.

Autor: Erlichman I; Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Breuer O; Pediatric Pulmonology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Shoseyov D; Pediatric Pulmonology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Cohen-Cymberknoh M; Pediatric Pulmonology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Koplewitz B; Pediatric Radiology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Averbuch D; Pediatric Infectious Disease Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Erlichman M; Department of Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel., Picard E; Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Jerusalem, Israel., Kerem E; Pediatric Pulmonology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2017 Feb; Vol. 52 (2), pp. 247-254. Date of Electronic Publication: 2016 Jul 08.
DOI: 10.1002/ppul.23523
Abstrakt: The incidence of pediatric community acquired complicated pneumonia (PCACP) is increasing. Questions addressed: Are different types of PCACP one disease? How do different treatment protocols affect the outcome?
Methods: Retrospective analysis of medical records of PCACP hospitalizations in the three major hospitals in Jerusalem in the years 2001-2010 for demographics, clinical presentation, management, and outcome.
Results: Of the 144 children (51% aged 1-4 years), 91% of Jewish origin; 40% had para-pneumonic effusion (PPE), 40% empyema (EMP), and 20% necrotizing pneumonia (NP). Bacterial origin was identified in 42% (empyema 79%, P = 0.009), most common S. pneumoniae (32%), group A streptococcus (9%). Patients with EMP, compared to PPE and NP, were less likely to receive prior antibiotic treatment (35% vs. 57% and 59%, respectively, P = 0.04). Mean hospitalization was longer in patients with NP followed by EMP and PPE (16.4 ± 10.6, 15.2 ± 7.9, and 12.7 ± 4.7 days, respectively), use of fibrinolysis was not associated with the outcome. All children had recovered to discharge regardless of antibiotic therapy or fibrinolysis.
Answer: NP is a more severe disease with prolonged morbidity and hospitalization in spite of prior antibiotic treatment. All types had favorable outcome regardless of treatment-protocol. Complicated pneumonia has an ethnic predominance. Pediatr Pulmonol. 2017;52:247-254. © 2016 Wiley Periodicals, Inc.
(© 2016 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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