Chest Radiograph Findings in Childhood Pneumonia Cases From the Multisite PERCH Study
| Autor: | Donald M. Thea, Yasmin Jahan, Daniel E. Park, Kamrun Nahar, Andrea DeLuca, J. Anthony G. Scott, Juliet O. Awori, W. Abdullah Brooks, Karen L. Kotloff, David R. Murdoch, Nicholas Fancourt, Maria Deloria Knoll, Henry C. Baggett, Mahamadou Diallo, Daniel R. Feikin, Scott L. Zeger, David P. Moore, Bernard E. Ebruke, Somwe Wa Somwe, James Chipeta, Melissa M. Higdon, Shabir A. Madhi, Ruth A. Karron, Sathapana Naorat, Katherine L. O'Brien, Christine Prosperi, Somsak Thamthitiwat, Breanna Barger-Kamate, Syed M. A. Zaman, Orin S. Levine, Stephen R. C. Howie, Nasreen Mahomed, Amanda J. Driscoll, Micah Silaba Ominde, Laura L. Hammitt |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics Internationality Mali South Africa 0302 clinical medicine Epidemiology Case fatality rate 030212 general & internal medicine Child chest radiograph Bangladesh medicine.diagnostic_test Child Health respiratory system Thailand 3. Good health Infectious Diseases Child Preschool Supplement Article Female Gambia Radiography Thoracic medicine.symptom Microbiology (medical) medicine.medical_specialty pediatrics Pneumonia Viral Zambia World Health Organization Tachypnea 03 medical and health sciences 030225 pediatrics Wheeze Pneumonia Bacterial medicine Animals Humans business.industry Australia Infant Newborn Infant Pneumonia medicine.disease mortality Kenya respiratory tract diseases signs and symptoms Radiography Perches Etiology Crackles Chest radiograph business |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/cix089 |
| Popis: | Summary In the Pneumonia Etiology Research for Child Health study, abnormal chest radiographs (CXRs) in cases were associated with hypoxemia, crackles, tachypnea, and fever. Overall, 54% of CXRs were abnormal (site range, 35%–64%). Consolidation on CXR was associated with an increased risk of mortality. Background. Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. Methods. The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)–defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable. Results. CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%–64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs. Conclusions. Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge. |
| Databáze: | OpenAIRE |
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