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Most Children With Alveolar Pneumonia Have Bacterial Infection
A DGReview of :"Differentiation of bacterial and viral pneumonia in children"
Thorax
05/15/2002
By David Loshak
Most children with alveolar pneumonia, especially those with lobar infiltrates, have bacterial infection. There are interstitial infiltrates in both viral and bacterial pneumonias.
These are the key findings of a study undertaken by investigators in Turku, Finland. They studied the differential diagnostic role of chest radiography findings, total white blood cell count, erythrocyte sedimentation rate and serum C reactive protein in 254 consecutive children admitted to hospital with community acquired pneumonia between 1993 and 1995.
White blood cell count, erythrocyte sedimentation rate and C reactive protein levels were determined on admission. The investigators searched for 17 infectious agents - 10 viruses and seven bacteria. Chest radiographs were reviewed by three paediatric radiologists retrospectively and separately.
The investigators found a potential causative agent in 215 (85 percent) of the 254 cases. There was bacterial infection in 71 percent of 137 children with alveolar infiltrates on the chest radiograph.
Of 134 cases with a bacterial pneumonia, 72 percent had alveolar infiltrates. Half of the 77 children with solely interstitial infiltrates had evidence of bacterial infection.
The proportions of patients with bacterial and viral pneumonias who had increased white blood cell count or erythrocyte sedimentation were the same. However, there were significant differences in C reactive protein levels, although the sensitivity for detecting bacterial pneumonia was too low for clinical use.
Thorax 2002;57:438-441.
"Differentiation of bacterial and viral pneumonia in children"
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