Clinical and laboratory features of children with community-acquired pneumonia are associated with distinct radiographic presentations

CAP-PRI Working Group, Oana G. Falup-Pecurariu, Javier Diez-Domingo, Susanna Esposito, Adam Finn, Fernanda Rodrigues, Vana Spoulou, George A. Syrogiannopoulos, Vytautas Usonis, David Greenberg*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
183 Downloads (Pure)

Abstract

Chest radiographs from children with community acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children <59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1,107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8.9% nonalveolar CAP and 16.3% clinical CAP. Alveolar CAP patients had significantly higher rates of fever (90.7%), vomiting (27.6%), and abdominal pain (18.6%), while non-alveolar CAP patients presented more with cough (96.9%). A model using independent parameters that characterize alveolar, non-alveolar and clinical CAP demonstrated that alveolar CAP patients were significantly older (OR= 1.02) and had significantly lower oxygen saturation than non-alveolar CAP patients (OR= 0.54). Alveolar CAP patients had significantly higher mean WBC (17,760±8539.68 cells/mm3) and ANC (11.5±7.5 cells/mm3) than patients categorized as non-alveolar CAP (WBC: 15,160±5996 cells/mm3, ANC: 9.2±5.1 cells/mm3) and clinical CAP (WBC: 13,180±5892, ANC: 7.3±4.7). Conclusion: Alveolar CAP, non-alveolar CAP and clinical CAP are distinct entities differing not only by chest radiographic appearance but also in clinical and laboratory characteristics. Alveolar CAP has unique characteristics, which suggest association with bacterial etiology
Original languageEnglish
Pages (from-to)1111-1120
Number of pages10
JournalEuropean Journal of Pediatrics
Volume177
Issue number7
Early online date11 May 2018
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Alveolar pneumonia
  • Children
  • Pneumonia
  • Radiographic presentation

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