Retrospective Analysis Of578Cases With Community Acquired Pneumonia In Children

ObjectiveTo retrospective analysis the age, clinical manifestations, pathogens, imagemanifestations and other indicators of children with community acquired pneumonia(CAP) in the pediatric ward of the First Affiliated Hospital of Zhengzhou Universityduring the last year, and to preliminary master the latest change of children with CAPin these aspects. It could provide evidences for the empirical treatment of childrenwith CAP.Methods1Study populationWe conducted a retrospective study of578hospitalized CAP children in thepediatric ward of the First Affiliated Hospital of Zhengzhou University during the lastyear. They were between1month and14years old. Patients were divided into3groups: infants (1month-1year)242patients (41.9%), preschool-aged children (>1year-5years)215patients (37.2%), and school-aged children (>5years-14years)121patients (20.9%).2Data collectionFollowing admission, information supplemented from a standardized writtenquestionnaire was filled out from each child; the results of detailed physicalexamination of respiratory apparatus were recorded for clinical data collection. Peripheral blood sample was obtained from all patients within the first24hours ofadmission for routine blood test, blood chemistry tests of liver and kidney functionand myocardial enzyme spectrum. Bacteria identification: pharyngeal swab was takenfor culture to find bacterial. Venous blood and sputum were selective collected forculture to find bacteria. Virus and mycoplasma pneumonia (MP) identification: IgMantibodies of respiratory viruses and MP were determined. IgM antibody positive wasdefined as virus and MP infection. All of the patients were selectively computeddigital radiography (DR) or64slice tomography (CT).Result1. Among the578patients, there were367(63.5%) males and211(36.5%) females(ratio M:F=1.74:1), A total of512cases (88.6%) with fever,532cases (92.0%)with cough,270cases (46.7%) with wheezing,558cases (96.5%) withaccelerated breathing,467cases (80.8%) with fixed crackles in lung auscultation.2. Detection results overview of pathogens In578cases, there were391cases(67.6%) were detected positive. A single pathogen was identified in346(59.9%)of578samples and multiple pathogens in45(7.8%) samples. The positive rate ofvirus was22.1%, the one of bacteria was14.7%, and the one of MP was23.0%.3. Imaging manifestation Of all the556children who had changes in imaging,357(61.8%)children showed as small high density patches,152(26.3%) showed as large high densitypatches,45(7.8%) showed as interstitial pneumonia, and only2(0.3%) showed enlargedhilar lymph nodes.Conclusions1. Fever, cough, accelerated breathing, dyspnea and fixed crackles are the mostcommon clinical manifestation of pneumonia. When diagnosing whether a childhad pneumonia, accelerated breathing was a more accuracy index than fever,cough and fixed crackles.2. Of all the578children with CAP in our department during the last year, thepositive rate of pathogens in descending order was virus, MP and bacteria. Mixedinfection of viruses and other pathogens was the most common form of mixed infection. We divided the578children with CAP into3groups by age. In the1m-1y group, the largest number of pathogen was virus, followed by bacteria andMP. In the1y-5y group, the largest number of pathogen was virus, followed byMP and bacteria. While in the5y-14y group, the largest number of the pathogenwas MP, followed by bacteria and virus.3. The imaging manifestations of mycoplasma pneumonia were various. In infants,almost always both lungs were involved, and the mainly imaging manifestationwas small high density patch. But in school-aged children, it usually involvedonly one lung, the mainly imaging manifestation was large high density patch,also often accompanied by pleural effusion and atelectasis.