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Pediatr Pulmonol. 2017 Feb;52(2):247-254. doi: 10.1002/ppul.23523. Epub 2016 Jul 8.

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

Author information

1
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
2
Pediatric Pulmonology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
3
Pediatric Radiology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
4
Pediatric Infectious Disease Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
5
Department of Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel.
6
Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

Abstract

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.

KEYWORDS:

empyema; necrotizing pneumonia; para-pneumonic effusion; pediatric community acquired complicated pneumonia

PMID:
27392317
DOI:
10.1002/ppul.23523
[Indexed for MEDLINE]

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