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2020, Number 4

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Rev Cub Med Int Emerg 2020; 19 (4)

Etiology of severe community-acquired pneumonia in pediatric patients

Abreu PD, Ramírez RM, Montero ÁL, Lacerda GÁJ, Sánchez RSÁ

Language: Spanish
References: 26
Page: 1-16
PDF size: 287.81 Kb.


ABSTRACT

Introduction: Community-acquired pneumonia is the leading cause of death in children under 5 years of age and represents 15% of deaths at these ages.
Objective: To determine if the Bacterial Pneumonia Score enables the diagnosis of the etiology of severe community-acquired pneumonia in pediatric patients.
Methods: A correlational descriptive study was carried out with patients under 18 years of age who were admitted to the Pediatric Intensive Care Unit of Roberto Rodríguez Fernández General Provincial Teaching Hospital, in Morón, due to severe pneumonia acquired in the community, from 1 September 2016 to September 30, 2017. The cases were distributed according to variables such as age, sex, etiology, as determined by the application of the Bacterial Pneumonia Score, symptoms on admission, findings in simple X-rays and ultrasound, complications, positivity of blood cultures, hospital stay and imposed treatment. A database was created on the SPSS version 24.0 system for Windows. Descriptive and inferential statistics were used and the chi-square goodness-of-fit and Pearson's bivariate correlation tests were performed.
Results: Cases between 1-4 years (34.6%) and males (59.6%) predominated. Bacterial etiology was more frequent (80.8%) (p <0.000) after applying the Bacterial Pneumonia Score. Bacterial etiology was associated with clinical manifestations such as fever (36.5%), condensation of a lobe on plain chest X-ray (55.8%), and small pleural effusion (37.2%) in the chest ultrasound. There was a relationship between the viral cause and dyspnea in 7 cases (13.5%), the viral cause and the radiological image with disseminated focus in 7 (13.5%), and the viral cause and the absence of pleural effusion on ultrasound in 6 patients (11.6%). Antimicrobials were used in 100% of cases and antivirals in 80.8%.
Conclusions: The use of the Bacterial Pneumonia Score facilitated the diagnosis of the bacterial etiology in severe community-acquired pneumonia.


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