Flores NG, Martínez GIM, Hernández DL, Delgado FA

Language: Spanish
References: 10
Page: 92-95
PDF size: 41.63 Kb.

ABSTRACT

Introduction: Community-Acquired Pneumonia (CAP) is the most common cause of hospitalization in children in general hospitals. The white blood cell count (WBC) is realized routinely in these patients.
Material and methods: This is a descriptive and retrospective study. We reviewed the files of children from 2 months to 7 years of age hospitalized in the Pediatrics Department of General Hospital Dr. Manuel Gea González with diagnosis of CAP in a period of 7 years. The variables analyzed were the clinical features of the patients, the WBC with its differential, and the pattern of X-ray.
Results: We reviewed 207 files. Female were 108 cases (52%) and male 99 (48%). The age was 15.4 ± 14 months (mean and standard deviation), range 2 months to 7 years. The days with symptoms prior to come to the hospital were 3.1 ± 2.5, range from 1 to 15, 88% within the first 5 days. In the X-ray we found; interstitial pattern with 124 cases (60%), condensation in 66 (32%), and mixed pattern with 12 (6%). The hospital days were 3.6 ± 1.8, range 2 to 12. In the analysis of the hematic cytology we found that only 27.9% of patients had abnormal total leukocyte count. In the differential count predominant monocytosis in 95 cases (45.8%), lymphopenia in 74 (35.7%), neutrophilia in 41 (19.8%), leukocytosis in 33 (15.9%), thrombocytosis in 27 (13%).
Conclusions: In the WBC monocytosis, lymphopenia and neutrofilia where the most frequent alterations. The total account of leukocytes was altered only in the third part of the patients indicating poor specificity of the test, and it put in question the need to do this routine in these patients.

REFERENCES

1. Hernández DL, Pallares TVC, Flores NG, Lavalle VA. Neumonía de la comunidad. Agentes causales, indicadores clínicos y empleo de antibióticos en niños. Rev Mex Pediatr 2004; 71: 191-8.

2. Michelow IC, Olsen K, Lozano J, Rollins NK, Duffy LB, Ziegler T et al. Epidemiology and Clinical Characteristics of Community-Acquired Pneumonia in Hospitalized Children. Pediatrics 2004; 113: 701-7.

3. Müller MP, Tomlison G, Marrie TJ, Tang P, McGeer A, Low DE et al. Can routine laboratory test discriminate between severe acute respiratory syndrome and other causes of community-acquired pneumonia? Clin Infect Dis 2005; 42: 1079-86.

4. Michelle H, Symons H. Hematology. In: Gunn VL, Nechyba C et al. The Harriet Lane Hand Book. A manual for pediatric house officers. Mosby Ed. Philadelphia Pennsylvania, USA, Sixteen edition 2002: 333.

5. Moreno L, Krishnan JA, Duran P, Ferrero F. Development and validation of a clinical prediction rule to distinguish bacterial from viral pneumonia in children. Pediatr Pulmonol 2006; 41: 331-7.

6. Peiris JS, Lai ST, Poon LL, Guan Y, Yam LY, Lim W et al. Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet 2003; 361: 1319-1325.

7. Berezne A, Bono W, Guillevin L, Mouthon L. Diagnosis of lymphocytopenia. Presse Med 2006; 35: 895-902.

8. Zahorec R. Ratio of neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.

9. Castelino DJ, McNair P, Kay TW. Lymphocytopenia in a hospital population-what does it signify? Aust NZJ Med 1997; 27: 170-4.

10. Khoruts A, Fraser JM. A causal link between lymphopenia and autoimmunity. Immunol Lett 2005; 98: 23-31.