Aspectos radiológicos e etiologia da pneumonia adquirida na comunidade: um estudo prospectivo

Abstract

RADIOLOGICAL ASPECTS AND ETIOLOGY OF PNEUMONIA ACQUIRED IN COMMUNITY: A PROSPECTIVE STUDY. Introduction: pneumonia acquired in community (PAC) continues to be one of the main causes of death and a common hospital admission for children under 5 years of age worldwide. Objective: to evaluate radiological findings in children with CAP and bacterial infection or exclusively viral. Methodology: prospective cross-sectional study carried out in Pediatric Emergency at the Federal University of Bahia Hospital, in Salvador, Brazil. Children under 5 years of age hospitalized with confirmed CAP radiologically were evaluated. For etiological investigation (11 viruses, 8 bacteria) nasopharyngeal aspirate, acute blood culture, buffy coat and blood samples were collected. paired serum samples (2 4 weeks apart). A chest x-ray (CXR) was obtained at the ad mission, when clinical data were collected. The CXR was read by a radiologist independent pediatrician, blinded to clinical and etiological information. Results: of 165 patients, 158 (95.8%) and 18 (10.9%) had pulmonary infiltrate and effusion plural, respectively. The pulmonary infiltrate was classified as alveolar (n=152) or interstitial (n=6). Patients with only interstitial infiltrate did not present pleural effusion. Hyperinflation (7.9%), atelectasis (7.3%), enlarged lymph nodes ( 6%), abscess (0.6%) and pneumatocele (0.6%) have been described. Overall, the median (IQR) age and disease duration were 18 (9 28) months and 7 (4 12.5) days, respectively and bacterial (n=86; 52.1%) and exclusively viral (n 79; 47.9%) were diagnosed. Among the 152 patients with alveolar infiltrate, 53.3% and 46.7% had bacterial or exclusively viral infection, respectively. Between of the 6 patients with only interstitial infiltrate, 33.3% and 66.7% had infection bacterial or exclusively viral, respectively. No significant difference was found when the radiological finding was compared between children with infection bacterial or exclusively viral. Conclusion: no radiological findings are associated with bacterial or viral infection.