Çocuklarda viral ve bakteriyel pnömoniyi ayırmada laboratuvar değerlendirmeleri arasındaki ilişki

Year 2020, , 397 - 405, 15.09.2020

Kamil Şahin , Murat Elevli , Ayhan Koçak , Funda Atash , Esma Yücetaş , Cihan Coşkun

https://doi.org/10.31832/smj.742661

Cited By: 1

Abstract

Amaç

Alt
solunum yolu (ASY)' nun temel enfeksiyonları; bronşiyolit ve pnömonidir.
Çalışmamızdaki amacımız akciğer grafi bulgularına göre sınıflanmış
viral-bakteriyel ASY enfeksiyonlarının ayırımında, labaratuvar değerlerinin
önemini saptamaktır.

Gereç ve Yöntem

Hastanemizde
2017 yılında, ASY enfeksiyonu tanısı almış hastalar,  akciğer grafi bulgularına göre radyoloji
uzmanı tarafındandört gruba ayrıldı ve bu bulgulara göre viral veya bakteriyel
ASY enfeksiyonu olarak sınıflandı. Hastaların c reaktif protein (CRP), lökosit,
trombosit, hematokrit, nötrofil, lenfosit, nötrofil/lenfosit ve ortalama
trombosit hacmi oranları istatistik yöntemlerle karşılaştırılarak, akciğer
grafisi ve labaratuvar bulguları arasında korelasyon istatistik yöntemlerle
saptandı.

Bulgular

Çalışmaya
dahil edilen 344 hastanın akciğer grafi bulgularına göre lober segmental ve
yoğun yamalı ve peribronşiyal infiltrasyonu olan 43 adedi bakteriyel,
yamalı-peribronşiyal infiltrasyonu olan veya grafileri normal bulunan 301 ASY
enfeksiyonu viral olarak değerlendirildi. Viral ve bakteriyel grup arasında
sadece CRP değerleri arasında istatistiksel fark bulduk (p=.0,034).

Sonuç

Toplumdan
kazanılmış pnömonilerde, yatan hastalarda yaptığımız çalışmada, viral
bakteriyel ASY enfeksiyonu ayırımında akciğer grafisi ile CRP nin arasında  anlamlı ilişki görülmüştür. Çocuklarda, CRP
değerindeki yükseklik, pnömoni tedavisinde ampirik antibiyotik başlama kararını
vermede, akciğer grafisindeki bakteriyel bulguları destekleyen değerli bir
göstergedir.

Keywords

antibiyotik, bronşiyolit, c reaktif protein, çocuk, pnömoni

Supporting Institution

Destekleyen kurum yoktur.

The relationship between laboratory evaluations in the separation of viral and bacterial pneumonia in children

Abstract

Abstract

Objective

Basic
infections of the lower respiratory tract (LRT) are bronchiolitis and pneumonia
in children. The aim our study that determines the guiding laboratory
parameters in discriminating between bacterial and viral LRT infections.

Materials and Methods

The
patients who were diagnosed with LRT infection were divided into four groups
based on the findings of chest radiography by radyologist in 2017. Their
disease was classified as either viral or bacterial LRT infection in line with
these findings. A correlation between chest radiography and laboratory findings
was found by comparing c reactive protein (CRP), leukocyte, platelet,
hematocrit, neutrophil, lymphocyte, neutrophil / lymphocyte and mean platelet
volume (MPV) ratios using statistical methods.

Results

Of
344 patients included in the study, 43 patients with lober segmental,
dense-patched and peribronchial infiltration and 301 patients with
patched-peribronchial infiltration or normal radiography were evaluated as
bacterial and viral according to the findings of chest radiography, respectively.
We found a statistically significant difference in only CRP values between the
viral and bacterial groups (p = 0.034).

Conclusion

It
is seen that CRP supports the findings of chest radiography in discrimination
of the bacterial cause in community-acquired LRT infections. In children, the
elevation in CRP value can be a valuable indicator in supporting bacterial
chest radiography finding and deciding to start empirically antibiotic
treatment of pneumonia.

Keywords

antibiotic, bronchiolitis, c reactive protein, children, pneumonia

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