Çocukluk Çağı Alt Solunum Yolu Enfeksiyonlarının Klinik, Radyolojik ve Epidemiyolojik Değerlendirmesi

Abstract

Amaç: Bu çalışmada alt solunum yolu enfeksiyonu klinik tanısıyla hastaneye yatırılan 1 ay-5 yaş arası hastalarda klinik, radyolojik ve epidemiyolojik çalışma ile etiyolojinin belirlenmesi amaçlandı. Gereç ve yöntem: Ankara Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları poliklinikleri ve çocuk acil servislerine başvuran, 1 ay-5 yaş arası, ASYE tanısı alan 150 hasta ile alt solunum yolu enfeksiyonu tanısı almayan 50 hastayı inceledik. Akut faz reaktanları için kan örnekleri ve bakteriyel etiyolojilerin tespiti için nazofarengeal swap örnekleri alındı. Tüm hastaların ilk postero-anterior akciğer grafileri kontrol edildi. Bulgular: En sık görülen patojenler 77 (%51,3) hastada Streptococcus pneumoniae ve 71 (%47,3) hastada Haemophilus influenzae idi. Üç grup hasta C-reaktif protein değerleri açısından karşılaştırıldı; alveolar pnömonili hastalar, normal radyografisi ve interstisyel infiltrasyonu olan hasta grubundan istatistiksel olarak daha fazla idi (P = 0.012, P = 0.008). Alveoler pnömonili hastalarda eritrosit sedimantasyon hızı, interstisyel infiltrasyonu olan ve radyolojisi normal olan hastalara göre istatistiksel olarak anlamlı derecede yüksekti (P = 0.015, P = 0.016). Sonuç: Alt solunum yolu enfeksiyonu şüphesi olan hastalarda uygun antibiyotik tedavisine başlanması klinik, radyolojik ve laboratuvar tetkikleriyle desteklenmelidir. Viral ve bakteriyel etkenlerin saptanmasında laboratuvar testlerinin multipleks polimeraz zincir reaksiyonu yöntemiyle birlikte kullanılabileceğini ancak bu konuyla ilgili ileri çalışmalara ihtiyaç olduğunu düşünüyoruz.

Keywords

• pnömoni
• çocuk sağlığı
• polimeraz zincir reaksiyonu

CLINICAL, RADIOLOGICAL, AND EPIDEMIOLOGICAL EVALUATION OF LOWER RESPIRATORY TRACT INFECTIONS OF CHILDREN

Abstract

Aim: In this study, we aimed to determine the etiology of lower respiratory tract infection in patients aged 1 month to 5 years with a clinical, radiological, and epidemiological study. Materials and method: We investigated 150 patients between 1 month to 5 years of age who required hospitalization and those who were admitted to pediatrics clinics and pediatric emergency services of Ankara Training and Research Hospital who had the clinical diagnosis of lower respiratory tract infection and 50 patients who had no pathological physical examination findings. Blood samples for acute phase reactants and nasopharyngeal swap samples for detection of bacterial etiologies were taken. Initial posteroanterior chest X-rays of all patients were checked. Results: The most common pathogens were Streptococcus pneumoniae in 77 (51.3%) and Haemophilus influenzae in 71 (% 47.3) patients. Three groups of patients compared with C-reactive protein values; patients with alveolar pneumonia were statistically higher than those with normal radiography and interstitial infiltrates (P= 0.012, P= 0.008). Erythrocyte sedimentation rates in patients with alveolar pneumonia were statistically significantly higher than the patients with interstitial infiltrates and normal radiology (P = 0.015, P= 0.016). Conclusion: In patients suspected of lower respiratory tract infection, the beginning of appropriate antibiotic treatment should be supported with clinical, radiological, and laboratory tests. We think laboratory tests of acute phase reactants should be used with multiplex PCR to detect viral and bacterial agents. Still, to deal with this issue, advanced studies are needed.

Keywords

• pneumonia
• pediatrics
• Polymerase Chain Reaction

Supporting Institution

Support and Acknowledgment: No financial support was received from any institution or person.

Ethical Statement

Ethics Committee Approval: The study protocol was approved by the Clinical Research Ethics Committee of the Ankara Training and Research Hospital (Decision dated 26th January 2011, numbered 402/3357)

Thanks

Thanks to Ülkü Tıraş and Ayfer Özışık for their contributions to the manuscript.

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