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Revista chilena de infectología

versión impresa ISSN 0716-1018


ZENTENO A, Daniel et al. Utility of chest x-ray like approach to etiology of community acquired pneumonia in children. Rev. chil. infectol. [online]. 2008, vol.25, n.1, pp.17-21. ISSN 0716-1018.

Introduction: Chest X-ray (CR) utility to predict etiology in community-acquired pneumonia (CAP), in children has been controversial. Nevertheless, some authors propose the use of well standardized radiological patterns. Objective: To evaluate usefulness of modified Swischuk's radiological patterns (RaP) to determine probable etiology in children hospitalized with CAP. Patients and Methods: Eighty children were studied using 6 standardized RaP. The RaP were blindly and individually analyzed by 9 pneumologists, who registered the results (stage 1). Thereafter, (stage 2) a second evaluation adding clinical information was performed. Then, the patients complementary examinations and clinical evolution were included (stage 3). The reference standard (RS) was generated from a blind consensus. Every result was compared with the RS using Student test. Results: According to RS, children were classified as having a virus-like pneumonia in 63% of cases, bacterial in 13%, mixed in 16%, atypical in 5% and ADV in 3%. The agreement of stage 1 and 2 with RS was 64 and 77%, respectively. Virus and bacterial RaP agreement increased from 66 to 82 % (p < 0.001) and from 82 to 90% (p < 0.05), respectively after incorporating clinical parameters. Conclusion: Modified Swischuk's RaP used in association with clinical elements allows a quite satisfactory approach to etiologic diagnosis of CAP

Palabras clave : community-acquired; pneumonia; chest X-ray; etiology; children.

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