Title: Differentiation of Bacterial and Viral Pneumonia in Children by Hematological Investigations
Authors: Prabakar S, Ramanathan R, Hari Vasudevan S
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.95
Abstract
Objective: To differentiate bacterial and viral community acquired pneumonias using WBC count (TC), differential count (DC),erythrocyte sedimentation rate(ESR).
Design: Descriptive Study
Setting: Semi-Urban tertiary care hospital
Methods: 100 cases of children aged between 1month to 12 years who were admitted to paediatric wards with tachypnoea as per WHO criteria and chest in drawing in Rajah Muthiah Medical college, Chidambaram were included in the study. Detailed history, physical examinations were recorded in a proforma. Investigations included WBC count, DC, ESR, Chest X ray. Children who had radiologically confirmed pneumonia (86 cases) were divided in to bacterial and viral pneumonia based on their radiological findings. These results were correlated with laboratory findings and results were given.
Results: In the present study, radiological findings were present in 86% of cases. Bacterial pneumonia was detected in 73%, viral pneumonia in 13%. Among bacterial pneumonia, bronchopneumonia was seen in 34% cases, consolidation was seen in 26%, alveolar infiltrate in 6% and complications of pneumonia in 7% cases. In the present study, among bacterial pneumonias defined radiologically,63% had elevated WBC count ,79% had neutrophilia, 76.7% had elevated ESR. There was no correlation of laboratory findings with bacterial and viral pneumonia defined radiologically (low sensitivity and specificity).
Conclusion: Routine hematological investigations like WBC count, DC, ESR aid very little in differentiating bacterial and viral pneumonias. Chest X-ray is valuable aid in the diagnosis of pneumonia in children. Follow up chest roentgenogram is vital for evaluating the response to treatment in pneumonia.
Keywords: Pneumonia, Bacterial, Viral, WBC count, DC, ESR.
