Details
Category: Volume 06 Issue 12 December 2018
Hits: 1287

Title: A Study on Clinico-Radiological Correlation of Pneumonia in Paediatric Age Group Patients (2 months-5 years) in a Tertiary Medical Institute

Authors: Muhammad Bin Selim Halder, Moksuda Khatun, Arun Kumar De

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.133

Abstract

Aim: The objective of the study  is  to  find out the correlation between clinical diagnosis of pneumonia and its radiological changes .

Material and Methods: One fifty and two children aged 2months to 5 years, admitted at the department of Paediatrics, Midnapore Medical College and Hospital, West Bengal, from April 2016 to March 2017  with tachypnoea and/or chest retraction were included in the study. Children with known cardiovascular disease, asthma, tuberculosis and neurological disorders were excluded. Detailed clinical history taking, meticulous clinical examinations were performed and Chest x-rays were taken on admission for all included patients.

Result: Sensitivity, Specificity, PPV, NPV of tachypnoea was 98.06%, 24.49%, 73.19% and 85.71% respectively. Sensitivity, specificity, PPV, NPV of grunting were calculated to be 9.70%,100%, 100% & 34.50% respectively. Fever, cough and tachypnoea together were present in 96(63.16%) children.  Sensitivity and specificity of presence of fever, cough, and tachypnoea were 76.70% and 65.31%; PPV and NPV were calculated to be 82.29% and 57.14% respectively.

Conclusion: Presence of Tachypnoea was the most sensitive parameter to diagnosis pneumonia. Grunting was the most specific parameter and had highest positive predictive value in respect of radiologically confirmed pneumonia.

Keywords: Pneumonia, Tachypnoea, Grunting.

References

  1. Black RE, Allen LH, Bhutta ZA, et al: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371:243-260.2008.
  2. Liu L, Johnson HL, Cousens S, et al. Global, regional, and national causes of child mortality: an updated systemic analysis for 2010 with time trends since 2000.Lancet 379:2151-2161, 2012.
  3. Wardlaw T, Salama P, White Johansson E: Pneumonia the leading killer of children, Lancet 368:1048-1050, 2006.
  4. Key NK.Araújo-Neto CA, Cardoso MRA, Carvalho CMN. Characteristics of radiologically diagnosed pneumonia in under-5 children in Salvador, Brazil.Indian paediatrics 2011 ;( 48):873-7.
  5. Rebecca N, James KT, Grace N, Marianne SO. Asthma and pneumonia among children less than five years with acute respiratory symptoms in Mulago Hospital, Uganda: Evidence of under diagnosis of Asthma. PLos ONE 2013;8(11):1-9.
  6. Hazir T, Nisar YB,Qazi SA, Khan SF, Raza M, Zameer S, et al. Chest radiography in children aged 2-59 months diagnosed with non severe pneumonia as defined by World Health Organization: Descriptive multicentre study in Pakistan.BMJ 2006;333(7569):1-4.
  7. Al-Dabbagh SA, Al-Zubaidi SN.The validity of clinical criteria in predicting pneumonia among children under 5 years of age.J Fam Community Med 2004;(11):11-6
  8. Eldin K, Salih MA,Wahb OA, Ibrahim SA. Radiological finding in severe pneumonia in children 1-59 months in a children’s Hospital, Khartoum, Sudan. Pediatr Therapeut 2012 Mar;2(3):1-3
  9. Lozano JM, Steinhoff M, Ruiz JG, Mesa ML, Martinez N, Dussan B.Clinical predictors of acute radiological pneumonia and hypoxaemia at high altitude.Arch Dis Child 1994 Oct;71(4):323-7.
  10. Mulholland EK,Simoes EA,Costales MO, McGrath EJ, Manalac EM,Gove S. Standardized diagnosis of pneumonia in developing countries. Pediatr Infect Dis J 1992 Feb;11(2):77-81.
  11. Palafox M, Guiscafré H,Reyes H, Muñoz Diagnostic value of tachypnoea in pneumonia defined radiologically. Arch Dis Child 2000;(82):41-5.
  12. Dai Y,Foy HM,Zhu Z,Chen B,Tong F. Respiratory rate and signs in roentgen graphically confirmed pneumonia among children in China. Pediatr Infect Dis J 1995 Jan;14(1)48-50.
  13. Gupta D.Mishra S, Chaturvedi P.Fast breathing in the diagnosis of pneumonia-a reassessment Trop Pediatr 1996 Aug; 42(4):196-9.
  14. Bilkis MD, Gorgal N, Carbone M, Vazquez M, Albanese P, Branda MC, et al. Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia. Pediatr Emerg Care 2010 Jun;26(6):399-405.
  15. Lynch T,Platt R, Gouin S, Larson C, Patenaude Y.Can We Predict Which Children With Clinically Suspected Pneumonia Will Have The Presence of Focal Infiltrates on Chest radiographs? Pediatrics 2004;113(3 Pt 1):e186-9.Available from PubMed.
  16. Kuti BP, Adegoke SA, Oyelami OA.Can we predict which children with clinical pneumonia will have radiologic findings on chest radiograph? World Journal of Medicine and Medical science 2014 Mar;2(3):1-12.
  17. Neuman MI,Scully KJ,Kim D,Shah S,Bachur RG.Physician assessment of the likelihood of pneumonia in a pediatric emergency department.Pediatric Emerg Care 2010 Nov;26(11):817-22.
  18. Singhi S, Dhawan A,Kataria S,Walia BN. Validity of clinical signs for the identification of pneumonia in children. Ann Trop Pediatr 1994;14(1):53-8.
  19. Gittens MEM, Phelan GJ, Brody AS, Donnelly LF, Bracey SE, Duma EM, et al.Identifying children with pneumonia in the emergency department.Clin Pediatr 2005 Jun;44(5):427-35
  20. Zukin DD, Hoffman JR, Cleveland RH, Kushner DC, Herman TE.Correlation of pulmonary signs and symptoms with chest radiographs in the pediatric age group. Ann Emerg Medicine 1986 Jul; 15(7):792-6.
  21. Shuba S, Amullya S,Raghu MB,Kumar R. Correlation of clinincal pneumonia with radiological changes in children less than 5 years. Available from: URL: www.iapindia.org/files/abstracts 2006/RESP.doc.
  22. Cornelius W, Van N, Lateef TM, Mathwes B. Reducing exposer in the ED. Pediatrics 2009 Jul;(1):1-3.
  23. Harari M, Shann F, Spooner V, Meisner S, Carney M, Campo DJ. Clinical signs of pneumonia in children. Lancet 1991 oct 12;338(8772):928-30.

Corresponding Author

Moksuda Khatun

Junior Resident, Paediatrics, Medical College and Hospital, Kolkata, West Bengal, India