Lahti Elina, Peltola Ville, Virkki Raimo, Ruuskanen Olli
Department of Pediatrics, Turku University Hospital, Vähä-Hämeenkatu 1A3, 20500 Turku, Finland.
Pediatr Infect Dis J. 2006 Feb;25(2):160-4. doi: 10.1097/01.inf.0000199265.90299.26.
Influenza and pneumonia are common childhood illnesses, but few studies have been conducted on influenza-related pneumonia in children. The aim of this study was to describe the frequency and characteristics of laboratory-documented and radiologically detected influenza pneumonia in children.
This study involved children treated at the Department of Pediatrics, Turku University Hospital, from 1980 through 2003. Influenza A or B infection was documented with the use of antigen detection from nasopharyngeal aspirates. Children with chest radiographs obtained during influenza episodes were identified. Chest radiographs were reevaluated by a pediatric radiologist for verification of pneumonic infiltrates. Clinical and laboratory data were collected from medical records.
Pneumonia was detected in 134 (14%) of 936 children with influenza infection. The most frequent signs of influenza pneumonia were fever and cough. Of these children, 47% had no specific clinical signs or symptoms suggesting pneumonia. White blood cell count was <15 x 10/L in 89% and serum C-reactive protein concentration <80 mg/L in 85% of the children. One-half of the children had solely interstitial infiltrates, one-fourth solely alveolar and one- fourth both alveolar and interstitial infiltrates on the chest radiograph. The hospitalization rate was 68%, and the median duration of hospitalization was 2 days. Complicated pneumonias were rare, and mortality was low (0.7%).
Pneumonia is detected in a minority of children treated for influenza at a tertiary center. Unlike in adults, influenza pneumonia in children is usually a benign illness, and the mortality is low.
流感和肺炎是常见的儿童疾病，但针对儿童流感相关性肺炎的研究较少。本研究旨在描述实验室确诊及影像学检测出的儿童流感肺炎的发生率和特征。
本研究纳入了1980年至2003年在图尔库大学医院儿科接受治疗的儿童。通过检测鼻咽吸出物中的抗原确定甲型或乙型流感感染。确定在流感发作期间进行过胸部X光检查的儿童。由一名儿科放射科医生重新评估胸部X光片以核实肺部浸润情况。从病历中收集临床和实验室数据。
936例流感感染儿童中有134例（14%）检测出肺炎。流感肺炎最常见的症状是发热和咳嗽。在这些儿童中，47%没有提示肺炎的特定临床体征或症状。89%的儿童白细胞计数<15×10⁹/L，85%的儿童血清C反应蛋白浓度<80mg/L。胸部X光片显示，一半儿童仅有间质性浸润，四分之一仅有肺泡性浸润，四分之一既有肺泡性浸润又有间质性浸润。住院率为68%，中位住院时间为2天。复杂性肺炎罕见，死亡率低（0.7%）。
在三级医疗中心接受流感治疗的儿童中，少数会检测出肺炎。与成人不同，儿童流感肺炎通常是一种良性疾病，死亡率低。
