Tinsa Faten, Boussetta Khadija, Gharbi Ahmed, Bousnina Dorra, Abdelaziz Rim, Brini Ines, Bousnina Souad
Service de Médecine Infantile B, Hôpital d'Enfants de Tunis, Tunis, Tunisie.
Tunis Med. 2009 Dec;87(12):851-6.
Community acquired pneumonia is responsible for a high morbidity in children. The etiological diagnosis is not always easy and treatment remains probabilistic.
To analysis clinical patterns and the outcome of community acquired pneumonia and to find arguments in favour of its origin.
A prospective analysis of the files of 39 children (20 boys, 19 girls) hospitalized between (1 december 2004 - 30 june 2005) for community acquired pneumonia was performed. Included dchildren whad between 6 months and 15 years-old.
The mean age was of 3 years and three months. Germ was identified in 41% of cases: Mycoplasma pneumoniae was the most important germ found in 9 cases, pneumococcus was found in 4 cases and hemophilus in four cases. Coinfection pneumococcus and mycoplasma were found in two cases. None virus was identified. We have separated two groups: bacterial pneumonia and pneumoniae without definite etiology. Fat cough was associated to bacterial pneumonia. mycoplama pneumoniae was significantly associated with high fever and dry cough. We haven't found any others associations between clinical, biological or radiological patterns and the two groups of pneumonia. C-reactive protein more than 66 mg/l has sensitivity of 77%, specificity of 73.3%, positive predictive value of 46.7% of and negative predictive value of 91.7%. The outcome was favourable in all cases.
Theses results showed the necessity to improve our microbiological methods to identify infectious agents of pneumonia. Mycoplasma pneumonia seems to be a frequent germ in preschool children.
社区获得性肺炎在儿童中发病率较高。病因诊断并非总是容易，治疗仍具有一定的不确定性。
分析社区获得性肺炎的临床模式和转归，并寻找支持其病因的依据。
对2004年12月1日至2005年6月30日期间因社区获得性肺炎住院的39名儿童（20名男孩，19名女孩）的病历进行前瞻性分析。纳入的儿童年龄在6个月至15岁之间。
平均年龄为3岁3个月。41%的病例中鉴定出病原体：肺炎支原体是最主要的病原体，有9例；肺炎球菌4例；嗜血杆菌4例。2例发现肺炎球菌和支原体合并感染。未鉴定出病毒。我们将其分为两组：细菌性肺炎和病因不明的肺炎。咳痰与细菌性肺炎相关。肺炎支原体与高热和干咳显著相关。我们未发现临床、生物学或放射学模式与两组肺炎之间有其他关联。C反应蛋白大于66mg/L时，敏感性为77%，特异性为73.3%，阳性预测值为46.7%，阴性预测值为91.7%。所有病例转归良好。
这些结果表明有必要改进我们的微生物学方法以鉴定肺炎的感染病原体。肺炎支原体似乎是学龄前儿童中常见病原体。
