Clinical, Bacteriological and Radiological Study of Severe Pneumonia in Children at a Tertiary Care Centre

Abstract

Background Pneumonia is the largest killer of children under 5 years, around the world. About four children die from pneumonia every minute. WHO definition of very severe pneumonia is a clinical diagnosis based on the presence of cough or difficulty in breathing plus at least one of the following: central cyanosis, refusal of feeds, convulsions, lethargy. The present study was done to know the risk factors, clinical, bacteriological and radiological features of severe pneumonia in children.

Methods This was a prospective study of severe pneumonia conducted in 150 children in the age group of 1 month to 5 years with clinical features of severe pneumonia. Detailed history and physical examination were done. Children were classified into severe and very severe pneumonia.

Results Study showed that 53% of children belonged to the age group of 1 month to 1 year. Fast breathing, cough and fever were the most common symptoms. Refusal of feed was present in 19% cases. Tachypnoea, chest retractions and crepitations were
the most common signs. Diarrhoea (6.6%) and septicaemia (3.3%) were the associated illness; 83.3% had severe pneumonia, 16.7% had very severe pneumonia; 30% were malnourished and 66.6% were anemic.

Conclusion Pneumonia is one of the major causes of morbidity and mortality in children. Among risk factors studied previous history of similar illness, inappropriate immunization, anaemia, malnutrition, poor housing conditions were found significant. Chest X-ray is valuable aids in the diagnosis of pneumonia in children. Severity of pneumonia and malnutrition associated illness were important risk factors for mortality.