Diagnostic significance of clinical and para-clinical signs of community-acquired pneumonia in children

Keywords: respiratory tract, pneumonia, complications, clinical symptoms, laboratory parameters, ultrasonographic parameters.


Annotation. Respiratory diseases are relevant in pediatric practice, which is associated with its widespread and frequent complications, especially in young children. The aim of the study was to assess the diagnostic value of clinical symptoms, laboratory and ultra-sonographic parameters in pneumonia in children of the first 3 years of life. A retrospective study of medical records of 218 children who were hospitalized in the department for young children diagnosed with pneumonia for the period from 2016 to 2018. The average age of children was 11.67±9.97 months and it was within the range from 1 month to 3 years. The ration of boys and girls was practically identical (51.8% and 48.2% accordingly). The first group included children aged under one year (the average age is 4.57±0.84 months; n=88). The second group included children aged from 1 to 3 years (the average age is 18.2±4.25 months; n=130). To characterize the information content of clinical and laboratory symptoms the study has used objective parameters defined as the operational characteristics of tests. The most important operational characteristics of diagnostic methods included: sensitivity (Se, sensitivity) and specificity (Sp, specificity). To check the statistical hypothesis on differences of absolute and relative frequencies, fractions, and ratios in two independent samples, the criteria of хі-square (χ2) was used. While detailing an anamnesis, the disease was more often related to untimely treatment and outpatient care. Various data were obtained on the absolute and relative risk, as well as the sensitivity and specificity of the localization of pneumonia depending on age. Therefore, the incidence of bilateral pneumonia was considered an indicator of risk. On admission to hospital, the body temperature of patients was 38.2±0.66°С. Most of the complaints were on the unproductive or productive cough. Besides, in some cases, shortness of breath and runny nose were mentioned. Thus, in young children with pneumonia, a diagnostically significant clinical symptom is a bilateral lung impression (82.6%), compared with right-handed (15.1%) and left-handed (2.3%), which is significantly more common in children under 1-th year of life compared with patients 1–3 years; laboratory features are probably higher levels of liver-specific enzymes – ALT and AST in children under 1 year; ultrasonographic indicators associated with the presence of pneumonia in young children include increased liver size, gallbladder deformity, the presence of sediment in the gallbladder, dyskinesia of the biliary tract, thickening of the gallbladder wall; children under 1 year of age have a risk of liver enlargement and biliary dyskinesia.


1. Martynenko, T. I., Balackaja, I. V., Kapitulin, S. Ju., & Shojhet, Ja. N. (2013). Klinicheskie varianty tjazheloj pnevmonii [Clinical variants of severe pneumonia]. Klinicheskaja medicina – Clinical medicine, 91 (10), 48–52. Взято с https://cyberleninka.ru/article/n/klinicheskie-varianty-tyazheloy-pnevmonii/viewer

2. Makarova, A. V., Vasil'eva, O. V., & Trushkina, A. V. (2017). Ostrye vnebol'nichnye pnevmonii u detej [Acute community-acquired pneumonia in children]. Prikladnye informacionnye aspekty mediciny – Applied information aspects of medicine, 20 (3), 115–118.

3. Andronikou, S. (2017). Imaging community-acquired pneumonia in children. Pediatric Radiology, 47 (11), 1390–1391. https://doi.org/10.1007/s00247-017-3861-6

4. Kim, Y. J., Shin, K. S., Lee, K. H., Kim, Y. R., & Choi, J. H. (2017). Clinical characteristics of macrolide-resistant mycoplasma pneumoniae from children in Jeju. Journal of Korean medical science, 32 (10), 1642–1646. DOI: 10.3346/jkms.2017.32.10.1642

5. Hendrickson, M. A., Obeya, E., Wey, A. R., & Gaillard, P. R. (2017). Community Primary Care Provider Preferences for Emergency Department Follow-up Recommendations: A Regional Study. Pediatric emergency care, 33 (10), 690–693. https://doi.org/10.1097/PEC.0000000000001068

6. Fernández-Mormontoy, J., Estremadoyro-Gallardo, A., & Vargas, O. F. (2017). Mortality predictive scores for community-acquired pneumonia in children. Pediatric pulmonology, 52 (9), 1119–1120. doi: 10.1002/ppul.23706

7. Le Roux, D. M., & Zar, H. J. (2017). Community-acquired pneumonia in children – a changing spectrum of disease. Pediatric radiology, 47 (11), 1392–1398. doi: 10.1007/s00247-017-3827-8

8. Koh, J. W. J. C., Wong, J. J. M., Sultana, R., Wong, P. P. C., Mok, Y. H., & Lee, J. H. (2017). Risk factors for mortality in children with pneumonia admitted to the pediatric intensive care unit. Pediatric pulmonology, 52 (8), 1076–1084. doi: 10.1002/ppul.23702
How to Cite
Pasik, V. (2020). Diagnostic significance of clinical and para-clinical signs of community-acquired pneumonia in children. Reports of Vinnytsia National Medical University, 24(2), 244-249. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2020-24(2)-08