The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children

  1. Matti Korppi1,
  2. Massimiliano Don2,
  3. Francesca Valent3,
  4. Mario Canciani2

Article first published online: 16 APR 2008

DOI: 10.1111/j.1651-2227.2008.00789.x

Issue

Acta Paediatrica

Acta Paediatrica

Volume 97, Issue 7, pages 943–947, July 2008

Additional Information

How to Cite

Korppi, M., Don, M., Valent, F. and Canciani, M. (2008), The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children. Acta Paediatrica, 97: 943–947. doi: 10.1111/j.1651-2227.2008.00789.x

Author Information

  1. 1

    Paediatric Research Centre, Tampere University and University Hospital, Tampere, Finland

  2. 2

    Pediatric Department, School of Medicine, DPMSC, University of Udine, Italy

  3. 3

    Hygiene Department, School of Medicine, DPMSC, University of Udine, Italy

*Correspondence Prof. Matti Korppi, Paediatric Research Centre, Tampere University and University Hospital, FIN-33014 Tampere University, Finland. Tel: +358-3-35518407 | Fax: +358-3-35518420 | Email. matti.korppi@uta.fi

Publication History

  1. Issue published online: 2 JUN 2008
  2. Article first published online: 16 APR 2008
  3. Received 15 November 2007; accepted 11 March 2008.

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Keywords:

  • Chest radiograph;
  • Child;
  • Clinical characteristic;
  • Community-acquired;
  • Mycoplasma;
  • Pneumococcus;
  • Pneumonia;
  • Sign;
  • Symptom;
  • Virus

Abstract

Objective: To evaluate the value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children.

Design: A retrospective analysis of clinical signs and symptoms, supplemented with chest radiograph and serum procalcitonin data, in 101 children with community-acquired pneumonia. Viral and bacterial aetiology was studied prospectively by antibody assays, and pneumococcal infection was found in 18, atypical bacterial infection in 28 and viral infection alone in 22 cases.

Methods: Chest radiographs and serum procalcitonin were studied in all cases. Data on clinical signs and symptoms were retrospectively collected from the medical cards of the patients.

Results: Among symptoms, cough was present in 89% and fever (>37.5°C) in 88% of the cases. Among physical signs, crackles were present in 49% and decreased breath sounds in 58%. No significant associations were found between any of the clinical signs or symptoms and the aetiology of pneumonia. In multivariate analyses, age over 5 years and serum procalcitonin over 1.0 ng/mL were the only independent predictors of bacterial aetiology, but no finding was able to screen between pneumococcal and atypical bacterial aetiology of infection.

Conclusion: No clinical or radiological characteristic was helpful in the separation between viral, pneumococcal and atypical bacterial aetiology of community-acquired pneumonia (CAP) in children.

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