Work

Clinical Implications of the Obstructive Pattern on Chest Radiography in Children Aged 3–59 Months With Severe Lower Respiratory Tract Infections

Year: 2024

Type: article

Abstract: OBJECTIVES: To investigate the clinical implications of the obstructive pattern on plain chest radiography, defined as peribronchial cuffing or hyperinflation, in young children with severe lower respiratory tract infections (LRTIs). METHODS: We reviewed all children aged 3‒59 months with LRTIs who underwent radiography and polymerase chain reaction in a Korean emergency department from 2016 through 2020. The radiographs were read as consolidation, peribronchial cuffing, or hyperinflation, with each interrater reliability computed. As per the obstructive pattern, we compared their clinical features, therapeutic interventions, outcomes, and microbiology. RESULTS: Among 599 children with LRTIs, 465 were enrolled, of whom 98 (21.1%) had consolidation (κ = 0.60; 95% confidence interval, 0.50‒0.70), and 367 (78.9%) had peribronchial cuffing (0.55; 0.46‒0.65) or hyperinflation (0.59; 0.52‒0.67). The obstructive pattern was significantly associated with more frequent wheezing (obstructive, 28.6% vs. consolidation, 10.2%) and the use of inhaled albuterol or systemic steroids (39.0% vs. 23.5%), and lower median values or frequencies of age (22.0 vs. 35.0 months), crackle or diminished breath sound (42.0% vs. 61.2%), C-reactive protein (1.4 vs. 2.9 mg/dL), antibiotic therapy (72.2% vs. 93.9%), length of hospital stay (4.0 vs 5.0 days), fever lasting 3 days or longer (7.9% vs. 29.6%), and complications (0.5% vs. 9.2%). Microbiologically, viruses, such as respiratory syncytial virus, were more frequently detected in children with the obstructive pattern or at a younger age. CONCLUSIONS: This study confirms an association of the obstructive pattern on radiography with viral infection and inflammatory airway obstruction-relieving therapy in young children with severe LRTIs.

Source: Pediatric Pulmonology

DOI: 10.1002/ppul.27458

Authors: Moon Ki Shim, Ji Eun Park, Hyelynn Jeon, Bumhee Park, Jung Heon Kim

Institutions: Ajou University, Samsung Medical Center, Sungkyunkwan University, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center

Language: English

Topic: Pneumonia and Respiratory Infections

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,740