Abstract
Aim: To study peculiarities of clinical course of community-acquired pneumonia (CAP) in children with connective tissue disorders (CTD).
Methods: 64 children with CAP aged 1-18 were studied during one year. Patients were divided for analysis into two age groups: children aged 1-3 (group A, n = 16), and aged 4-18 (group B, n= 48). All patients had manifestations of CTD. CAP was clinically and radiographically diagnosed with detection of serum antibodies (IgG and IgM) against intracellular pathogens measured by enzyme-linked immunosorbent assay (ELISA).
Results: All patients had CAP caused by atypical pathogens with indistinct clinical manifestations and symptoms. Recurrent course of CAP was in 54 (84,4%) patients. CAP caused by Chlamydophilla pneumonia (Cp) was more frequent in group A – in 15 (93,7% of the group) patients. CAP caused by Mycoplasma pneumonia (Mp) was more frequent in group B - in 44 patients (91,6% of the group), in 6,8% - together with Cp, in 27,3% - with Cytomegalovirus. Asthma was diagnosed in 29 (45,3%) patients mainly of group B, with recurrent CAP in 10 (34,5% of patients with asthma); 62,1% of these children had pulmonary hypertension (PH). 44,4% of patients with PH had evidence of pulmonary fibrosis (PF), which led to pneumatocele (PC) in 27,7%, polyserositis (PS) in 11,1% and spontaneous pneumothorax (SP) in 3,4% of patients.
Conclusions: 1. Close relationship between CTD and CAP is revealed. 2. In children up to 3 years old Cp CAP was more frequent, in children aged 4-18 - Mp CAP. 3. More than one-third of patients with asthma had recurrent CAP. 4. Asthma in children with CAP and CTD was more severe with development of PH, PF, PS, SP.
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