Abstract
Objective: High rates of connective tissue disorders (CTD) among children modify clinical course of community-acquired pneumonia (CAP) in pediatric patients that leads to diagnosis and therapeutic mistakes.
Aim: To study role of CTD in CAP clinical course in children.
Methods: 171 children aged 0-18 years with CTD and CAP were observed. CAP was clinically and radiographically diagnosed with detection of serum antibodies (IgG and IgM) against intracellular pathogens measured by enzyme-linked immunosorbent assay (ELISA) and PCR.
Results: Recurrent course of CAP (with 3 and more episodes in 5-year period of study) was in 106 (61,9%) patients and in all cases followed a viral respiratory infection. 156 (91,2%) children had abnormal perinatal history. Asthma (A) was diagnosed in 59 (34,5%) children. CAP caused by Mycoplasma pneumonia (Mp) was in 88 (51,5%) patients; by Cytomegalovirus (Cmv) and Mp – in 42 (24,5%); by Chlamydia pneumonia (Cp) – in 18 (10,5%); by Cp and Mp – in 33 (13,5%) patients. 78% of patients with A, CTD and CAP and 53,6% of patients with CTD and CAP had pulmonary hypertension (PH). 76,4% of patients with recurrent CAP demonstrated radiographic and clinical evidence of pulmonary fibrosis (PH), 30,2% of them had A. 12,5% of children with A, CTD, recurrent CAP and PF had CT evidence of development of pneumatocele (PC).
Conclusions: 1. Manifestations of CTD were in all children with CAP. 2. All patients with CTD and recurrent CAP had abnormal perinatal history. 3. High frequency of PH and PF was observed in patients with CTD and recurrent CAP. 4. 12,5% of children with A, recurrent CAP, CTD and PF had evidence of development of PC.
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