Community acquired pneumonia and its complications in children in a tertiary care hospital

Background: Community acquired Pneumonia (CAP) can be defined clinically as the presence of signs and symptoms of pneumonia in a previously healthy child caused by an infection acquired outside a hospital. CAP is a substantial cause of childhood morbidity and mortality throughout the world. We studied the clinical features, laboratory findings, radiological features of CAP and its complications in children admitted to a tertiary care hospital. Material And Methods: This is a retrospective observational study of 50 children aged 2 months to 14 years admitted under Paediatric care at a tertiary care hospital in Mumbai between Jan 2014 to April 2015. Pneumonia was diagnosed based on evidence of consolidation on chest radiograph and lor presence of clinical findings suggestive of pneumonia. Results: The mean age of children was 4.5 years with range from 4 months to 13 years. Male to Female ratio was 0.98:1. 16 children had pre-existing risk factors. 65% children had history of fever? 5 days with tachypnea noted in 3 2 % children and 2 0 % had SP02 < 95%. Tachypnea was noted in 32 % of children. As per WHO clinical classification, the distribution of pneumonia as very severe pneumonia, severe pneumonia; pneumonia; and no pneumonia was 4%,2%, 32% , 62% respectively. However 42% of children as no pneumonia as per WHO criteria had evidence of pneumonia on chest radiograph and remainder 20% had clinical findings on auscultation. 80% of study subjects had evidence ofpneumonia on chest radiograph. Average length of hospital stay was 7.2 days. A l l children were started on intravenous antibiotics. Complications developed in 5 patients. 4% of patients died in our study which co-relates with the outcome in developed nation. Conclusion: Community acquired pneumonia has been on the decline in developed countries due to newer vaccines, anti-microbial therapy, advances in diagnostic modalities and excellent access to healthcare; childhood pneumonia still remains a major cause of morbidity and mortality in developing countries.