Bacterial pneumonia: Diagnostic scale Neumonía bacteriana: Escala diagnóstica

Abstract

Pneumonia is an important cause of morbidity and mortality in childhood. The differentiation between bacterial and non-bacterial can generate difficulties for the clinician. The scale of Laura Moreno combines clinical, radiological and laboratory aspects with a sensitivity of 1100% and specificity of 93.9% in the diagnosis of bacterial pneumonia. Objective: to describe the concordance observed in the diagnosis of bacterial pneumonia, by applying a prediction scale applied by the pediatrician and the radiologist compared with the clinical diagnosis, in the patients of the pediatric service of the Hospital of San José. Methodology: children with ages ranging from one month to five years, hospitalized with a diagnosis of pneumonia in the period from September 1 to November 30, 2007, were studied. Seventy-three patients who met the inclusion criteria were analyzed. Results: according to the clinical diagnosis, 52 patients had NB, 18 viral pneumonia and three were not classified on admission. The frequency according to sex was 31 (42%) for girls; the most frequent symptom was cough 72 (98%); The common radiological finding was the well-defined infiltrate 27 (37%). The degree of agreement between radiologist and pediatrician was good (k = 0.77) and that observed between the scale and the clinical diagnosis was low (k = 0.19). Conclusions: the data found when applying the Laura Moreno scale create the question of whether we are overdiagnosing bacterial pneumonias, which should be a stimulus for new studies in our population. Abbreviations: NB, bacterial pneumonia; NAC, pneumonia acquired in the community.