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Clinical factors associated with focal infiltrates in wheezing infants and toddlers

E M Mahabee-Gittens1, M D Dowd, J A Beck

  • 1Children's Hospital Medical Center, Division of Emergency Medicine, Cincinnati, Ohio 45229-2899, USA.

Clinical Pediatrics
|July 29, 2000
PubMed

Insights

Grunting and low oxygen saturation (≤93%) in wheezing infants are key indicators of focal infiltrates on chest X-rays, aiding pneumonia diagnosis. This finding helps differentiate serious lung conditions in young children.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Radiology

Background:

  • Diagnosing focal infiltrates in young wheezing children presents a clinical challenge.
  • Focal infiltrates on chest radiography are observed in 23% of wheezing children under 18 months.

Purpose of the Study:

  • To identify clinical findings associated with focal infiltrates in young wheezing children.
  • To improve the diagnostic accuracy for pneumonia in infants and toddlers presenting with wheezing.

Main Methods:

  • Prospective study involving wheezing children aged 18 months or younger.
  • Multivariate analysis to determine significant associations with focal infiltrates on chest radiograph.

Main Results:

  • Grunting (OR 4.1) and oxygen saturation ≤93% (OR 2.2) were significantly associated with focal infiltrates.
  • The combination of grunting and oxygen saturation ≤93% demonstrated high specificity (97%) for pneumonia.
  • First-time wheezing, fever, and tachypnea were not significantly associated with focal infiltrates.

Conclusions:

  • Grunting and low oxygen saturation are valuable clinical signs for diagnosing pneumonia in wheezing infants.
  • These findings can assist clinicians in identifying pneumonia in young children with wheezing, reducing diagnostic uncertainty.

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