Related Experiment Videos
Simple clinical signs of lower respiratory infection
N Usha1, S Katariya, B N Walia
1Department of Pediatrics and Radiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Insights
This study found that elevated respiratory rates are the most reliable clinical sign for diagnosing paediatric lower respiratory infection (LRI). Chest indrawing and nasal flaring indicate more severe LRI cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Diagnostic Accuracy
Background:
- Paediatric lower respiratory infection (LRI) is a common cause of childhood illness.
- Accurate and timely diagnosis of LRI is crucial for effective management.
- Simple clinical signs are often used for initial assessment in outpatient settings.
Purpose of the Study:
- To evaluate the diagnostic reliability of simple clinical signs for paediatric lower respiratory infection (LRI).
- To identify the most accurate clinical indicators for LRI in infants and children.
Main Methods:
- A prospective study involving 70 infants and 148 children with cough duration less than 15 days.
- Clinical examination by a pediatrician using a standardized proforma for LRI signs.
- Comparison of clinical findings with chest X-ray interpretations by a blinded radiologist.
Main Results:
- Receiver-operating-characteristic (ROC) curve analysis identified respiratory rates >40/min (infants) and >30/min (children) as the best indicators of LRI.
- Chest indrawing and nasal flaring were associated with moderate to severe LRI.
- The study assessed the diagnostic performance of various clinical signs against radiographic confirmation.
Conclusions:
- Elevated respiratory rate is a highly reliable clinical sign for diagnosing paediatric lower respiratory infection (LRI).
- Specific clinical signs like chest indrawing and nasal flaring correlate with disease severity.
- These findings can aid clinicians in the accurate diagnosis and assessment of LRI in children.
Abstract:
We studied the reliability of some simple clinical signs in the diagnosis of paediatric lower respiratory infection (LRI). Seventy infants and 148 children attending the outpatient department for cough of less than 15 days duration were studied. These children were examined by a paediatrician, and a proforma of simple clinical signs of LRI was filled in. A chest X-ray was taken on the same day and interpreted by a radiologist who did not know the clinical features of the patient. Clinical signs were then compared with X-ray changes, the latter being taken to indicate the presence of LRI. Respiratory rates of greater than 40/min in infants and greater than 30/min in older children were found to be the best indicators of LRI as revealed by a receiver-operating-characteristic curve. Chest indrawing and nasal flaring were found to be associated with moderate and severe disease.