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Radiographic Pneumonia in Febrile Infants 60 Days and Younger
Todd A Florin1, Octavio Ramilo2, John D Hoyle3
1From the Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago & Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Pediatric Emergency Care
|July 24, 2020
Summary
Radiographic pneumonia is uncommon in febrile infants under 60 days old. Ill appearance was a key predictor, while viral infections were frequent, but other factors like lab markers showed unclear significance.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Radiology
Background:
- Prospective studies on radiographic pneumonia in young febrile infants are limited.
- Early identification of pneumonia in infants is crucial for timely treatment and management.
- Understanding predictors of pneumonia can aid clinical decision-making in pediatric emergency settings.
Purpose of the Study:
- To assess the occurrence of radiographic pneumonia in febrile infants 60 days or younger.
- To identify factors associated with radiographic pneumonia in this population.
- To analyze the role of clinical appearance, laboratory markers, and viral testing.
Main Methods:
- Secondary analysis of a prospective cohort study in 26 pediatric emergency departments (2008-2013).
- Inclusion of febrile infants (≥38°C) aged 60 days or younger who underwent chest radiography.
- Categorization of chest radiograph reports (no, possible, definite pneumonia) and comparison of demographics, Yale Observation Scale scores, lab markers, and viral testing.
Main Results:
- Radiographic pneumonia was uncommon: 2.7% definite and 3.9% possible pneumonia among 1724 infants with radiographs.
- Ill appearance (Yale Observation Scale >10) was significantly associated with definite or possible pneumonia (28.3% vs 22.7% vs 13.2%).
- Viral infections were more frequent in infants with definite (65.8%) or possible (50.9%) pneumonia compared to those without (45.1%).
Conclusions:
- Radiographic pneumonia is infrequent in febrile infants aged 60 days or younger.
- Ill appearance is a notable predictor, while viral detection is common in these cases.
- Few other clinical or laboratory factors reliably predicted radiographic pneumonia in this age group.
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