Community acquired pneumonias in the University Hospital of Salamanca

Abstract

Introduction. Community acquired pneumonia is an important cause of morbidity and mortality in children, with an annual global incidence in developed countries of 14.5 cases per 100,000 inhabitants between 0 and 16 years old.
Materials and methods. Cross-sectional observational study, between September 2013 and August 2014.
Results. The sample size was 107 patients, 51% of whom required hospitalization, 25% of them with atypical pneumonia caused by Mycoplasma pneumoniae. In the clinical analysis, 86% presented with fever, 9% of cases were associated with abdominal pain, and in 1% of the cases abdominal pain was the only manifestation. 50% of the radiographs showed an alveolar pattern. An etiologic diagnosis was obtained in 27% of the patients. 34% of the patients received empirical antibiotic therapy for atypical pneumonia and 45% of the patients were treated for typical pneumonia. In this last group, it was necessary to add macrolides afterwards in 46% of the cases
due to a lack of clinical improvement. 50% of the serologies performed were Mycoplasma IgM-positive (19% of the total sample). In that group, 43% of them were initially treated as typical pneumonia, and in 77% of the cases it was necessary to add macrolides due to the persistence of the clinical symptoms.

Conclusions:
– A higher incidence of hospitalized patients with pneumonia caused by Mycoplasma was observed, compared ith the 2 previous years.
– Atypical pneumonia may present with the criteria of typical neumonia. In these patients, an empirical treatment hould be considered for both etiologies.
– If a patient with suspicion of typical pneumonia and an dequate empirical treatment shows a poor evolution, an nfection must be suspected, or antibiotics for Mycoplasma ust be added in the context of an epidemic outbreak.