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The Causes of Hospital-Treated Acute Lower Respiratory Tract Infection in Children

Hanna Nohynek, MD; Juhani Eskola, MD; Eija Laine, MD; Pekka Halonen, MD; Petri Ruutu, MD; Pekka Saikku, MD; Marjaana Kleemola, MD; Maija Leinonen, PhD
Am J Dis Child. 1991;145(6):618-622. doi:10.1001/archpedi.1991.02160060036016.
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• Objective:  To determine the etiologic agents in children with acute lower respiratory infection.

Design:  A survey of a series of patients.

Setting:  General pediatric hospital serving an urban population with and without referrals in Helsinki, Finland. Participants: 135 Finnish children aged 2 months to 15 years (mean, 1.75 years), with clinically defined acute lower respiratory infection (with difficulty of breathing), or found to ave fever and a pneumonic infiltrate on chest roentgenogram.

Selection Procedures:  Consecutive sample on voluntary basis.

Interventions:  None.

Main Results:  Of 121 children with adequate samples, an etiologic diagnosis could be established in 84 (70%): 30 (25%) had bacterial, 30 (25%) viral, and 24 (20%) mixed infections. Antibody assays alone identified the agent in 91% of positive cases.

Conclusions:  Bacterial infections are common but generally underestimated in acute lower respiratory infection; serologic methods add significantly to their detection.(AJDC. 1991;145:618-622)


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