Bursa Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğine tekrarlayan pnömoni nedeniyle yatışı yapılan çocuk olguların retrospektif değerlendirilmesi
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Date
2022
Authors
Çetiner, Şükran
Journal Title
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Publisher
Bursa Uludağ Üniversitesi
Abstract
Bursa Uludağ Üniversitesi Çocuk Enfeksiyon Hastalıkları Bilim Dalında 25 Mayıs 2017 ve 25 Mayıs 2022 tarihleri arasında tekrarlayan pnömoni nedeniyle yatışı yapılan 152 olgu retrospektif olarak incelenmiştir. Tekrarlayan pnömoni kriterleri ile uyumlu olan olguların yaş ortalaması 21,36 ± 16,61 ay ve %52’si erkek cinsiyetti. Olguların %44,7’sinde vücut ağırlığı <3 persentil altındaydı. Olguların %27,6’sında prematürite öyküsü ve %12,5’inde bronkopulmoner dizplazi (BPD) saptandı. Altta yatan hastalık olguların %92,7’sinde mevcut olup en sık %30,’unda nörolojik hastalık, %15,7’sinde konjenital kalp hastalığı (KKH) ve %12,5’inde gastroözefageal reflü (GÖR) mevcuttu. En sık başvuru yakınması %73 oranında öksürüktü. Hastalardan alınan kan örneklerinde %25,6’inde lökositoz ve %50’sinde CRP yüksekliği saptandı. Kan kültüründe %11,2’inde üremesi olup, %3,9’ünde Staphylococcus hominis saptanmıştı. Solunum PCR testi %32,2’sinde pozitif olup en sık etken %44,8 oranında Rinovirüs’tü. İnfiltrasyon bulgusu olguların %85,5’ünde göğüs grafisinde ve %79,2’sinde toraks bilgisayarlı tomografisinde (BT) saptandı. Yoğun bakım ünitesine (YBÜ) 24 olgu (%15,8) yatırıldı, %8,6’sı entübe edildi ve %9,2’si eksitus oldu. Birden fazla hastalık bulunan grupta boy uzunluğu ve vücut ağırlığı <3 persentil olan olguların sıklığının, birden fazla hastalığı olmayan gruba göre istatistiksel olarak anlamlı düzeyde daha fazla olduğu saptandı (p<0,05). Olguların semptom başlama yaşı ile tanı yaşı arasındaki korelasyona bakıldığında istatistiksel olarak anlamlılık göstermektedir (p<0,001). Altta yatan hastalık varlığı ile olguların geçirdikleri pnömoni atak sayısı arasındaki ilişkiye bakıldığında kistik fibrozis (KF) (p<0,001), aspirasyon sendromu (p=0,007) ve tüberkülozlu (TB) (p=0,003) olguların ortalama atak sayısı daha yüksek bulunmuştur.
In our study 152 patients that hospitalized for recurrent pneumonia between 25 May 2017 and 25 May 2022, in Bursa Uludağ University, Department of Pediatric Infectious Diseases were retrospectively analyzed. The mean age of patients who were diagnosed with the criteria for recurrent pneumonia was 21.36 ±1 6.61 months and 52% of them were male. Body weight in 44.7% was <3 percentile. 27.6% of the cases were premature and 12.5% of the cases were diagnosed as bronchopulmonary dysplasia (BPD). The underlying diseases were present in 92.7% of the cases, and the most common was neurological diseases (30.9%), congenital heart disease (CHD) in 24 (15.7%) and gastroesophageal reflux (GER) in 19 (12.5%) had bronchial asthma. The most frequent reason for hospital admission was cough with a rate of 73%. In the blood samples taken from the patients, leukocytosis was found in 25.7% and elevated CRP levels in 50%. İn 11.8% of the blood cultures pathogen microornganisms were detected and 3.9% of them was Staphylococcus hominis. Respiratory Viral PCR test was positive in 32.2% of the cases and the most common cause of viral pnömonia was Rhinovirus with a rate of 44.8%. İn all cases there were signs of infiltration on 84.5% of chest X-ray and 79.2% of thorax computed tomography (CT). 24 of the cases (15.8%) were admitted to the intensive care unit (ICU), 8.6% were intubated and 9.2% died. The cases with more than one underlying diease, the height and body weigh was found to be <3 percentile, and its statistically significantly higher than the other group (p<0.05). The correlation between the age of symptom onset and the age of diagnosis shows statistical significance (p<0.001). Considering the relationship between the presence of the underlying disease and the number of pneumonia attacks, the mean number of attacks per cases with cystic fibrosis (CF) (p<0.001), aspiration syndrome (p=0.007) and tuberculosis (TB) (p=0.003) was found to be higher.
In our study 152 patients that hospitalized for recurrent pneumonia between 25 May 2017 and 25 May 2022, in Bursa Uludağ University, Department of Pediatric Infectious Diseases were retrospectively analyzed. The mean age of patients who were diagnosed with the criteria for recurrent pneumonia was 21.36 ±1 6.61 months and 52% of them were male. Body weight in 44.7% was <3 percentile. 27.6% of the cases were premature and 12.5% of the cases were diagnosed as bronchopulmonary dysplasia (BPD). The underlying diseases were present in 92.7% of the cases, and the most common was neurological diseases (30.9%), congenital heart disease (CHD) in 24 (15.7%) and gastroesophageal reflux (GER) in 19 (12.5%) had bronchial asthma. The most frequent reason for hospital admission was cough with a rate of 73%. In the blood samples taken from the patients, leukocytosis was found in 25.7% and elevated CRP levels in 50%. İn 11.8% of the blood cultures pathogen microornganisms were detected and 3.9% of them was Staphylococcus hominis. Respiratory Viral PCR test was positive in 32.2% of the cases and the most common cause of viral pnömonia was Rhinovirus with a rate of 44.8%. İn all cases there were signs of infiltration on 84.5% of chest X-ray and 79.2% of thorax computed tomography (CT). 24 of the cases (15.8%) were admitted to the intensive care unit (ICU), 8.6% were intubated and 9.2% died. The cases with more than one underlying diease, the height and body weigh was found to be <3 percentile, and its statistically significantly higher than the other group (p<0.05). The correlation between the age of symptom onset and the age of diagnosis shows statistical significance (p<0.001). Considering the relationship between the presence of the underlying disease and the number of pneumonia attacks, the mean number of attacks per cases with cystic fibrosis (CF) (p<0.001), aspiration syndrome (p=0.007) and tuberculosis (TB) (p=0.003) was found to be higher.
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Keywords
Tekrarlayan pnömoni, Alta yatan hastalıklar, Çocukluk dönemi, Recurrent pneumonia, Underlying diseases, Childhood
Citation
Çetiner, Ş. (2022). Bursa Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğine tekrarlayan pnömoni nedeniyle yatışı yapılan çocuk olguların retrospektif değerlendirilmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.