بررسی بیماران بستری به علت پنومونی در بیمارستان حضرت علی‌اصغر(ع) در مدت 3 سال

ABSTRACT Acute respiratory infections (ARI) are a leading cause of childhood illness and death. In most countries, ARI occurs more frequently than other acute illnesses, including diarrhea and tropical disease. WHO estimates that in 1990, ARI caused 4.3 million death in this age group. Pneumonia is responsible for the majority of these deaths. The type and severity of the illness are influenced by several factors including age, season of the year, immune status of the host and Enviromental factors. Most cases of pneumonia are caused by microorganisms but a number of noninfectious causes sometimes, need to be considered, these non infectious causes include but are not limited to aspiration of food or gastric acid, foreign bodies, hypersensitivity reactions, and drug induced pneumonitis. This study was done retrospectively by the study of case records during 1990-1993. 457 cases were hospitalized with primary diagnosis of pneumonia. Diagnosis was made by physical examination, result of chest radiography and culture of blood, urine, and respiratory tract secretions. Description of cases: Of 457 cases that met the criteria for inclusion, age distribution: 0-3 month 147 cases, 4 month-5years 266 cases and 6-16 years 44 cases. Sex distribution male 273 cases, female 184 cases. 30 cases were hospitalized with recrrent pneumonia, in 14 cases there were no definitive cause and in others, asthma, cerebral palsy, gastroesophageal reflux, foreign body, lymphoblastic leukemia esophageal atresia and convulsion were found. the symptoms of the disease by their prevalence were as follows: cough, increased respiratory rate per minute, respiratory distress, poor feeding, vomiting, lethargy and cyanosis. Growth & development. 75% of patients had some degrees of FTT. Temperature. 58.5% of patients had high temperature. Respiratory Rate per minute was increased in 80.1%. Lab test: ESR was elevated in 66%., Bandemia were seen in 147 cases, and cultures were positive in 78 cases asfollow: blood culture in 24 cases, urine in 24 cases, CSF in 9 cases, eye, ear, pustules, respiratory secretions and stool culture in 21 cases were positive. ABG was done and 37 cases had hypoxia and 39 cases had metabolic acidosis. The results of chest radiography finding was diffuse infiltration in all three age groups. Antibiotic treatment was done in 373 cases, and duration of treatment was equal or less than 14 days in (95.7%), and more than 14 days in (4.3%). Mortality rate of pneumonia in this study was 31 cases (7%) because of young age and FTT. As life threatening lower respiratory tract infections do occur especially among infants younger than three months and those with underling conditions such as FTT (that were seen in this study), With appropriate antibiotic therapy instituted early in the course of the illness the mortality rate during infancy and childhood can be reduced.