Chlamydial pneumonia in children requiring hospitalization

Effect of mixed infection on clinical outcome

Ming Han Tsai, Yhu Chering Huang, Chih Jung Chen, Pen Yi Lin, Luan Yin Chang, Cheng Hsun Chiu, Kuo Chien Tsao, Chung Guei Huang, Tzou Yien Lin

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The etiology of community-acquired pneumonia (CAP) in a children's hospital was studied among 209 previously healthy children treated from August 1, 2001 to July 31, 2002. A total of 26 children (12.4%) with a diagnosis of chlamydial infection were included in this study. The diagnosis of chlamydial infection was based on either a positive immunofluorescent assay result for chlamydial antigen in sputum, or positive serologic results for immunoglobulin M (IgM), an IgG titer ≥1:640 or a 4-fold rise in IgG titer by microimmunofluorescence test. Fourteen patients (53.8%) were female and 20 (76.9%) were less than 5 years of age. The onset of infection occurred between August and January in 21 cases (80.7%). Twenty one patients (80.8%) had other pathogens identified. Fever and cough were the most common presenting symptoms. The signs and symptoms were similar for the children with and without coinfection except for tachypnea and wheezing sound, which were significantly more common in patients with mixed infection. None of the laboratory parameters seemed to be specific for chlamydial infection; however, serum C-reactive protein level was significantly higher in cases with mixed infection. Among the 26 children, 12 (46.2%) needed respiratory therapy, and most of them (91.7%, 11/12) had coinfection. Two patients (7.7%) with mixed infection were admitted to the pediatric intensive care unit. One had lobar pneumonia with pleural effusion and the other had necrotizing pneumonia requiring surgical intervention. None of the patients died. In conclusion, Chlamydia sp. was identified in 12.4% of children with CAP in this series, and mixed infections were common (80.8%) among these patients. The clinical course of chlamydial pneumonia was not serious in most patients, but alertness is needed to the possibility of developing severe pneumonia in cases with bacterial coinfection.

Original languageEnglish
Pages (from-to)117-122
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume38
Issue number2
Publication statusPublished - Apr 2005
Externally publishedYes

Fingerprint

Chlamydial Pneumonia
Coinfection
Hospitalization
Pneumonia
Infection
Immunoglobulin G
Tachypnea
Respiratory Therapy
Pediatric Intensive Care Units
Chlamydia
Respiratory Sounds
Pleural Effusion
Sputum
Cough
C-Reactive Protein
Signs and Symptoms
Immunoglobulin M
Blood Proteins
Fever
Antigens

Keywords

  • Bacterial pneumonia
  • Chlamydia
  • Community-acquired infection
  • Hospitalization
  • Risk factors

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Immunology and Microbiology(all)

Cite this

Chlamydial pneumonia in children requiring hospitalization : Effect of mixed infection on clinical outcome. / Tsai, Ming Han; Huang, Yhu Chering; Chen, Chih Jung; Lin, Pen Yi; Chang, Luan Yin; Chiu, Cheng Hsun; Tsao, Kuo Chien; Huang, Chung Guei; Lin, Tzou Yien.

In: Journal of Microbiology, Immunology and Infection, Vol. 38, No. 2, 04.2005, p. 117-122.

Research output: Contribution to journalArticle

Tsai, MH, Huang, YC, Chen, CJ, Lin, PY, Chang, LY, Chiu, CH, Tsao, KC, Huang, CG & Lin, TY 2005, 'Chlamydial pneumonia in children requiring hospitalization: Effect of mixed infection on clinical outcome', Journal of Microbiology, Immunology and Infection, vol. 38, no. 2, pp. 117-122.
Tsai, Ming Han ; Huang, Yhu Chering ; Chen, Chih Jung ; Lin, Pen Yi ; Chang, Luan Yin ; Chiu, Cheng Hsun ; Tsao, Kuo Chien ; Huang, Chung Guei ; Lin, Tzou Yien. / Chlamydial pneumonia in children requiring hospitalization : Effect of mixed infection on clinical outcome. In: Journal of Microbiology, Immunology and Infection. 2005 ; Vol. 38, No. 2. pp. 117-122.
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abstract = "The etiology of community-acquired pneumonia (CAP) in a children's hospital was studied among 209 previously healthy children treated from August 1, 2001 to July 31, 2002. A total of 26 children (12.4{\%}) with a diagnosis of chlamydial infection were included in this study. The diagnosis of chlamydial infection was based on either a positive immunofluorescent assay result for chlamydial antigen in sputum, or positive serologic results for immunoglobulin M (IgM), an IgG titer ≥1:640 or a 4-fold rise in IgG titer by microimmunofluorescence test. Fourteen patients (53.8{\%}) were female and 20 (76.9{\%}) were less than 5 years of age. The onset of infection occurred between August and January in 21 cases (80.7{\%}). Twenty one patients (80.8{\%}) had other pathogens identified. Fever and cough were the most common presenting symptoms. The signs and symptoms were similar for the children with and without coinfection except for tachypnea and wheezing sound, which were significantly more common in patients with mixed infection. None of the laboratory parameters seemed to be specific for chlamydial infection; however, serum C-reactive protein level was significantly higher in cases with mixed infection. Among the 26 children, 12 (46.2{\%}) needed respiratory therapy, and most of them (91.7{\%}, 11/12) had coinfection. Two patients (7.7{\%}) with mixed infection were admitted to the pediatric intensive care unit. One had lobar pneumonia with pleural effusion and the other had necrotizing pneumonia requiring surgical intervention. None of the patients died. In conclusion, Chlamydia sp. was identified in 12.4{\%} of children with CAP in this series, and mixed infections were common (80.8{\%}) among these patients. The clinical course of chlamydial pneumonia was not serious in most patients, but alertness is needed to the possibility of developing severe pneumonia in cases with bacterial coinfection.",
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AB - The etiology of community-acquired pneumonia (CAP) in a children's hospital was studied among 209 previously healthy children treated from August 1, 2001 to July 31, 2002. A total of 26 children (12.4%) with a diagnosis of chlamydial infection were included in this study. The diagnosis of chlamydial infection was based on either a positive immunofluorescent assay result for chlamydial antigen in sputum, or positive serologic results for immunoglobulin M (IgM), an IgG titer ≥1:640 or a 4-fold rise in IgG titer by microimmunofluorescence test. Fourteen patients (53.8%) were female and 20 (76.9%) were less than 5 years of age. The onset of infection occurred between August and January in 21 cases (80.7%). Twenty one patients (80.8%) had other pathogens identified. Fever and cough were the most common presenting symptoms. The signs and symptoms were similar for the children with and without coinfection except for tachypnea and wheezing sound, which were significantly more common in patients with mixed infection. None of the laboratory parameters seemed to be specific for chlamydial infection; however, serum C-reactive protein level was significantly higher in cases with mixed infection. Among the 26 children, 12 (46.2%) needed respiratory therapy, and most of them (91.7%, 11/12) had coinfection. Two patients (7.7%) with mixed infection were admitted to the pediatric intensive care unit. One had lobar pneumonia with pleural effusion and the other had necrotizing pneumonia requiring surgical intervention. None of the patients died. In conclusion, Chlamydia sp. was identified in 12.4% of children with CAP in this series, and mixed infections were common (80.8%) among these patients. The clinical course of chlamydial pneumonia was not serious in most patients, but alertness is needed to the possibility of developing severe pneumonia in cases with bacterial coinfection.

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