Hamza YAZGAN, Zerrin YAZGAN, Ahmet Ruhi TORAMAN, Mehmet DEMİRDÖVEN, Muzaffer ÇAKMAK, Ahmet GÜREL

Pandemik inflüenza ön tanısı ile hastaneye yatırılan çocuk hastaların klinik sonuçları

Bu çalışma; pandemik influenza A (H1N1) düşünülerek hastaneye yatırılan çocuk hastaların risk faktörleri, klinik durumları ve sonuçlarının değerlendirilmesi amacı ile planlandı. Kasım ve Aralık 2009’da Hastanemiz Çocuk Hastalıkları Polikliniği’ne grip semptomları ile başvuran 503 olgudan 42 tanesinin hastaneye yatırıldığı tespit edildi. Bu hastaların risk faktörleri, semptomları, hastaneye yatış nedenleri, klinik seyir ve sonuçları retrospektif olarak incelendi. H1N1 tanısı için nazofarinks sürüntüsünden real-time revers transkriptaz-polimeraz zincir reaksiyonu (RT-PCR) yöntemi kullanıldı. 42 olgunun 19’u erkek (%45.2), 23’ü bayan(%54.8) idi. Hastaların yaş ortalaması 8,8 yıl idi (altı ay-17 yaş arasında). 28 hastanın PCR sonucu pozitif (%66.6), 14 hastada ise PCR negatif (33.4) idi. Risk sorgulamasında; astım 12 (%28.5), serbral palsi iki (%4.76), bir yaştan küçük iki (%4.76), konjenital kalp hastalığı olan Down sendromlu bir (%2.38) hasta vardı. 25 hastada ise (%59.5) herhangi bir risk faktörü saptanmadı. Hastaneye yatış tanıları; akut bronşiolit 15 (%35.7), akut farenjit ve genel durum bozukluğu 12 (%28.6), pnömoni sekiz (%19), akut sinüzit üç (%7), akut gastroenterit iki (%4.7) ve febril konvulsiyon iki (%4.7) idi. Tüm hastalara oseltamir başlandı. Hastanede yatış süresi ortalama beş gün (2-8 gün) idi. Bir hasta da yoğun bakım ve mekanik ventilasyona ihtiyaç oldu. Ölen hastamız olmadı. Yeni pandemik influenza A iç in risk grubundaki hastaların yakın takibi ve özellikle gelişebilecek sekonder enfeksiyonların erken tedavisi mortalite riskini azaltmaktadır.

Clinical outcomes of children admitted with admission diagnosis of pandemic influenza

This study was designed to review the risk factors, clinical status and clinical outcomes of patients with an admission diagnosis of pandemic influenza A. Out of 503 patients seen at our hospital’s outpatient Pediatric Unit for flu symptoms between November and December 2009, 42 were admitted. These 42 patients’ risk factors, symptoms, reasons for admission, clinical treatment course and clinical outcomes were analyzed retrospectively. H1N1 was diagnosed using the real-time Reverse Transcriptase-Polymerase Chain Reaction Method (RT-PCR) in nasopharyngeal swabs. Of the 42 patients included in the study, 19 were male (45.2%) and 23 were female (54.8%). The mean age was 8.8 years (patient ages range from six months to 17 years of age). 28 patients were PCR positive (66.6%) and 14 were PCR negative (33.4%). Investigation of risk factors revealed 12 patients with asthma (28.5%), two with cerebral palsy (%4.76), up until one years old children two (%4.76), and one Down Syndrome patient with congenital heart disease (%4.76). No risk factors were identified for 25 patients (59.5%). Admission diagnoses included 15 patients with acute bronchiolitis (35.7%), 12 with acute pharyngitis and general poor health (28.6%), eight with pneumonia (19%), three with acute sinusitis (7%), two with acute gastroenteritis (4.7%) and two with febrile seizures (4.7%). All patients were given oseltamir at admission. The average length of stay was five days (ranging from 2-8 days). One patient required mechanical ventilator and intensive care services. There were no mortalities in the study group. In the event of a new pandemic influenza, patients in the risk groups identified may experience lower risk of mortality if provided with close monitorization and early treatment of potential secondary infections.

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