Kamil ŞAHİN, Murat ELEVLİ, Ayhan KOÇAK, Funda ATASH, Esma YÜCETAŞ, Cihan COŞKUN

Çocuklarda viral ve bakteriyel pnömoniyi ayırmada laboratuvar değerlendirmeleri arasındaki ilişki

Amaç Alt solunum yolu (ASY)' nun temel enfeksiyonları; bronşiyolit ve pnömonidir. Çalışmamızdaki amacımız akciğer grafi bulgularına göre sınıflanmış viral-bakteriyel ASY enfeksiyonlarının ayırımında, labaratuvar değerlerinin önemini saptamaktır. Gereç ve Yöntem Hastanemizde 2017 yılında, ASY enfeksiyonu tanısı almış hastalar, akciğer grafi bulgularına göre radyoloji uzmanı tarafındandört gruba ayrıldı ve bu bulgulara göre viral veya bakteriyel ASY enfeksiyonu olarak sınıflandı. Hastaların c reaktif protein (CRP), lökosit, trombosit, hematokrit, nötrofil, lenfosit, nötrofil/lenfosit ve ortalama trombosit hacmi oranları istatistik yöntemlerle karşılaştırılarak, akciğer grafisi ve labaratuvar bulguları arasında korelasyon istatistik yöntemlerle saptandı. Bulgular Çalışmaya dahil edilen 344 hastanın akciğer grafi bulgularına göre lober segmental ve yoğun yamalı ve peribronşiyal infiltrasyonu olan 43 adedi bakteriyel, yamalı-peribronşiyal infiltrasyonu olan veya grafileri normal bulunan 301 ASY enfeksiyonu viral olarak değerlendirildi. Viral ve bakteriyel grup arasında sadece CRP değerleri arasında istatistiksel fark bulduk (p=.0,034). Sonuç Toplumdan kazanılmış pnömonilerde, yatan hastalarda yaptığımız çalışmada, viral bakteriyel ASY enfeksiyonu ayırımında akciğer grafisi ile CRP nin arasında anlamlı ilişki görülmüştür. Çocuklarda, CRP değerindeki yükseklik, pnömoni tedavisinde ampirik antibiyotik başlama kararını vermede, akciğer grafisindeki bakteriyel bulguları destekleyen değerli bir göstergedir.

Anahtar Kelimeler:

antibiyotik, bronşiyolit, c reaktif protein, çocuk, pnömoni

The relationship between laboratory evaluations in the separation of viral and bacterial pneumonia in children

Abstract Objective Basic infections of the lower respiratory tract (LRT) are bronchiolitis and pneumonia in children. The aim our study that determines the guiding laboratory parameters in discriminating between bacterial and viral LRT infections. Materials and Methods The patients who were diagnosed with LRT infection were divided into four groups based on the findings of chest radiography by radyologist in 2017. Their disease was classified as either viral or bacterial LRT infection in line with these findings. A correlation between chest radiography and laboratory findings was found by comparing c reactive protein (CRP), leukocyte, platelet, hematocrit, neutrophil, lymphocyte, neutrophil / lymphocyte and mean platelet volume (MPV) ratios using statistical methods. Results Of 344 patients included in the study, 43 patients with lober segmental, dense-patched and peribronchial infiltration and 301 patients with patched-peribronchial infiltration or normal radiography were evaluated as bacterial and viral according to the findings of chest radiography, respectively. We found a statistically significant difference in only CRP values between the viral and bacterial groups (p = 0.034). Conclusion It is seen that CRP supports the findings of chest radiography in discrimination of the bacterial cause in community-acquired LRT infections. In children, the elevation in CRP value can be a valuable indicator in supporting bacterial chest radiography finding and deciding to start empirically antibiotic treatment of pneumonia.

Keywords:

antibiotic, bronchiolitis, c reactive protein, children, pneumonia,

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