Empyema and bacteremic pneumococcal pneumonia in children under five years of age.

We compared bacteremic pneumococcal pneumonia (BPP) and pneumococcal empyema (PE), in terms of clinical, radiological, and laboratory findings, in under-fives. A cross-sectional nested cohort study, involving under-fives (102 with PE and 128 with BPP), was conducted at 12 centers in Argentina, Brazil, and the Dominican Republic. Among those with PE, mean age was higher; disease duration was longer; and tachypnea, dyspnea, and high leukocyte counts were more common.

[Evaluation of two standardized methods for chest radiographs interpretation in children with pneumonia].

Objective: To evaluate the accuracy of World Health Organization (WHO) method of interpreting chest radiographs on identifying young children with bacterial pneumonia, and to compare its accuracy with other method.

Methods: Chest radiographs from children aged under 5 years old hospitalized for pneumonia, with microbiological evidence of bacterial or viral infection, were evaluated by 3 observers blinded to other data (pediatrician [P], pulmonologist [N], radiologist [R]) according to WHO and Khamapirad scores. A WHO score=1 and a Khamapirad score >2 were selected as the thresholds suggesting bacterial pneumonia.

Penicillin-resistant pneumococcus and risk of treatment failure in pneumonia.

Objective: To determine whether the presence of in vitro penicillin-resistant Streptococcus pneumoniae increases the risk of clinical failure in children hospitalised with severe pneumonia and treated with penicillin/ampicillin.

Design: Multicentre, prospective, observational study.

Setting: 12 tertiary-care centres in three countries in Latin America.

Integrated management of childhood illness: an emphasis on the management of infectious diseases.

The Integrated Management of Childhood Illness (IMCI) strategy has helped strengthen the application and expand coverage of key child survival interventions aimed at preventing deaths from infectious disease, respiratory illness, and malnutrition, whether at the health services, in the community, or at home. IMCI covers the prevention, treatment, and follow-up of the leading causes of mortality, which are responsible for at least two-thirds of deaths of children younger than 5 years in the countries of the Americas. The IMCI clinical guidelines take an evidence-based, syndrome approach to case managment that supports the rational, effective, and affordable use of drugs and diagnostic tools.

Childhood pneumonia: clinical aspects associated with hospitalization or death.

Objective: To determine which available information at an Emergency Room (ER) consultation is associated with hospitalization or death among children with pneumonia.

Design: Prospective cohort study.

Setting: The ER of one university and one private hospital.

Effects of socioeconomic status on presentation with acute lower respiratory tract disease in children in Salvador, Northeast Brazil.

Two different socioeconomic groups of children with pneumonia were studied, and their clinical and demographic aspects were evaluated. The diagnosis of pneumonia was based on findings of cough and tachypnea, or on crackles on auscultation or on radiologically confirmed infiltrate. This was a prospective cross-sectional study conducted at the Professor Hosannah de Oliveira Pediatric Center, which cares for children of lower socioeconomic status (PHOPC), and at one private hospital which cares for children from middle to high socioeconomic status (Aliança Hospital, AH).