Community-acquired pneumonia and parapneumonic effusions in developing countries.

Ninety-eight patients with diagnosis of community-acquired pneumonia and parapneumonic effusion were retrospectively evaluated in order to determine the demographic properties of the patients, etiologic microorganism and the resistance patterns. Ages of study groups were between 2 to 16 years (mean 6.5 +/- 3.5 years) and 56 of 98 patients (56%) were male. There were four groups: Pneumonia (Group 1, n: 57), pleural effusion-medical treatment (Group 2, n: 18), pleural effusion-tube thoracostomy (Group 3, n: 19), and pleural effusion-operative treatment (Group 4, n: 4). Pre-admission antibiotic use was up to 84% in study groups. Evaluation of seasonal dispersion revealed that 86.7% of patients were admitted to hospital in the October-May period. Blood cultures were positive in 4 of 98 patients (4%). Nine of 27 (33.3%) pleural effusion cultures were positive and 4 of them revealed Streptococcus pneumoniae. Intermediate penicillin resistance was found in 1/4 of S. pneumoniae isolates (25%). Our study illustrates the problems in the diagnosis and management of pediatric respiratory tract infections in developing countries. Chest X-ray together with erythrocyte sedimentation rate (ESR) was also shown to be important in classifying lower respiratory tract infections. Increase in the usage of specific viral serologic studies will probably lower the percentage of antibiotic usage and lower the costs of cultures.