The Pediatric infectious disease journal
-
Pediatr. Infect. Dis. J. · Jan 1995
Respiratory rate and signs in roentgenographically confirmed pneumonia among children in China.
A clinical study was conducted in three Chinese community hospitals to investigate the reliability of respiratory rate and various clinical signs in the diagnosis of pneumonia among 54 children less than 5 years of age. Anteroposterior chest film was used as the diagnostic standard. The cutoff criterion for rapid breathing was 50 breaths/minute for infants ages 2 to 11 months and 40/minute in children 1 to 5 years old. ⋯ Nasal flaring, chest indrawing, stridor and cyanosis of the tongue had predictive values of > 86%, but these clinical signs were observed in only a small proportion of patients. We recommend that village health workers use rapid breathing for diagnosis of pneumonia, rather than auscultation which is difficult and has proved unreliable. Sensitivity, specificity and positive and negative predictive values are presented for seven signs and symptoms of pneumonia.
-
Pediatr. Infect. Dis. J. · Jan 1995
Acute pyelonephritis as a cause of hyponatremia/hyperkalemia in young infants with urinary tract malformations.
Obstructive uropathy causes tubular resistance to aldosterone and severe metabolic imbalance may be precipitated by an episode of pyelonephritis. In the last 3 years we investigated 52 episodes of pyelonephritis (positive urine culture, elevated C reactive protein, fever, elevated neutrophil count) in 50 children between 15 days and 15 months of age. Ultrasonography voiding cystography and renal scintiscan were performed in all cases and i.v. urography in some. ⋯ Thirteen infants < 3 months, 7 with no urinary tract malformations, did not have electrolyte imbalance. Pyelonephritis was diagnosed in 20 other patients ages 4 to 15 months, including 16 with severe UT malformations; 4 had normal UTs. We conclude that a salt-losing syndrome with tubular resistance to aldosterone can occur during pyelonephritis in young infants with congenital UT malformation, that the risk diminishes considerably or disappears after 3 months of age and that in the absence of UT malformation pyelonephritis does not cause acute sodium loss of clinical relevance.