DOI: 10.36347/sjams.2021.v09i04.018

Pages: 578-582

Introduction: Pneumonia is an inflammation of the parenchyma of the lungs. It is usually caused by viruses or bacteria. Most serious episodes are caused by bacteria. Pneumonia is classified as very severe, severe and non-severe based on the clinical features with specific treatment for each of them. Children with severe and very severe pneumonia require hospital admission for their treatment. Methods: We did a prospective observational cohort study at Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh over a 6-month period (December 2012 to May 2013) on 150 children below 5 years of age admitted with clinical pneumonia. Data was collected from the legal guardians by interview and by physical examination of the child and from investigation reports. Results: Our study included 150 children admitted with clinical pneumonia, 100(66.7%) patients were male and 50(33.3%) were female. Male to female ratio was 2:1. The most sensitive and specific signs and symptoms for prediction of pneumonia were cough, tachypnoea and chest wall indrawing. We found that presence of tachypnoea and lower chest wall indrawing can detect most cases of pneumonia. All the children had chest X-rays, which were read by a radiologist. If all clinical signs are negative, chest X-ray findings are unlikely to be positive. Conclusions: Initial observation of the infant may be the most critical component for the diagnosis of pneumonia. Tachypnoea is the most valuable of the individual clinical signs for prediction of radiological pneumonia and can be a sensitive and reasonably specific indicator of respiratory infection. The absence of tachypnoea and chest wall indrawing can safely be used to reduce the number of chest X-rays ordered for children under investigation.