Asthma diagnosis in children with community-acquired pneumonia: New challenges

Abstract

Early onset asthma symptoms and community-acquired pneumonia (CAP) diagnosis in children remains relevant because of variation of symptoms, late detection and treatment, which lead to development of complications and disability in patients. Aim: To study the features of CAP clinical symptoms in children with asthma. Material: 118 children aged 1-18 years with asthma were observed. Results. In 35(29.7%) patients CAP was diagnosed. Asthma symptoms in them were more severe with longer episodes of bronchial obstruction compared with children without CAP signs: 11,5±2 days and 5,5±2,3 comparatively. Pulmonary hypertension (PH) and fibrosis (PF) in children with CAP and asthma developed in 37.1% of patients. In 38.4% of children with asthma, CAP, PH and PF CT-scans revealed emphysematous bullae (EB). In 17 of 20 patients older than 3 years, with asthma and CAP, signs of connective tissue disorders (CTD) in skeletal system (95.8%), skin (35.8%), cardiovascular (82.2%), gastrointestinal (40%), urinary system(19.5%) were determined with strong positive correlation (rxy=0.8; p«0.001) between CAP frequency and presence of CTD signs in children with asthma, that significantly complicated asthma and CAP diagnosis and caused development of complications and disability due to inadequate treatment. Conclusions: 1. One-third of asthmatic patients had CAP that led to more severe and prolonged asthma exacerbations. 2. Strong positive correlation between CAP frequency and CTD signs in children with asthma was revealed. 3. A variety of clinical symptoms associated with involvement of multiple systems in children with CAP and asthma in CTD process complicated diagnosis of both asthma and CAP and worsened prognosis.