SOVREMENNAYA PEDIATRIYA.2019.2(98):7-11; doi 10.15574/SP.2019.98.7

Koloskova О. К., Tarnavska S. І., Shakhova О. О., Prunchak Н. І.
HSEЕ «Bukovinian State Medical University», Chernivtsi, Ukraine

Objective: to improve the results of treatment of children suffering from community-acquired pneumonia (CAP) by means of studying diagnostic value of the blood leukocytic indices as risk markers of an unfavourable course of the disease.

Materials and methods. 72 children suffering from CAP underwent a comprehensive examination. Considering the mean value of blood leukocyte shift index (BLSI) the children were divided into two clinical groups. I group included 28 children suffering from uncomplicated community-acquired pneumonia with BLSI >2.0 standard units (an average age — 7.8±1.6 years, including — 57.2±3.6% boys). ІІ group included 44 children suffering from uncomplicated community-acquired pneumonia with BLSI <2.0 standard units (an average age — 6.8±1.1 years (p>0,05), including — 59.1±2.2% boys (p>0.05). The groups of the study were comparable by the main clinical characteristics.

Results. The analysis of the data obtained showed that the course of CAP among children of I group with a marked leukocyte formula left shift (BLSI >2 standard units) was more frequently associated with severity of community-acquired pneumonia >78 points by PSI scale, signs of pneumonia with confluent foci and segmental pneumonia on X+ray films. At the same time, the chances of a severe course of the disease 2.5 times increased reliably. The representatives of І group developed more frequent cases of complications in the form of exudative pleuritis, which chances of development 3.4 times increased. At the same time patients from І group, in spite of relatively lower frequency of development of febrile fever, developed a longer course of pneumonia, and the signs of bronchial obstructive syndrome were registered more often. Contrary to children with CAP and BLSI <2 standard units, focal forms of pneumonia on X-ray films were found more frequently, and acute infectious-inflammatory process was more often localized on the level of the upper respiratory tract in the form of suppurative sinusitis.

Conclusions. In case of a marked value of intoxication index (leukocyte shift indexі >2 standard units) the chances of an unfavourable course of community-acquired pneumonia in children 2.5 times increased.

Key words: children, community-acquired pneumonia, blood leukocyte shift index.

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Article received: Nov 26, 2018. Accepted for publication: Feb 28, 2019.