Recurrent Pneumonia in Children

Objective: The aim of this study was to determine the relative frequency and describe the predisposing causes of recurrent pneumonia in children. Material and methods: We retrospectively reviewed the medical records of patients with pneumonia at Uludag University Medical Faculty, Department of Pediatrics, between January 1998 and December 2007. Recurrent pneumonia was defined as at least two episodes in a 1 year period or at least three episodes over a lifetime. Patients with recurrent pneumonia were included in this study. Results: During the study period, 1617 children were admitted to hospital with a diagnosis of pneumonia, 185 (11.4%) met the criteria for recurrent pneumonia. The mean age of patients was 16 +/- 32 months (3 months-14 years) and 61% were male. An underlying cause was identified in 143 patients (77%). Of these, the underlying cause was diagnosed prior the pneumonia in 25 patients (17%), during the first episode in 30 (21%), and during recurrence in 88 (62%). Underlying causes included congenital cardiac defects in 32 patients (17.2%), gastroesophageal reflux in 31 patients (16.7%), aspiration syndrome in 27 patients (14.5%), asthma in 16 patients (8.6%), cystic fibrosis in 12 patients (6.4%) immune disorders in 10 patients (5.4%), tuberculosis in 9 patients (4.8%) and anomalies of the chest and lung in 6 patients (3.2%). No predisposing illness could be demonstrated in 42 patients (33%). Conclusion: Recurrent pneumonia occurred in 11.4% of all children hospitalized for pneumonia. The underlying cause was identified in 77% of the children. The most common causes were congenital cardiac defects, gastroesophageal reflux and aspiration syndrome.