Influenza pneumonia

Background: Influenza and pneumonia are common childhood illnesses, but few studies have been conducted on influenza-related pneumonia in children. The aim of this study was to describe the frequency and characteristics of laboratory-documented and radiologically detected influenza pneumonia in children. Methods: This study involved children treated at the Department of Pediatrics, Turku University Hospital, from 1980 through 2003. Influenza A or B infection was documented with the use of antigen detection from nasopharyngeal aspirates. Children with chest radiographs obtained during influenza episodes were identified. Chest radiographs were reevaluated by a pediatric radiologist for verification of pneumonic infiltrates. Clinical and laboratory data were collected from medical records. Results: Pneumonia was detected in 134 (14%) of 936 children with influenza infection. The most frequent signs of influenza pneumonia were fever and cough. Of these children, 47% had no specific clinical signs or symptoms suggesting pneumonia. White blood cell count was < 15 X 10(9)/L in 89% and serum C-reactive protein concentration < 80 mg/L in 85% of the children. One-half of the children had solely interstitial infiltrates, one-fourth solely alveolar and one-fourth both alveolar and interstitial infiltrates on the chest radiograph. The hospitalization rate was 68%, and the median duration of hospitalization was 2 days. Complicated pneumonias were rare, and mortality was low (0.7%). Conclusions: Pneumonia is detected in a minority of children treated for influenza at a tertiary center. Unlike in adults, influenza pneumonia in children is usually a benign illness, and the mortality is low.