Complicated Pneumonia in Children: A Single Centre Experience

Abstract Background: Despite advances in health care and the avail-ability of an anti-pneumococcal vaccine, community-acquired pneumonia (CAP) remains a primary cause of morbidity in children. Complicated pneumonia is a major cause of extend-ed hospitalization. Finding risk factors for complex pneumonia can assist adapt treatment. Aim of Study: This study aimed to describe children hos-pitalized with community-acquired pneumonia complicated by parapneumonic effusion (PPE), pleural empyema (PE), ne-crotizing pneumonia, lung abscess, pneumothorax, and hydro-pneumothorax. Patients and Methods: 70 children with complicated pneu-monia were included from December 2022 to July 2023, docu-mented with chest X-ray, chest computed tomography (CT), or ultrasound, without other comorbidities. The organisms detect-ed by cultures and polymerase chain reaction (PCR) and their antibiotic sensitivity were collected. Their demographic data, laboratory findings, and their length of hospital stay and out-comes were statistically analyzed. Results: It was observed that pleuraleffusion and necrotiz-ing pneumonia were the commonest complications. PCR was better than cultures in detecting the causative organisms. Strep-tococcus pneumonia, Klebsiella pneumonia, and Haemophilus influenza were the most causative bacterial organisms detected by PCR, and parainfluenza virus, adenovirus and rhinovirus were the commonest viral co-infections. 60% of patients were admitted to the Pediatric Intensive Care Unit (PICU) with a prolonged duration of overall admission median (IQR) of 20 days (range: 7-55 days). The overall outcome was a complete improvement. Conclusion: Complicated pneumonia was associated with a prolonged duration of admission and a high rate of PICU ad-mission. PCR was the best and facilitated early detection of the causative organism which contributes to better antibiotic choice and management of the patients.