Analysis of clinical and imaging features of air-borne and blood-borne Staphylococcus aureus pneumonia in children / 中国小儿急救医学

ABSTRACT

Objective:To compare the clinical and imaging features of air-borne and blood-borne Staphylococcus aureus pneumonia(SAP) in children.Methods:The clinical data of 54 children with SAP from 2015 to 2020 at Shengjing Hospital of China Medical University were retrospectively analyzed, including 28 cases in air-borne group and 26 cases in blood-borne group.The general data, clinical manifestations, laboratory tests and imaging data of the patients in two groups were compared.Results:There were no significant differences in age, sex and onset season between air-borne group and blood-borne group( P>0.05). The incidences of cough, dyspnea and lung rale in air-borne group were significantly higher than those in blood-borne group( P<0.05). Air-borne group was often complicated with acute respiratory distress syndrome and respiratory failure, but extrapulmonary infection was rare.The symptoms and signs of respiratory tract in patients from the blood-borne group were not obvious, and more complicated with other parts or systemic infection and poisoning symptoms, such as septic shock, skin and soft tissue infection, osteomyelitis, etc.The patients with leukocyte decrease(<4.0×10 9/L) in blood-borne group were more than those patients from air-borne group.The median values of C-reactive protein, procalcitonin and interleukin -6 in blood-borne group were higher than those in air-borne group, but there were no statistical differences( P>0.05). On imaging, the incidences of massive pulmonary exudation and consolidation in air-borne SAP were higher, while the incidences of pulmonary nodules and air sacs in blood-borne SAP were higher( P<0.05). Conclusion:The clinical and imaging manifestations of air-borne SAP and blood-borne SAP are different.Respiratory symptoms of air-borne SAP are prominent, however, systemic poisoning symptoms of blood-borne SAP are severe.As for imaging, air-borne SAP is more prone to large lung consolidation, while blood-borne SAP is more prone to lung nodules and air bags.