Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007 / Neumonía afebril del lactante (síndrome tosferinoso) en el Hospital Universitario del Valle, Cali, 2001-2007

Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries.Objective: To describe children with afebrile pneumonia syndrome.Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the child’s birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications.Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides.Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides.

Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007.

INTRODUCTION: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. OBJECTIVE: To describe children with afebrile pneumonia syndrome. METHODS: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the childs birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications. RESULTS: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides. CONCLUSIONS: These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides.

INTRODUCCIÓN: La neumonía afebril del lactante, llamada también neumonitis del lactante, neumonía por gérmenes atípicos o síndrome tosferinoso, es una causa importante de infección respiratoria baja grave en lactantes pequeños, tanto en países en vía de desarrollo como en países desarrollados. OBJETIVO: Describir los niños con neumonía afebril. MÉTODOS: Por medio de un estudio de corte transversal, se revisaron las historias clínicas de niños con diagnóstico de neumonía afebril, atendidos en el Hospital Universitario del Valle, centro de referencia del suroccidente colombiano, entre junio de 2001 y diciembre de 2007. Se obtuvo información sobre la edad y origen materno, control prenatal, el nacimiento del menor, lactancia materna, estado de vacunación, síntomas, signos, diagnóstico, tratamiento y complicaciones. RESULTADOS: Se evaluaron 101 niños con esta entidad, observando una presentación estacionaria: junio-agosto y noviembre-diciembre. El 73% de los niños eran menores de 4 meses, los síntomas más frecuentes fueron: tos espasmódica y cianosante (100%), dificultad respiratoria (70%) y fiebre no cuantificada (68%). Los hallazgos más frecuentes: estertores (50%), sibilancias y roncus espiratorias (37%). El 66% se clasificó como leve y del 33% restante, la mitad requirió unidad de cuidados intensivos. En todos se hizo el diagnóstico clínico de la neumonía afebril del lactante, pero no se realizó el diagnóstico etiológico y, a pesar de esto, el 94% de los niños recibió macrólidos. CONCLUSIONES: Los datos presentes soportan la hipótesis que la mayoría de estos pacientes, adquirieron la enfermedad por vía aérea, posiblemente de etiología viral y no requerían el uso indiscriminado de antibióticos tipo macrólidos.