Abstract

Objective: To analyze the indications for chest (CXR) radiography, radiological abnormalities and the clinical predictors for pneumonia in children who present withacute wheeze to the pediatric emergency department.

Methods: This prospective study was conducted in the emergency department of a tertiary care pediatric referral hospital between July and December 2012. Children between 6 months to 18 years of age presenting with acute wheeze were included in the study.

Results: Of a total of 126 children included in the study, the most common indication for CXR was temperature > 100°F at presentation (65%). The most common radiological abnormality was prominent bronchovascular markings in 67%. Ten children (8.7%) had radiological evidence of pneumonia, seven of them were <5years of age . Presence of fever during triage (p=0.006), hypoxia (p=0.01) and localised chest findings on auscultation (p=0.001) were statistically significant clinical predictors for pneumonia.

Conclusion: The incidence of radiographically confirmed pneumonia among children with wheezing is uncommon. Definite clinical criteria should be defined to avoid unwarranted chest radiography in children with acute wheeze.

Keywords: Acute, wheeze, children, pneumonia, chest radiography