[Rapid differentiation between bacterial and atypical pneumonia in children]. / Mogucnosti brzog razvrstavanja bakterijskih od atipicnih pneumonija u djece.

We examined 116 children aged 3-7 years who were hospitalized in our Clinic during the period of one year. We observed certain clinical and laboratory parameters connected with chest X-rays. These parameters were necessary for fast distinguishing between bacterial and atypical pneumonia, in order to initiate an adequate antimicrobial therapy. The most important laboratory parameter for a fast diagnosis is CRP (reactant of acute phase of inflammation, which increases as soon as 6 to 12 hours from the beginning of the illness), and also important is: leukocyte count together with neutrophilia in differential count, which is also shown in our article. Erythrocyte sedimentation rate was moderately elevated in both bacterial and atypical pneumonia. However, the values were moderately higher in cases of bacterial pneumonia, especially in children who were hospitalized between the 2nd and the 5th day of the illness. Nevertheless, there was no correlation between the erythrocyte sedimentation rate and the type of the illness in children who were hospitalized on the first day of the illness. We conclude that CRP was the most useful parameter in fast distinguishing bacterial from atypical pneumonia.

Asymptomatic pharyngeal carriage of beta-haemolytic streptococci and streptococcal pharyngitis among patients at an urban hospital in Croatia.

In a one-year study at the University Hospital of Infectious Diseases in Zagreb, Croatia the rate of asymptomatic throat carriage of beta-haemolytic streptococci was investigated. Throat carriage was investigated in 1796 patients, none of whom had a sore throat nor signs and/or symptoms of a respiratory tract infection. The carrier rate of beta-haemolytic streptococci was 8.3%, for group A streptococci 6%, group B 1.3%, group C 0.3% and group F 0.1%. The highest rate was observed in the 6 to 14 year age group: 13.8% for all streptococcal groups, 11.7% for group A alone. The proportion of non-A streptococci was higher in older age groups. Tonsillectomised individuals were less frequently carriers. No sex or season-dependent variations were observed. In a four-month study of 629 patients with pharyngitis the throat cultures yielded: group A streptococci in 44.7%, group B in 1.7%, group C in 0.8%, and group G in 0.6% of the patients. Group A streptococci in 44.7%, group B in 1.7%, group C in 0.8%, and group G in 0.6% of the patients. Group A streptococcal rates in carriers compared to rates in patients with pharyngitis suggest that approximately one fourth of the schoolchildren with culture-positive pharyngitis actually are not truly infected, but only carriers currently having a sore throat of non-streptococcal etiology. Antibiotics were administrated to 605 (96.2%) patients with pharyngitis; in 571 (94.4%) of the cases before culture results became available. After culture-negative results were obtained the therapy was discontinued in only 28.5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)