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Article in Japanese

Scoring system to distinguish between bacterial pneumonia and atypical pneumonia in children

Naruhiko ISHIWADA1), Fumie NAGAI2), Junko TANAKA1), Masanaga ARIMA3), Katsuaki ABE4), Chie FUKASAWA1), Haruka HISHIKI1), Tadashi HOSHINO4), Nobue INOUE3), Jiro AIZAWA5), Hiroko OHSHIMA2), Nobuyasu ISHIKAWA5), Tomomichi KUROSAKI3), Yoichi KOHNO1)

Clinical differentiation between atypical pneumonia and bacterial pneumonia was examined in children using the scoring system described below.
The criteria were: (1) age more than 6 years, (2) no underlying disease, (3) no β-lactam antibiotic therapy within a week, (4) good general condition, (5) dry cough, (6) limited chest auscultatory findings, (7) segmental shadow of chest x-ray film, (8) CRP bellow 4 mg/dl, and (9) a peripheral white blood cell count bellow 10,000/μl.
The sensitivity and specificity for atypical pneumonia were 82% and 100% based on meeting five or more of the criteria. This scoring system is useful in choosing an initial course of antibiotics for treating pediatric community-acquired pneumonia.

1) Department of Pediatrics, Chiba University Hospital
2) Department of Pediatrics, Teikyo University Chiba Medical Center
3) Department of Pediatrics, Chiba Kaihin Municipal Hospital
4) Division of Infectious Diseases, Chiba Children's Hospital
5) Department of Pediatrics, Chiba Aoba Municipal Hospital

Key words
Received July 13, 2010
Accepted August 23, 2010

22 (4):343─348,2010