STUDY OF RESPIRATORY INFECTION CAUSED BY CHLAMYDIA PNEUMONIAE IN CHILDREN IN THE DEPARTAMENT OF PEDIATRICS - THE IPIRANGA HOSPITAL, MOGI DAS CRUZES (BRAZIL)

Introduction: Chlamydia pneumoniae is a pathogen usually associated with respiratory pathology. It has been estimated that this agent causes 5 to 15% of all pneumonias but its incidence among hospitalized children with respiratory infections is unknown. Objective: Characterization of the Chlamydia pneumoniae respiratory infections in hospitalized children. Patients and Methods: Retrospective longitudinal study of the Chlamydia pneumoniae respiratory infections in children admitted between January 2005 and June 2007 in the Department of Pediatrics in the Ipiranga Hospital - Brazil. Sex, age, race, socio-economic status, number of scholar siblings, frequency of nursery/school, parents smoking habits, familiar atopy, personal history, clinical presentation, diagnosis, treatment and follow-up were analyzed for each child. Results: 55 cases were documented, 67% males and 52% whites. The age on admission varied between 14 days and 16 years-old, with a higher incidence below 6 years-old (57%). Twenty-three (40%) of the children were in nursery or in school and 12 (43%) had siblings at school-ages. Parent smoking habits were documented in 21 (56%) and familiar atopy in 21 (48%) children. Respiratory atopy (9 children), gastroesophageal reflux (5), cerebral palsy (1), cleft palate (3) and prematurity (3). Pneumonia was the most frequent c1inical presentation (67%), followed by bronquiolitis (29%). The clinical presentation was not specific, with cough (86%), respiratory distress (69%) and fever (66%) being the most frequent signs. The most prevalent radiological pattern was the interstitial (49%). Coinfection by other agents occurred in five cases: S. pneumoniae (2), H. injluenzae tipo b (1), P. aeroginosa (1) and tuberculosis (1). Complications were documented in 32 (58%) children: hypoxemia (24), pleural effusion (11), atelectasis (5) e atelectasis and hypoxemia (5). Macrolids were prescribed in 49% cases. Discussion: This study calls the attention to the fact that Chlamydia pneumoniae infection is an etiology to be considered in children with respiratory infection and hospitalization criteria. This infection can occur in all ages. Because the clinical presentation is not specific and complications can occur, a high leveI of suspicion is necessary for its diagnosis. Gnarpe, Judy ; Gnarpe, Håkan ; Wettergren, Björn: Chlamydia pneumoniae in children attending day-care centers in Gävle, Sweden. Pediatr Infect Dis J, 17(1998): no. 6, 474-8 Nääs, Jessica ; Gnarpe, Håkan ; Karlsson, Mats G ; Wettergren, Björn: Chlamydia pneumoniae in children undergoing adenoidectomy. Acta Paediatrica, 90(2001): no.2, 126-9.