Predisposing Factors of Recurrent Pneumonia in Children

Shin, Hye Jung; Lee, Hyun Hee; Park, Kyoung Hwa; Jeong, Byung Ju; Kim, Kyu Earn; Lee, Ki Young

Abstract

PURPOSE
While the recurrent pneumonia is a relatively common problem, there are very few studies or reports in the literature on the subject. This study was designed to provide with a systematic approach to evaluation of the patient who presented with recurrent pneumonia.
METHODS
We reviewed clinical records of 12,137 patients who had been admitted to Yonsei University Severance Hospital with pneumonia for the period of 10 years from January 1986 to December 1995. Recurrent pneumonia is defined as pneumonia with at least 2 episodes in a year or with at least 3 episodes for the period of 10 years mentioned above. We investigated incidence of recurrent pneumonia, age distribution, number of recurrent episodes. Then we reviewed the interval period of episodes, location of lesions in chest X-ray, associated etiology in 200 patients with recurrent pneumonia who were selected randomly.
RESULTS
Among the patients with pneumonia, 840 patients(6.9%) had recurrent pneumoia. The patients with two episodes of pneumonia were in the highest in incidence(66.9%). The intervals between episodes were usually 1 to 3 month(45.2%). The lesions involved most frequently in both lung fields(61%) on simple chest X-ray. Predisposing factors were widely varied. They were in orders of frequency respiratory disease(43.0%), neuromuscular disease(9.5%), anatomic problem(6.5%), immunologic disease(3.5%) and gastrointestinal disease(1.5%). The most frequent predisposing factor among the respiratory diseases was bronchio;itis(24.0%) and asthma(14.0%).
CONCLUSION
The key to optimal treatment lies in the prompt detection of the predisposing factors. We emphasize that patients present recurrent pneumonia should be carefully evaluated for possibility of underlying bronchiolitis in children under age two years and asthma in older children.