PP29 INVESTIGATIONS OF RECURRENT PNEUMONIA IN CHILDREN: A RETROSPECTIVE STUDY IN A TERTIARY CENTRE

Asiah Kassim1,2, Fatimah Az Zaharah Suhaimi 1, Nur Izyani Abdul Halim1, N.Fafwati Faridatul Akmar Mohammad2, Shangari Kunaseelan2, Koo Shin Lam1, Lee Ching Hai1

1. Clinical Research Centre, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
2. Pediatric Department, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.

 

Introduction
Recurrent pneumonia (RP) in children is a common yet concerning clinical presentation. The aim of the study is to describe findings of investigations for RP.

Methodology
A retrospective medical record was reviewed for 4-year period from September 2019 until December 2023.

Results
A total of 327 children with recurrent pneumonia were identified. Investigations done were chest X-rays(327), Computed Tomography scan(183), Flexible bronchoscopy(54), and Primary immunodeficiency (PID) screening (288). Abnormal CXR findings were observed in 97.2% of cases, with hyperinflation lung (212,64.8%), consolidation (122,37.3%), collapse (52,15.9%), mediastinal widening (37,11.3%), dilated airways (7,2.1%), pleural thickening (6,1.8%), and cardiomegaly (2,0.6%). CT thorax most commonly showed hyperinflation (69,37.7%), peribronchial thickening (55,30%), collapse (52, 28.4%), and consolidation (27, 14.7%). Notably, 21(11.4%) of patients were diagnosed with Bronchiolitis Obliterans based on mosaic patterns, vascular attenuation, and peribronchial thickening. Dilated airways suggestive of bronchiectasis were found in 7(3.8%), while 155(84.6%) showed mixed radiological features. Flexible Bronchoscopy found Upper airway pathologies (10, 19%), Lower airway pathologies (10,18.5%) and other findings in 30(55.5%). Common Lower airway pathologies were tracheomalacia, bronchomalacia, or tracheal stenosis.  Thirty-seven (12.8%) of them had abnormal Primary Immuno-deficiency (PID) results.

Conclusion
RP in children is frequently associated with abnormal radiological findings, underlying airway or immunological abnormalities. A structured diagnostic approach, which includes CXR, CT thorax, bronchoscopy, and immunological screening, is essential for early detection of contributing factors and early intervention.