THE CAUSES OF HOSPITAL-TREATED ACUTE LOWER RESPIRATORY-TRACT INFECTION IN CHILDREN

Objective: To determine the etiologic agents in children with acute lower respiratory infection. Design: A survey of a series of patients. Setting: General pediatric hospital serving an urban population with and without referrals in Helsinki, Finland. Participants: 135 Finnish children aged 2 months to 15 years (mean, 1.75 years), with clinically defined acute lower respiratory infection (with difficulty of breathing), or found to have fever and a pneumonic infiltrate on chest roentgenogram. Selection Procedures: Consecutive sample on voluntary basis. Interventions: None. Main Results: Of 121 children with adequate samples, an etiologic diagnosis could be established in 84 (70%): 30 (25%) had bacterial, 30 (25%) viral, and 24 (20%) mixed infections. Antibody assays alone identified the agent in 91% of positive cases. Conclusions: Bacterial infections are common but generally underestimated in acute lower respiratory infection; serologic methods add significantly to their detection.