Improving Treatment and Diagnostic Measures for Pneumonia in Infants with Dyspeptic Syndrome

Abstract

Background. Pneumonia in infants remains one of the leading causes of hospitalization and mortality. A distinct group consists of children in whom the disease is accompanied by dyspeptic syndrome, which significantly worsens the course of the illness, contributes to dehydration and impaired nutritional status, and prolongs treatment.

Objective. To evaluate the effectiveness of a comprehensive treatment and diagnostic approach for pneumonia in infants with dyspeptic syndrome.

Materials and methods. A prospective study included 120 children aged 1 to 12 months with clinically and radiographically confirmed community-acquired pneumonia, treated at the pediatric department of the Regional Multidisciplinary Children's Center. Group I comprised 50 children with pneumonia and dyspeptic syndrome who received modified therapy including Hilak Forte; Group II comprised 50 children with pneumonia and dyspeptic syndrome who received standard therapy; the control group consisted of 20 apparently healthy children. All patients underwent clinical examination, complete blood count, C-reactive protein and procalcitonin measurement, chest radiography and lung ultrasound. Fecal calprotectin and coprological examination were used to assess intestinal inflammation.

Results. Combination therapy was followed by a significant reduction in systemic inflammatory markers (leukocytes 15.8±2.9 to 8.7±1.8 ×109/L; CRP 48.6±10.4 to 8.2±3.1 mg/L; procalcitonin 2.3±0.8 to 0.42±0.15 ng/mL; ESR 27.5±6.2 to 11.3±3.7 mm/h; all p<0.001) and by a decline in fecal calprotectin. In Group I, temperature normalization (2.7±0.8 vs. 3.6±1.0 days), diarrhea relief (2.5±0.7 vs. 4.4±1.2 days), appetite recovery (3.0±0.8 vs. 5.1±1.3 days) and length of hospitalization (8.3±1.4 vs. 10.5±1.6 days) were significantly shorter than in Group II.

Conclusion. The results confirm the value of a comprehensive approach to the management of infants with pneumonia. Combining clinical, laboratory and instrumental examination with gastrointestinal assessment permits timely identification of associated disorders and individualized treatment. This is particularly important in young patients, in whom even moderate dyspeptic disorders may lead to dehydration, electrolyte imbalance and deterioration of nutritional status.