Acute Klebsiella, Pseudomonas and Proteus Pneumonia in Childhood.

Abstract

Summary: The clinical, radiological and laboratory features in 21 children, aged between one and 27 months, with acute pneumonia caused by Klebsiella in 15 cases, Pseudomonas in four cases and by Proteus species in two cases, are presented. Fifty seven percent of the children had received antibiotics before presentation. Sixty-seven percent of those with Klebsiella infection had patchy infiltrates alone or with lobar consolida tion, while four of the six cases with Pseudomonas and Proteus infections had lobar consolidation alone or in association with air leak syndromes. Mortality was high at 28.6 per cent and was significantly associated with malnutrition. Although 71 per cent of the cases were malnourished, the clinical features and laboratory data were unhelpful in distinguishing acute pneumonia due to these organisms from that caused by other organisms; by contrast, the radiographic changes were somewhat helpful, as a lobar consolidation with a bulging interlobar fissure would strongly suggest an infection with Klebsiella, while Klebsiella as well as Proteus species must be considered along with Staphylococcus aureus as possible aetiological  organisms in those with pneumatocoeles.