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Clinical Pediatrics
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Clinical Factors Associated with Focal Infiltrates in Wheezing Infants and Toddlers

E. M. Mahabee-Gittens, MD, MS

Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, OH

M. D. Dowd, MD, MPH

Division of Emergency Medicine, Children's Mercy Hospital, Kansas City, MO

J. A. Beck, RRT

S. Z. Smith, RRT

Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, OH

It can be challenging to determine which findings are associated with focal infiltrates in young wheezing children. A prospective study of wheezing children ≤18 months of age revealed focal infiltrates on chest radiograph in 23%. By use of multivariate analysis, findings significantly associated with focal infiltrates included grunting (OR 4.1, 95% CI, 2.0, 8.6) and oxygen saturation≤93% (OR 2.2, 95% CI, 1.1, 4.8); with a sensitivity and specificity of 12.5% and 97%, respectively. Variables not associated with focal infiltrates included first-time wheezing, fever, and tachypnea. The combination of grunting and oxygen saturation≤93% is highly specific and can be used to help diagnose pneumonia in wheezing infants and toddlers.

Clinical Pediatrics, Vol. 39, No. 7, 387-393 (2000)
DOI: 10.1177/000992280003900702
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B. Mathews, S. Shah, R. H. Cleveland, E. Y. Lee, R. G. Bachur, and M. I. Neuman
Clinical Predictors of Pneumonia Among Children With Wheezing
Pediatrics, July 1, 2009; 124(1): e29 - e36.
[Abstract] [Full Text] [PDF]