Clinical, laboratory, and immunological characteristics of community-acquired pneumonia in young children and markers of its severe course

Background. Community-acquired pneumonia (CAP) in young children remains a leading cause of morbidity and complications, necessitating early detection of clinical, laboratory, and immunological markers of severe disease. Despite the decrease in overall child mortality in recent decades, CAP remains the leading cause of death among infectious diseases in early childhood, especially in countries with economies in transition. Objective. To evaluate the analysis of clinical, laboratory, and immunological characteristics of community-acquired pneumonia in young children and identify markers most closely associated with a severe course of the disease. Materials and methods. Eighty children aged 12–36 months with confirmed CAP were examined. Clinical manifestations, respiratory function, radiographic signs, complete blood count, biochemical markers (including C-reactive protein), microbiological data, and immunity parameters (IgA, IgM, IgG, CD4+, CD8+, CD4/CD8 index) were analyzed. Patients were divided into groups with mild (n = 40) and severe (n = 40) course. Statistical analysis included Student's t-test, Mann–Whitney test, and χ² (p < 0.05). Results. The data obtained indicate that children with severe CAP exhibit a pronounced inflammatory response and immunoregulatory imbalance. Increased levels of leukocytes, neutrophils, ESR, and C-reactive protein are accompanied by a decrease in lymphocytes. Conclusions. Severe CAP was accompanied by severe respiratory failure, high fever, extensive infiltrates on radiographs, leukocytosis, neutrophilia, increased ESR and CRP, and a decrease in lymphocytes. Immunological testing revealed a decrease in CD4+ and IgA, an increase in CD8+ and IgM, and a significant decrease in the CD4/CD8 ratio. Clinical signs, inflammatory markers, and immunological markers can serve as a reliable system for the early diagnosis of severe CAP in young children.

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