الفهرس 
Community Acquired Pneumonia CAPOnly 14 pages are availabe for public view
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Abstract
Community acquired pneumonia (CAP) is a major health problem with significant morbidity and mortality all over the world especially in developing countries. Hyponatremia (HN) is considered as the most frequent laboratory finding in hospitalized children especially those with CAP. The aim of the present study was directed to identify the frequency of hyponatremia in children hospitalized with CAP and also to detect the predictive tools of HN in cases of CAP and to find out any relation between sex and hyponatremia in such patients. 100 cases of hospitalized patients with CAP were selected from the pediatric department of Ain Shams University. They were 53 females and 47 males. The age of the studied cases ranged from 1.5 to 72 months with a mean of 17.2 ± 21 months. Each of the studied children was subjected to detailed history taking, through clinical evaluation as well as the following investigations: CXR, CBC, CRP, ESR, SGOT, SGPT, RBS, urea, creatinine, serum Na+ and K+. The result of this study showed that CAP was more common in children who belong to low socio-economic standards compared with those with average and high socio-economic standards. Analysis of the clinical manifestations in the studied children with CAP showed that cough and fever were the most common presenting symptoms followed by respiratory distress, wheeze and vomiting. Chest X ray study showed that bronchopneumonic infiltrate was the commonest radiological finding in children with CAP as it was present in 31% of the studied cases. Study of serum sodium in children with CAP showed that hyponatremia is the commonest finding in the studied cases as it was present in 74% of the cases. Statistical analysis of serum Na+ in relation to the clinical and laboratory findings showed that there is a significant relationship between serum Na+ levels and fever grades, respiratory rate and CRP p-value < 0.05. Study of serum Na+ in patients with hyponatremia revealed that mild hyponatremia was present in 31 cases, while moderate and severe hyponatremia were present in 24 and 19 cases respectively. Statistical comparison between the degree of hyponatremia in relation to the severity of CAP showed that hyponatremia was more evident in children suffering from severe CAP (x̅ 15.4 p< 0.001). The severity of HN in the present study was also significantly related to exposure to ETS, PICU admission, duration of hospital stay and mortality (p< 0.001). The severity of HN in studied children was also significantly related to common laboratory findings as TLC, neutrophil count, CRP and serum K+ levels (p<0.005). The result of this study showed that there is no sex predilection between males and females with CAP as regards demographic data pneumonia severity, routine laboratory investigations and serum Na+ levels, so no sex difference was found in the studied parameters of CAP in the pediatric age group. Our results showed that there was a significant correlation between serum Na+ levels and fever grading, duration of hospital stay and pneumonia severity scoring. Also there was a significant correlation between serum Na+ levels and TLC, neutrophil count and CRP p<0.005).