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Asthma after childhood pneumonia

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7271.1289 (Published 18 November 2000) Cite this as: BMJ 2000;321:1289

Microbiological assessment is needed for accurate diagnosis of pneumonia

  1. John Furness (J.C.Furness@ncl.ac.uk), paediatric specialist registrar
  1. Sunderland Royal Hospital, Sunderland SR4 7TP
  2. Department of University Child Health, Mail point 803, Southampton General Hospital, Southampton SO16 6YD
  3. Mid Devon General Practice, Witheridge, Devon EX16 8AH
  4. Royal Devon and Exeter Hospital (Wonford), Exeter EX2 5DW

    EDITOR—Clark et al comment that “the cumulative prevalence of asthma after childhood pneumonia is high; therefore careful follow up is recommended to detect new cases.”1 I agree with this sentiment, but I do not believe that they have made an accurate diagnosis of pneumonia; they have not determined a microbiological cause. Without this, consolidation on chest radiography, together with fever and tachypnoea, might be confused with a viral exacerbation of asthma and the radiological features of mucous plugging.

    I believe that the authors have highlighted an important message: keep an open mind about radiological and clinical diagnoses of asthma versus pneumonia. I do not think that they have shown an association between pneumonia and asthma.

    References

    1. 1.↵
      1. Clark CE,
      2. Coote JM,
      3. Silver DAT,
      4. Halpin DMG
      . Asthma after childhood pneumonia: six year follow up study. BMJ 2000; 320:1514–1516.
      OpenUrlAbstract/FREE Full Text

    Cumulative prevalence was not best statistic to use

    1. Simon Fearby, clinical research fellow,
    2. J B Clough (jbc@soton.ac.uk), senior lecturer in child health
    1. Sunderland Royal Hospital, Sunderland SR4 7TP
    2. Department of University Child Health, Mail point 803, Southampton General Hospital, Southampton SO16 6YD
    3. Mid Devon General Practice, Witheridge, Devon EX16 8AH
    4. Royal Devon and Exeter Hospital (Wonford), Exeter EX2 5DW

      EDITOR—Clark et al found that of 131 children recruited into their study, 35 had symptoms of asthma or a diagnosis of asthma or received treatment for asthma during six years' follow up.1 This is presented as a cumulative prevalence of 45%, …

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