LATE PULMONARY SCINTIGRAPHIC DEFECTS AFTER UNEVENTFUL RECOVERY FROM SIMPLE FOCAL PNEUMONIA OF CHILDHOOD

We present a pilot study designed to determine whether pneumonia in ch ildren accompanied by focal consolidation on the chest radiograph (CXR ) is associated with late abnormality as detected by radionuclide lung scintigraphy. 14 children with focal pneumonia were assessed 1 year a fter initial presentation. In 12 both krypton-81m ventilation and tech netium-99m MAA perfusion studies were performed, while in two only per fusion studies were obtained. All cases had a further CXR. Abnormal or equivocal cases were reviewed clinically. Scans and CXRs were indepen dently assessed by two observers and subsequently consensus reached by discussion. There were five abnormal and nine normal lung scans. Two defects matched the site of the initial pneumonia while three did not. A CXR at the time of lung scanning was normal except for one case wit h a small focus of consolidation on the opposite side to the initial p neumonia but with a normal lung scan. Similarly, clinical assessment a t the time of scanning was unremarkable, with no history of further re spiratory episodes except in one child excluded from the study because of an interval diagnosis of asthma. This pilot study indicates that l ung scan defects are common in the medium term after supposedly uncomp licated pneumonia in childhood. The cause of these defects remains unc ertain. The correlation with the site of the initial radiological abno rmality is variable, pointing to the need for further research in this area. The importance of independent blind interpretation is also high lighted.