Objective: The aim of this investigation was to identify the clinical symptoms and signs of pneumonia in hospitalised patients with confirmed aetiologic diagnosis and to study whether it is possible to differentiate viral from bacterial pneumonia by these means.
Design: A 3-year prospective study.
Setting: Turku University Hospital, Turku, Finland.
Patients: 254 children with radiologically confirmed community-acquired pneumonia.
Main outcome measures: Data on symptoms and signs were collected from the hospital records of patient files. A standardised case record form was used.
Results: Eleven percent of the patients presented the illness without any respiratory symptoms. Patients with viral pneumonia versus those with bacterial pneumonia were younger (means 2.8 vs 4.1 years) and more often had acute otitis media (41% vs 18%), dyspnea (48% vs 25%) and rhonchi on auscultation (47% vs 26%). Thoracic pain, headache and decreased breathing sounds were more common in patients with bacterial pneumonia.
Conclusions: Although the clinical findings in viral pneumonia showed some differences from those in bacterial pneumonia, they were largely overlapping. This similarity and the frequent occurrence of mixed infections make it impossible to differentiate between viral and bacterial pneumonia simply by clinical symptoms and signs.