Platter’s syndrome in infants with acute pneumonia

Abstract

Introduction: Acute pneumonia is an inflammatory and infectious process localized in alveolus and pulmonary interstitial tissue caused by a bacterial pathologic agent. According to WHO common symptoms of pneumonia in children and infants include rapid or difficult breathing, cough, fever, chills, headaches, loss of appetite and wheezing. Children under five with severe cases of pneumonia may struggle to breathe, with their chests moving in or retracting during inhalation (known as “lower chest wall indrawing”). Young infants may suffer convulsions, unconsciousness, hypothermia, lethargy and feeding problems. It has been observed that in infants with severe cases of acute pneumonia, thymomegalia (also called Platter syndrome) is frequently present. Purpose and objectives: To find the incidence of thymomegalia (Platter’s syndrome) in infants. To appreciate the clinic and paraclinic signs and symptoms of thymomegalia in infants with acute pneumonia with a severe evolution. Materials and Methods: The research is based on the observation of 320 patients with acute pneumonia, severe evolution selected during the 2013-2014 years. They have been investigated using clinic and paraclinic examinations. Thymomegalia has been confirmed by radiologic examination. The anamnesis and epidemiologic data, also the personal physiological and pathologic antecedents have been statistically analyzed and interpreted. Results: From 600 hospitalized infants (1-6 months old) were selected 320 with acute pneumonia. From the total number of infants diagnosed with pneumonia, 27, 5 % presented an enlarged thymus (of I/II/III degree), confirmed by a radiologic examination, more frequent in male infants than female. Acute pneumonia associated with thymomegalia presented a severe evolution with difficulties in treatment. A high rate of co-associated morbidities as anemia, torticollis and hypoxic ischemic encephalopathy were noted in infants with thymomegalia. Discussions: The possibility that Platter’s syndrome is a sign of a compromised immune system with long-term impact on children health exists. Frequently the thymus hyperplasia disappears to the age of 1 year, if it doesn’t, the children are highly vulnerable to infections. To the age of 3, the incidence ofthym om egalic patients is very high in the group of frequently ill children. Conclusion: Thymomegalia is a frequent condition in infants, causing a severe evolution of acute pneumonia. The infants with Platter’s syndrome are often re-hospitalized, thymomegalia being a sign of a compromised immune system.