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Kelly, M.S. and Sandora, T.J. (2020) Community-Acquired Pneumonia. In: Berman, R.E., Kliegman, M.R., St Geme, J.W., Blum, N.J., Shah, S.S., Tasker, R.C., et al., Eds., Nelson Textbook of Pediatrics, 21st Edition, Elsevier Inc., Philadelphia, 2266-2274.

has been cited by the following article:

• TITLE: Myocarditis in Under-Five Children with Community-Acquired Pneumonia Using Serum Cardiac Troponin-T and Electrocardiography

  AUTHORS: Samsudeen Alao, Chinyere Uzodimma, Adebiyi Olowu

  KEYWORDS: Cardiac Troponin-T, Myocarditis, Electrocardiography, Pneumonia

  JOURNAL NAME: Open Access Library Journal, Vol.10 No.11, November 24, 2023

  ABSTRACT: Community-acquired pneumonia (CAP) kills more under-five (U-5) children in Sub-Saharan Africa than in any other part of the world. Co-existing myocarditis and congestive cardiac failure (CCF) in the setting of CAP could play a crucial role in determining the disease outcome. The aim of the study was to evaluate myocarditis in U-5 children with CAP in the emergency room setting using cardiac troponin-T (cTnT) and electrocardiography (ECG). A hospital based cross-sectional study involving 76 children with CAP aged between 2 - 59 months, and their age- and sex-matched controls. Serum cTnT was measured using Roche Cobas® h232 POC system and standard electrocardiographic (ECG) tracings were obtained from participants using the APS Three Channel ECG-3B (Model- EKG-903A3) machine to evaluate for myocarditis. The mean age of subjects in this study was 19.8 ± 12.2 months. The prevalence of ECG features of myocarditis was 45%. The ECG features of myocarditis detected in the study include prolonged PR interval, reduced QRS voltages in limb leads, right axis deviation and prolonged QTc. Presence of elevated cTnT (≥50 ng/L) suggestive of myocarditis was detected in about 10% of subjects with CAP, particularly in those with CCF. The presence of elevated cTnT was a better predictor of mortality than the ECG features of myocarditis (p = 0.029). The prevalence of myocardial involvement in U-5 children with CAP is high and an elevated serum cTnT predicts mortality better than ECG changes in children with CAP.