Sixty-seven children with age range from 2 months to 15 years were hospitalized with signs and symptoms suggestive of pneumonia. For all patients, complete history, clinical examination and laboratory investigations were done. The patients were classified into two major groups as regards results of blood culture ; 1st group consisted of 20 patients with positive blood culture of Streptococcus pneumoniae (29.8% of patients), 2nd group consisted of 47 patients with negative blood culture representing (70.2%) of cases. For all patients, pleural fluid, serum and urine samples were taken and tested by latex agglutination test for detection of pneumococcal antigen in these samples. It was found that pleural fluid was the best in diagnosing pneumococcal pneumonia because 19 '(95%) in the 1st group were positive, while in the 2nd group showing negative blood culture, pleural fluid as tested by latex agglutination yielded -ve result, so, the sensitivity of the test was 95.0% and specificity was 100.0%. By testing the serum by latex agglutination test (30.0%) of the first group have +ve result for detection of capsular antigen. Only one case gave false +ve in the 2nd group. So, the sensitivity was 30.0% and specificity was 97.9%. In urine samples, the test gave+ve only (20.0%) in the 1st group, with sensitivity 20.0% and specificity 80.0%. We concluded that latex agglutination test for detection of pneumococcal capsular antigen in pleural fluid in patients with pneumonia is a reliable method for establishing that Streptococcus pneumoniae is the definite cause and antibiotic treatment can be directed to Pneumococci. The test is rapid, cheap and easy to use especially in communities with limited laboratory facilities as rural areas in Egypt. |
