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1996-02-27
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Document 0413
DOCN M9630413
TI Bacteremic pneumococcal pneumonia. A community hospital experience.
DT 9603
AU Lippmann ML; Goldberg SK; Walkenstein MD; Herring W; Gordon M; Albert
Einstein Medical Center, Philadelphia, PA 19141, USA.
SO Chest. 1995 Dec;108(6):1608-13. Unique Identifier : AIDSLINE
MED/96098005
AB We reviewed our experience with bacteremic pneumococcal pneumonia (BPP)
over a 1-year period at a 600-bed community teaching hospital; 26 cases
were identified. The mean age was 57.5 years and there were 12 male and
14 female subjects. Cough, sputum production, fever, and mental status
changes were the most frequent symptoms. Risk factors included drug
abuse in 10, HIV in 4, current smoking in 7, diabetes in 3, and cancer
in 3. The mean PaO2/FIo2 ratio was 274. Radiographic features included a
consolidation pattern in 7, bronchopneumonia in 15, combined in 1, and
an initial normal film in 3. Average length of stay (LOS) was 11 days
with an overall mortality of 11.5%. Four patients required mechanical
ventilation, two meeting the criteria for ARDS (if this group were
eliminated, LOS would be 8.4 days). Three of these survived. Four
patients had organisms resistant to penicillin and all survived. We
conclude that (1) BPP remains a serious but treatable infection
particularly when utilizing full supportive care; (2) the
bronchopneumonia x-ray film pattern was associated with all the
mortality; and (3) the occurrence of penicillin resistance did not
contribute to the mortality, since early recognition and the use of
appropriate antibiotics saved all of these patients.
DE Adult Aged Aged, 80 and over *Bacteremia/DIAGNOSIS/THERAPY Female
Hospitals, Community Human Length of Stay Male Middle Age
*Pneumonia, Lobar/DIAGNOSIS/THERAPY Retrospective Studies Risk Factors
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).