Bacteraemic pneumococcal pneumonia: A continuously evolving disease

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Summary

During an 8 year prospective study of community-acquired pneumonia (CAP) requiring hospitalisation we found that 47 of 1118 (4·2%) patients had Streptococcus pneumoniae bacteraemia. Females outnumbered males 27:20. The mean age was 63·4 years and 25% of our patients were admitted from a nursing home. A comparison with the 1071 other patients with CAP showed that patients with bacteraemic pneumococcal pneumonia (BPP) were more likely to be female and to have alcoholism, diabetes mellitus, and chronic obstructive pulmonary disease as co-morbidities. The mortality rate of 19% in BPP was not significantly lower than the 22% rate for the remaining patients with CAP.

Four of the nine (44%) patients with BPP who died, did so within 24h of admission, compared with 29 of 236 (12·3%) (P<0·02) who died of CAP. A notable clinical feature was the absence of cough in 19% while overall in only 66% was the cough productive. Most of the patients had a non-specific clinical presentation. Fifty-three per cent had an uncomplicated stay in hospital.

We conclude that bacteraemic pneumococcal pneumonia is a continuously evolving disease and for the first time may now be more common in women.

References (36)

  • GrandsenWR et al.

    Pneumococcal bacteraemia; 325 episodes diagnosed at St Thomas's Hospital

    Br Med J

    (1985)
  • EspositoAL

    Community-acquired bacteremic pneumococcal pneumonia. Effect of age on manifestations and outcome

    Arch Intern Med

    (1984)
  • FinkelsteinMS et al.

    Pneumococcal bacteremia in adults: Age dependant differences in presentation and in outcome

    J Am Geriatr Soc

    (1983)
  • LipskyBA et al.

    Risk factors for acquiring pneumococcal infections

    Arch Intern Med

    (1986)
  • PerlinoCA et al.

    Alcoholism, leukopenia, and pneumococcal sepsis

    Am Rev Respir Dis

    (1985)
  • SelwynPA et al.

    Increased risk of bacterial pneumonia in HIV-infected intravenous drug users without AIDS

    AIDS

    (1988)
  • PesantiEL et al.

    Infection with the immunodeficiency virus as a risk factor for bacteremic illness due to Streptococcus pneumoniae

    Conn Med

    (1988)
  • SimberkoffMS et al.

    Streptococcus pneumoniae in patients with acquired immune deficiency syndrome with report of a pneumococcal vaccine failure

    Am Rev Respir Dis

    (1984)
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