Macfarlane J T, Adegboye D S, Warrell M J
Thorax. 1979 Dec;34(6):713-9. doi: 10.1136/thx.34.6.713.
Over a six-month period we studied 74 adult Nigerians who presented consecutively to Ahmadu Bello University Teaching Hospital, Zaria, with lobar or segmental pneumonia. Pneumococcal infection was diagnosed in 50% by the detection of pneumococcal polysaccharide antigen in serum or purulent sputum: 24% had pneumococcal antigenaemia. Twelve patients had evidence of Mycoplasma pneumoniae infection and half of these also had pneumococcal infection. The suggestion that M pneumoniae respiratory infection may predispose to serious bacterial pneumonia is discussed. The initial clinical and radiological features were similar in the pneumococcal and M pneumoniae groups. Raised cold agglutinin titres were not a reliable indication of M pneumoniae infection, perhaps due to altered autoantibody production in Nigerians. Pneumonia was commoner in the dry season, probably related to depressed nasopharyngeal defences caused by drying. Less common causes of lobar pneumonia that were found are also discussed and no cases of legionnaires' disease were identified.
在六个月的时间里,我们研究了74名成年尼日利亚人,他们连续前往扎里亚的阿哈穆杜·贝洛大学教学医院,患有大叶性或节段性肺炎。通过检测血清或脓性痰中的肺炎球菌多糖抗原,50%的患者被诊断为肺炎球菌感染:24%的患者有肺炎球菌血症。12名患者有肺炎支原体感染的证据,其中一半也有肺炎球菌感染。本文讨论了肺炎支原体呼吸道感染可能易引发严重细菌性肺炎的观点。肺炎球菌组和肺炎支原体组的初始临床和放射学特征相似。冷凝集素滴度升高并非肺炎支原体感染的可靠指标,这可能是由于尼日利亚人自身抗体产生的改变。肺炎在旱季更为常见,可能与干燥导致的鼻咽防御功能下降有关。本文还讨论了所发现的大叶性肺炎的较少见病因,未发现军团病病例。