Koyama H, Honda K, Okuda K, Tsuchiya K, Tanaka S, Kawasaki H
Shizuoka City Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Sep;29(9):1111-8.
Community-acquired pneumonia is one of the major respiratory diseases causing hospital admission in previously healthy patients. Prompt and appropriate antibiotic selection is essential for recovery. The authors tried to determine the distribution of the etiologic agents of community-acquired pneumonias and to analyze predictive factors. Out of 188 cases of community-acquired pneumonia presenting to our hospital, etiologic agents were determined in 106 cases (56%). Twenty-nine cases were due to Streptococcus pneumoniae, 27 cases due to Mycoplasma, 17 cases due to Haemophilus influenzae and 21 cases due to Mycobacterium tuberculosis. M. tuberculosis was the cause in 11% of all cases and the importance of pulmonary tuberculosis must be emphasized as a community-acquired pneumonia. Out of 58 cases under 50 years old, Mycoplasma pneumoniae was the etiologic agent in 23 cases (40%) and S. pneumoniae in 7 cases (12%). Out of 62 cases not less than 70 years old. M. tuberculosis was the most common etiologic agent (15 cases, 24%). S. pneumoniae followed, being causative in 13 cases (21%). M. tuberculosis was the cause in 10 cases out of 31 cases who did not complain of fever at presentation. In 86 cases who did not show leukocytosis on admission, 21 cases were due to Mycoplasma (24%) and 15 cases were due to M. tuberculosis (17%). In particular 17 cases were due to Mycoplasma among 28 cases under 50 years old without leukocytosis (61%), and 11 cases were due to M. tuberculosis in the 27 cases no less than 70 years old without leukocytosis (41%).(ABSTRACT TRUNCATED AT 250 WORDS)
社区获得性肺炎是导致既往健康患者住院的主要呼吸道疾病之一。及时且恰当的抗生素选择对康复至关重要。作者试图确定社区获得性肺炎病原体的分布并分析预测因素。在我院就诊的188例社区获得性肺炎病例中,106例(56%)确定了病原体。29例由肺炎链球菌引起,27例由支原体引起,17例由流感嗜血杆菌引起,21例由结核分枝杆菌引起。结核分枝杆菌在所有病例中占11%,必须强调肺结核作为社区获得性肺炎的重要性。在50岁以下的58例病例中,肺炎支原体是23例(40%)的病原体,肺炎链球菌是7例(12%)的病原体。在70岁及以上的62例病例中,结核分枝杆菌是最常见的病原体(15例,24%)。其次是肺炎链球菌,13例(21%)为病原体。在就诊时未主诉发热的31例病例中,10例由结核分枝杆菌引起。在入院时未出现白细胞增多的86例病例中,21例由支原体引起(24%),15例由结核分枝杆菌引起(17%)。特别是在50岁以下未出现白细胞增多的28例病例中,17例由支原体引起(61%),在70岁及以上未出现白细胞增多的27例病例中,11例由结核分枝杆菌引起(41%)。(摘要截短至250字)