Lehtomäki K
Central Military Hospital, Helsinki, Finland.
Eur Respir J. 1988 Apr;1(4):324-9.
Clinical characteristics and course of disease of 19 pneumococcal, 11 adenoviral, 15 mycoplasmal and 10 mixed pneumonias, diagnosed in 55 military conscripts, were compared. Controls consisted of 104 conscripts with upper respiratory infections (URI). The triad: productive cough, blood stained sputum, and chest pain aggravated by breathing (pneumococcal score) distinguished pneumococcal and mixed pneumonias but not adenoviral and mycoplasmal pneumonias from URI. Higher C-reactive protein (CRP) and white blood cell (WBC) count distinguished the pneumococcal pneumonias, but not the other pneumonias, from URI. The pneumococcal scores and simple laboratory tests on admission were compared. The score effectively separated pneumococcal from adenoviral and mycoplasmal pneumonias, and patients with mixed infections from mycoplasmal infections. Higher CRP values and WBC counts distinguished pneumococcal pneumonia from other pneumonias. Auscultation revealed crackles in 27% of adenoviral and in 60-70% of mycoplasmal, pneumococcal and mixed pneumonias. Maxillary sinusitis was more common in pneumococcal (56%) than in mycoplasmal (7%) or mixed pneumonia (10%) or URI (14%). Pneumococcal pneumonias differed in most respects from the other groups. It is difficult to distinguish between adenoviral, mycoplasmal and mixed pneumonia and also URI.
对55名应征入伍军人中诊断出的19例肺炎球菌性肺炎、11例腺病毒性肺炎、15例支原体性肺炎和10例混合性肺炎的临床特征和病程进行了比较。对照组由104例上呼吸道感染（URI）的应征入伍军人组成。三联征：咳痰、血痰以及呼吸时加重的胸痛（肺炎球菌评分）可区分肺炎球菌性肺炎和混合性肺炎，但无法区分腺病毒性肺炎和支原体性肺炎与URI。较高的C反应蛋白（CRP）和白细胞（WBC）计数可区分肺炎球菌性肺炎与URI，但无法区分其他肺炎与URI。比较了入院时的肺炎球菌评分和简单实验室检查。该评分有效地将肺炎球菌性肺炎与腺病毒性肺炎和支原体性肺炎区分开来，并将混合感染患者与支原体感染患者区分开来。较高的CRP值和WBC计数可将肺炎球菌性肺炎与其他肺炎区分开来。听诊发现，27%的腺病毒性肺炎以及60 - 70%的支原体性肺炎、肺炎球菌性肺炎和混合性肺炎有啰音。上颌窦炎在肺炎球菌性肺炎中（56%）比在支原体性肺炎（7%）、混合性肺炎（10%）或URI（14%）中更常见。肺炎球菌性肺炎在大多数方面与其他组不同。难以区分腺病毒性肺炎、支原体性肺炎和混合性肺炎以及URI。
