Anaerobic bacterial pneumonitis.

Clinical features of 46 patients with anaerobic bacterial pneumonitis were compared with those of patients with pneumococcal pneumonia. The presenting features in these 2 groups were comparable in terms of fever, leukocyte count, and radiographic abnormalities. In only 2 patients with anaerobic bacterial pneumonitis was putrid sputum noted on initial evaluation. None of the patients with anaerobic bacterial pneumonitis had shaking chills, although this was reported by nearly one half of those with pneumococcal pneumonia. The response to treatment with antimicrobial drugs was comparable in the 2 groups, except that 20% of patients with anaerobic bacterial pneumonitis subsequently developed pulmonary abscesses, despite the use of antimicrobial agents presumed to be active against the infecting flora. There was also a high incidence of bronchogenic neoplasms among patients who had anaerobic bacterial pneumonitis in the absence of an associated condition that would predispose to aspiration. The findings of this review suggest that anaerobic bacterial pneumonitis may be difficult to distinguish from pneumococcal pneumonia on the basis of clinical presentation.