Adult Bacteremic Pneumococcal Pneumonia in a Community Teaching Hospital, 1992-1996n

Abstract

We found a recent increase in the prevalence of bacteremic pneumococcal pneumonia in adults. Gram stain of sputum is useful, but sputum culture is less sensitive in the diagnosis of pneumococcal pneumonia. The fatality rate remains high. More effort should be made at prevention using pneumococcal immunization.

Absence of leukocytosis in bacteraemic pneumococcal pneumonia

“…These findings are consistent with one previously published study. 8 This detailed analysis of adult bacteraemic pneumococcal pneumonia in a community teaching hospital during the years 1992-1996 found that, among 108 patients, only 73.2% presented with a leukocyte count >11,000 cells/mm 3 . The authors noted that leukocytosis was associated with a better prognosis than a normal leukocyte count and leukopenia, 8,15 findings that were not confirmed in our study.…”

“…In patients with pneumococcal pneumonia the peripheral WBC count generally exceeds 11,000/mm 3 , 7,8 although it can be lower than 6,000/mm 3 in 5-10% of patients. Such a low count has been found to be strongly associated with a poor prognosis.…”

“…Such a low count has been found to be strongly associated with a poor prognosis. [8][9][10] It is not known what proportion of patients with bacteraemic pneumococcal pneumonia present with a normal WBC count and thus might have a deferred or incorrect diagnosis and treatment.…”

“…8,13 However, as many as 30% of patients might have an atypical illness, demonstrating the clinical variability of bacteraemic pneumonia. 7 As shown previously by Toikka et al 7 and confirmed in our study, 17% of children presented with normal WBC on admission.…”

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

“…Diabetes is one of the conditions associated with recurrent pneumonia [83]. Bacteraemic pneumococcal pneumonia occurs relatively commonly in diabetic individuals [84,85], but a recent population-based study found a death rate that was similar to that in non-diabetic patients with this condition [86]. However, the adverse impact of diabetes on morbidity and mortality during influenza epidemics has long been recognized [87].…”