Diagnosis of pneumonia by cultures, bacterial and viral antigen detection tests, and serology with special reference to antibodies against pneumococcal antigens.
In a prospective study of the etiology of pneumonia 196 adult patients were included. One of the following criteria was required for diagnosis of pneumococcal pneumonia: isolation of pneumococci from blood; isolation from transtracheal aspirate; isolation from sputum or nasopharynx or detection of capsular antigen in sputum in combination with a significant increase in antibodies against at least one pneumococcal antigen (type-specific capsular polysaccharide, C-polysaccharide, pneumolysin); or increase in antibodies against two pneumococcal antigens. Pneumococcal pneumonia was diagnosed in 63 patients (32%). Other diagnoses were nonencapsulated Haemophilus influenzae isolated from transtracheal aspirates, 9; Mycoplasma pneumoniae diagnosed by serology, 17; Chlamydia psittaci, 6; and viral infections, 42. Twenty-two patients (11%) had evidence of infection with more than one agent. The pathogen could not be determined in 70 (36%). Many patients were given antibiotics before admittance to the study, and in some cases a convalescent serum sample was not available.
Burman
L A
LA
Department of Infectious Diseases and Virology, University of Umeå, Sweden.
Trollfors
B
B
Andersson
B
B
Henrichsen
J
J
Juto
P
P
Kallings
I
I
Lagergård
T
T
Möllby
R
R
Norrby
R
R
D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000032:analysis*; D006192:Haemophilus Infections / Q000175:diagnosis; D006801:Humans; D009305:Nasopharynx / Q000382:microbiology; D011014:Pneumonia / Q000175:diagnosis* / Q000209:etiology; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis; D011024:Pneumonia, Viral / Q000175:diagnosis; D011446:Prospective Studies; D009956:Psittacosis / Q000175:diagnosis; D013183:Sputum / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial