A positive response to any of seven intradermal antigens predicts favorable outcome in patients hospitalized with community-acquired pneumonia.
We used the commercially available Multitest (R) CMI to assess the response of 100 adults hospitalized with community-acquired pneumonia to the following seven antigens: tetanus toxoid, diphtheria toxoid, Streptococcus, Proteus, tuberculin, Candida, and trichophyton. Thirty-one of the patients responded to one or more of these antigens and survived their acute illness. Of the Multitest (R) CMI negative patients, 49 lived and 20 died. A comparison of the three groups revealed that the 31 patients with positive tests were significantly younger and had a higher mean serum albumin than did those with negative tests who died. Multivariate analysis revealed that a positive Multitest (R) CMI and the albumin level were independent predictors of survival. A positive Multitest (R) CMI identified a less seriously ill group of patients as evidenced by 100% survival, by a very low rate of complications (0.18/patient), and by less utilization of resources (fewer hemograms and chest radiographs). Thus a positive Multitest (R) CMI may identify patients who could be discharged earlier, and a negative test should target its patients for more aggressive therapy.
Marrie
T J
TJ
Department of Medicine, Dalhousie University, Halifax, Nova Scotia.
Durant
H
H
D000328:Adult; D000368:Aged; D000941:Antigens / Q000276:immunology*; D002175:Candida / Q000276:immunology; D004168:Diphtheria Toxoid / Q000276:immunology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology / Q000276:immunology*; D011379:Prognosis; D011513:Proteus mirabilis / Q000276:immunology; D012709:Serum Albumin / Q000378:metabolism; D013291:Streptococcus / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D014249:Trichophyton / Q000276:immunology
D000941:Antigens; D004168:Diphtheria Toxoid; D012709:Serum Albumin; D013745:Tetanus Toxoid