title: A three-year study of severe community-acquired pneumonia with emphasis on outcome.
abstract: Fifty-eight consecutive patients with severe community-acquired pneumonia were studied prospectively during a three-year period. The group included 44 men and 14 women (mean age: 45.0 +/- 15.7 years). The cause of pneumonia was diagnosed in 35 (60.3 percent) cases, and the most common pathogens were Streptococcus pneumoniae (37.1 percent), Legionella pneumophila (22.8 percent) and Gram-negative bacilli (11.4 percent). The fact that Mycobacterium tuberculosis was present in four (11.4 percent) patients and Pneumocystis carinii in three (8.5 percent) is worthy of note. The overall death rate was 22.4 percent. More than 50 percent of deaths occurred within the first five days and were caused by septic shock, hemoptysis (tuberculosis) or hypoxia. However, hypoxia remains the main fatal complication and all late-occurring deaths (> 5 days) observed were due to this cause. These data could be important in planning strategies and protocols to improve prognosis.
authors.affiliation: Intensive Care Department, Hospital de la S. Creu i S. Pau, Universitat Autonoma de Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Rello
authors.forename: E
authors.initials: E
authors.lastname: Quintana
authors.forename: V
authors.initials: V
authors.lastname: Ausina
authors.forename: A
authors.initials: A
authors.lastname: Net
authors.forename: G
authors.initials: G
authors.lastname: Prats
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology; D002439:Cefotaxime / Q000627:therapeutic use; D003422:Critical Care; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007877:Legionnaires' Disease / Q000175:diagnosis; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis; D011379:Prognosis; D011446:Prospective Studies; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
chemical_list: D004917:Erythromycin; D002439:Cefotaxime