Clinical picture of community-acquired Chlamydia pneumoniae pneumonia requiring hospital treatment: a comparison between chlamydial and pneumococcal pneumonia.
BACKGROUND
The importance of Chlamydia pneumoniae as a cause of pneumonia has remained controversial. The clinical picture of C pneumoniae and Streptococcus pneumoniae in patients admitted to hospital with community-acquired pneumonia was compared during a C pneumoniae epidemic in Finland.


METHODS
Group I consisted of 24 patients in whom serological testing and bacterial culture indicated an association with C pneumoniae only, group II comprised nine patients with both C pneumoniae and S pneumoniae, and group III consisted of 13 patients with S pneumoniae only.


RESULTS
The patients with C pneumoniae suffered from headache more frequently than the other patients (group I, 46%; group II, 11%; and group III, 15%) and had received antimicrobial treatment more often before admission to hospital (group I, 54%; groups II and III, 0%). The patients with C pneumoniae produced few good sputum samples and had suffered from respiratory symptoms longer than those with S pneumoniae (group I, 10 days; groups II and III, 4 days). C reactive protein values on admission were lowest in group I and highest in group II. The antimicrobial treatment provided in hospital covered C pneumoniae in 36% of cases in group I and 0% in group II, while S pneumoniae was covered in all patients. C pneumoniae and S pneumoniae together were associated with more severe disease and a longer stay in hospital.


CONCLUSIONS
Pneumonia caused by C pneumoniae was milder but clinically resembled that caused by S pneumoniae, and required hospital treatment even among young patients. Mixed infections were common and should be taken into account when planning antimicrobial treatment for community-acquired pneumonia. Further studies with more patients are needed to evaluate the severity of C pneumoniae pneumonia.
Kauppinen
M T
MT
Department in Oulu, National Public Health Institute, Finland.
Saikku
P
P
Kujala
P
P
Herva
E
E
Syrjälä
H
H
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016993:Chlamydophila pneumoniae; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005387:Finland; D006261:Headache / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M