[Mycoplasma pneumoniae pulmonitis: delayed diagnosis and empirical therapy].
MYCOPLASMA PNEUMONIAE: Delayed diagnosis and empiric therapy.


BACKGROUND
To evaluate the consistency of IHA test to the initial diagnosis and therapy in suspected cases of Mycoplasma pneumoniae pneumonia (MP).


METHODS



METHODS
retrospective-descriptive.


METHODS
Division of Pneumology, IRCCS Policlinico S. Matteo, Pavia from November 1991 to October 1993.


METHODS
235 pts inpatients.


METHODS
age, sex, clinical diagnosis, microbiology, serological investigations for MP by indirect hemagglutination test (IHA); therapy, monitoring and evaluation; considered as positive IHA titres > or = 1:40.


RESULTS
Clinical presentation not different from other "atypical" pneumonia. Macrolides, aminoglycosides, quinolones or cephalosporins were the usual treatment; patients recovered within 1 to 2 weeks consistently to the severity of disease. Sixty-five cases were IHA-positive (28%). Serological outcomes were usually known after 7 to 10 days or more, when most of patients resulted discharged. Mean age in IHA-positive pts was younger than in IHA-negative (31.3 vs 51.6 yrs; p < 0.0001). IHA test was repeated after 3 weeks in 23/235: 2 (9%) remained negative and 15 (65%) positive; 5 (22%) turned from positive to negative; 1 (4%) from negative to positive.


CONCLUSIONS
Clinical and roentgenological presentation similar to other "atypical" pneumonia; late etiological diagnosis and only in 28%, including those monitored distally; significantly young age among IHA-positives; empiric therapy, effective even on the remaining 72% IHA-negative. IHA, commonly used test with good specificity and sensitivity, is of late support to the clinician in short course and uncomplicated disease.
Divisione di Pneumologia, IRCCS Policlinico S. Matteo, Pavia.
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Rizzo
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents