title: [Evaluation of community-acquired pneumonia guidelines of Japanese Respiratory Society: differentiation of atypical pneumonia and bacterial pneumonia].
abstract: To evaluate the usefulness of differentiation of atypical pneumonia and bacterial pneumonia in the community-acquired pneumonia guidelines of the Japanese Respiratory Society, we investigated 124 cases of three atypical pneumonias (Mycoplasma pneumonia, 62 cases; Chlamydia pneumoniae pneumonia, 46 cases; Chlamydia psittaci pneumonia, 13 cases) and 403 cases of bacterial pneumonia at our hospital over seven years. Overall, the sensitivity and specificity of the criteria in the guideline were 70.4% and 91.8%, respectively. High accordance was recognized in patients under 60 years old with atypical pneumonia. Items in the criteria that included subjective factors were considered inassessable. We found that the differentiation of pneumonias in the guideline is useful for the diagnosis of atypical pneumonia among younger patients, but it should be concise and objective. We therefore propose that the criteria would be more effective if they consisted of only 4 items: age under 60 years, no underlying disorders, presence of stubborn dry cough, and normal peripheral white blood cell count.
authors.affiliation: Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Toru
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Machiko
authors.initials: M
authors.lastname: Arita
authors.forename: Eiji
authors.initials: E
authors.lastname: Kaneshiro
authors.forename: Makoto
authors.initials: M
authors.lastname: Osawa
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Tachibana
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Nishioka
authors.forename: Kizuku
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis; D016993:Chlamydophila pneumoniae; D002691:Chlamydophila psittaci; D017714:Community-Acquired Infections / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis*; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D009956:Psittacosis / Q000175:diagnosis