Community-acquired staphylococcal pneumonia.
OBJECTIVE
Staphylococcal pneumonia typically presents high rates of morbidity and mortality. It typically occurs in cases of influenza (airborne transmission) or during episodes of bacteremia (blood-borne transmission).


METHODS
A retrospective and descriptive study was conducted in patients admitted to our hospital between January of 1992 and December of 2003. All of he patients included had been diagnosed with community-acquired pneumonia caused by Staphylococcus aureus. All were older than 14 years of age, and none were intravenous drug users.


RESULTS
Community-acquired pneumonia was identified in 332 cases, of which 24 (7.3%) were identified as cases of staphylococcal pneumonia. Age ranged from 14 to 89 years. Fifteen patients were male, and nine were female. Twelve patients met the criteria for severe pneumonia. Chest X-rays showed unilateral consolidation in 14 cases, bilateral consolidation in 10, pleural effusion in 15, rapid radiological progression of pulmonary lesions in 14, cavitation in 6 and pneumothorax in 1. Most of the patients presented comorbidities, of which diabetes mellitus was the most common. Twelve patients presented complications such as empyema and septic shock. Four patients died, translating to a mortality rate of 16.6% in our sample.


CONCLUSIONS
The clinical presentation of pneumonia caused by S. aureus is similar to that of pneumonia caused by other etiological agents. Radiological findings, epidemiological data and risk factors provide important clues to the diagnosis. These factors are important for clinical suspicion, since S. aureus is not typically addressed in empirical treatment.
Santos
José Wellington Alves dos
JW
Pulmonology Department, Santa Maria University Hospital of the Federal University of Santa Maria, Santa Maria, Brazil. jwasb@terra.com.br
Nascimento
Douglas Zaione
DZ
Guerra
Vinicius André
VA
Rigo
Vanessa da Silva
Vda S
Michel
Gustavo Trindade
GT
Dalcin
Tiago Chagas
TC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000453:epidemiology; D015897:Comorbidity; D004653:Empyema / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012189:Retrospective Studies; D012772:Shock, Septic / Q000382:microbiology; D013183:Sputum / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D055815:Young Adult