title: Etiology of suspected pneumonia in adults admitted to a high-dependency unit in Blantyre, Malawi.
abstract: The microbiologic etiology of severe pneumonia in hospitalized patients is rarely known in sub-Saharan Africa. Through a comprehensive diagnostic work-up, we aimed to identify the causative agent in severely ill patients with a clinical picture of pneumonia admitted to a high-dependency unit. A final diagnosis was made and categorized as confirmed or probable by using predefined criteria. Fifty-one patients were recruited (45% females), with a mean age of 35 years (range = 17-88 years), of whom 11(22%) died. Forty-eight (94%) of the patients were seropositive for human immunodeficiency virus; 14 (29%) of these patients were receiving antiretroviral treatment. Final diagnoses were bacterial pneumonia (29%), Pneumocystis jirovecii pneumonia (27%), pulmonary tuberculosis (22%), and pulmonary Kaposi's sarcoma (16%); 39 (77%) of these cases were confirmed cases. Fifteen (29%) patients had multiple isolates. At least 3 of 11 viral-positive polymerase chain reaction (PCR) results of bronchoalveolar lavage fluid were attributed clinical relevance. No atypical bacterial organisms were found.
authors: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Respiratory Medicine, Victoria Hospital, Kirkcaldy, United Kingdom. thomas.hartung@nhs.net [corrected]
authors: Thomas K
authors: TK
authors: Hartung
authors: Daniel
authors: D
authors: Chimbayo
authors: Joep J G
authors: JJ
authors: van Oosterhout
authors: Tarsizio
authors: T
authors: Chikaonda
authors: Gerard J J
authors: GJ
authors: van Doornum
authors: Eric C J
authors: EC
authors: Claas
authors: Willem J G
authors: WJ
authors: Melchers
authors: Malcolm E
authors: ME
authors: Molyneux
authors: Ed E
authors: EE
authors: Zijlstra
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D019090:Case Management; D005260:Female; D006760:Hospitalization; D006801:Humans; D008295:Malawi; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology*; D011446:Prospective Studies; D055815:Young Adult