Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos

Background: The presence of bacteremia during a pneumococcal pneumonia is a sign of bad prognosis. Aim: To report a clinical experience with bacteremic pneumococcal pneumonia. Patients and methods: We reviewed the clinical and laboratory data from 45 adults (36 male, aged 17 to 97 years) with commun...

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Autores principales:	Rioseco Z,María Luisa, Riquelme O,Raúl
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Materias:	APACHE Pneumonia, bacterial Streptococcus pneumoniae
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000500008
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spelling	oai:scielo:S0034-988720040005000082005-11-18Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticosRioseco Z,María LuisaRiquelme O,Raúl APACHE Pneumonia, bacterial Streptococcus pneumoniae Background: The presence of bacteremia during a pneumococcal pneumonia is a sign of bad prognosis. Aim: To report a clinical experience with bacteremic pneumococcal pneumonia. Patients and methods: We reviewed the clinical and laboratory data from 45 adults (36 male, aged 17 to 97 years) with community acquired pneumonia (CAP) and Streptococcus pneumoniae bacteremia, hospitalized between January 1997 and August 2002 at the Puerto Montt Hospital (Southern Chile). Results: Eighty four percent of patients had underlying aggravating conditions, mainly alcoholism (40%), chronic obstructive lung disease (17.8%) and renal failure (17.8%). Seven percent were homeless. Fever, cough, dyspnea and sputum were the most common presenting symptoms. Five patients had pleural involvement. Four strains (8.9%) of S. pneumoniae had diminished susceptibility to penicillin. Nine patients died (case-fatality rate of 20%), but mortality was attributed to pneumonia in only three of them. Main factors associated with a higher mortality were renal failure, absence of cough, an arterial pH <7.3 on admission, ICU hospitalization, shock, mechanical ventilation and an APACHE score >16. Conclusions: The high death rate of these patients could be explained mainly by underlying conditions. ICU management and higher cost preventive measures could reduce this rate (Rev Méd Chile 2004; 132: 588-94).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.5 20042004-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000500008es10.4067/S0034-98872004000500008
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	APACHE Pneumonia, bacterial Streptococcus pneumoniae
spellingShingle	APACHE Pneumonia, bacterial Streptococcus pneumoniae Rioseco Z,María Luisa Riquelme O,Raúl Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
description	Background: The presence of bacteremia during a pneumococcal pneumonia is a sign of bad prognosis. Aim: To report a clinical experience with bacteremic pneumococcal pneumonia. Patients and methods: We reviewed the clinical and laboratory data from 45 adults (36 male, aged 17 to 97 years) with community acquired pneumonia (CAP) and Streptococcus pneumoniae bacteremia, hospitalized between January 1997 and August 2002 at the Puerto Montt Hospital (Southern Chile). Results: Eighty four percent of patients had underlying aggravating conditions, mainly alcoholism (40%), chronic obstructive lung disease (17.8%) and renal failure (17.8%). Seven percent were homeless. Fever, cough, dyspnea and sputum were the most common presenting symptoms. Five patients had pleural involvement. Four strains (8.9%) of S. pneumoniae had diminished susceptibility to penicillin. Nine patients died (case-fatality rate of 20%), but mortality was attributed to pneumonia in only three of them. Main factors associated with a higher mortality were renal failure, absence of cough, an arterial pH <7.3 on admission, ICU hospitalization, shock, mechanical ventilation and an APACHE score >16. Conclusions: The high death rate of these patients could be explained mainly by underlying conditions. ICU management and higher cost preventive measures could reduce this rate (Rev Méd Chile 2004; 132: 588-94).
author	Rioseco Z,María Luisa Riquelme O,Raúl
author_facet	Rioseco Z,María Luisa Riquelme O,Raúl
author_sort	Rioseco Z,María Luisa
title	Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
title_short	Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
title_full	Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
title_fullStr	Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
title_full_unstemmed	Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos
title_sort	neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: cuadro clínico y factores pronósticos
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000500008
work_keys_str_mv	AT riosecozmarialuisa neumonianeumococicabacteremicaen45adultosinmunocompetenteshospitalizadoscuadroclinicoyfactorespronosticos AT riquelmeoraul neumonianeumococicabacteremicaen45adultosinmunocompetenteshospitalizadoscuadroclinicoyfactorespronosticos
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Neumonía neumocócica bacterémica en 45 adultos inmunocompetentes hospitalizados: Cuadro clínico y factores pronósticos

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