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Clinical picture of community-acquired Chlamydia pneumoniae pneumonia requiring hospital treatment: a comparison between chlamydial and pneumococcal pneumonia.
  1. M. T. Kauppinen,
  2. P. Saikku,
  3. P. Kujala,
  4. E. Herva,
  5. H. Syrjälä
  1. Department in Oulu, National Public Health Institute, Finland.

    Abstract

    BACKGROUND: The importance of Chlamydia pneumoniae as a cause of pneumonia has remained controversial. The clinical picture of C pneumoniae and Streptococcus pneumoniae in patients admitted to hospital with community-acquired pneumonia was compared during a C pneumoniae epidemic in Finland. METHODS: Group I consisted of 24 patients in whom serological testing and bacterial culture indicated an association with C pneumoniae only, group II comprised nine patients with both C pneumoniae and S pneumoniae, and group III consisted of 13 patients with S pneumoniae only. RESULTS: The patients with C pneumoniae suffered from headache more frequently than the other patients (group I, 46%; group II, 11%; and group III, 15%) and had received antimicrobial treatment more often before admission to hospital (group I, 54%; groups II and III, 0%). The patients with C pneumoniae produced few good sputum samples and had suffered from respiratory symptoms longer than those with S pneumoniae (group I, 10 days; groups II and III, 4 days). C reactive protein values on admission were lowest in group I and highest in group II. The antimicrobial treatment provided in hospital covered C pneumoniae in 36% of cases in group I and 0% in group II, while S pneumoniae was covered in all patients. C pneumoniae and S pneumoniae together were associated with more severe disease and a longer stay in hospital. CONCLUSIONS: Pneumonia caused by C pneumoniae was milder but clinically resembled that caused by S pneumoniae, and required hospital treatment even among young patients. Mixed infections were common and should be taken into account when planning antimicrobial treatment for community-acquired pneumonia. Further studies with more patients are needed to evaluate the severity of C pneumoniae pneumonia.

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