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Aetiology and Clinical Presentation of Mild Community-Acquired Bacterial Pneumonia

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Abstract

A prospective study was initiated to analyse the bacterial aetiology and clinical picture of mild community-acquired pneumonia in Slovenia using the previously described Pneumonia Severity Index. Radiographically confirmed cases of pneumonia in patients treated with oral antibiotics in seven study centres were included. An aetiological diagnosis was attempted using culture of blood and sputum, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, and antibody testing for Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila in paired serum samples. One hundred thirteen patients were evaluable for clinical presentation and 109 for aetiological diagnosis. At least one pathogen was detected in 62.4% patients. The most common causative agents were Mycoplasma pneumoniae in 24.8%, Chlamydia pneumoniae in 21.1%, and Streptococcus pneumoniae in 13.8% of patients. Dual infection was detected in 8.3% of patients. Most patients suffered from cough, fatigue, and fever. Patients with atypical aetiology of pneumonia differed from those with typical bacterial pneumonia or pneumonia of unknown aetiology in age, presence of dyspnea, and bronchial breathing on lung auscultation. Patients with pneumococcal, chlamydial, and mycoplasmal infections differed in age, risk class, presence of dyspnea, bronchial breathing, and proteinuria. There was an overlap of other clinical symptoms, underlying conditions, and laboratory and radiographic findings among the groups of patients classified by aetiology. Since patients with mild community-acquired pneumonia exhibit similar clinical characteristics and, moreover, since a substantial proportion of cases are attributable to atypical bacteria, broad-spectrum antibiotic treatment seems to be recommended.

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Article 08 April 2021

Antoni Torres, Catia Cilloniz, … Tom van der Poll

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Acknowledgements

We thank Lek d.d. Pharmaceutical Company for partial financial support of the study and Stojan Kariž, M.D., Tatjana Remec, M.D., Jani Dernič, M.D., and Mateja Logar, M.D., for their help in providing the patients.

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Authors and Affiliations

  1. Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525, Ljubljana, Slovenia

    B. Beović

  2. Lek Pharmaceutical Company, Verovškova 57, 1000, Ljubljana, Slovenia

    B. Bonač

  3. Institute of Microbiology and Immunology, Zaloška 2, 1000, Ljubljana, Slovenia

    D. Keše & T. Avšič-Županc

  4. Faculty of Pharmacy, Aškerčeva 25, 1000, Ljubljana, Slovenia

    S. Kreft

  5. General Hospital Celje, Oblakova 5, 3000, Celje, Slovenia

    G. Lesničar

  6. General Hospital Maribor, Ljubljanska 5, 2000, Maribor, Slovenia

    J. Gorišek-Reberšek

  7. Hospital Topolšica, Topolšica 61, 3226, Topolšica, Slovenia

    L. Rezar

  8. Institute Golnik, 4204, Golnik, Slovenia

    S. Letonja

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  1. B. Beović
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Correspondence to B. Beović.

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Beović, B., Bonač, B., Keše, D. et al. Aetiology and Clinical Presentation of Mild Community-Acquired Bacterial Pneumonia. Eur J Clin Microbiol Infect Dis 22, 584–591 (2003). https://doi.org/10.1007/s10096-003-0997-0

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