Chest
Clinical InvestigationsMicrobial Etiology of Acute Pneumonia in Hospitalized Patients
Section snippets
Patient Selection
All patients hospitalized on the medical service of the John L. McClellan Veterans Administration Medical Center, Little Rock, Ark, during the calendar year 1985 (approximately 6,500 admissions) were evaluated both on admission and throughout their hospital course for the presence or development of pneumonia. All patients with clinical evidence of pneumonia were evaluated within 24 h for inclusion in the study. For selection, each patient was required to have a new or progressive pulmonary
Patients
In all, 233 patients who experienced a total of 240 episodes of suspected pneumonia were evaluated and admitted to the study. Each met the criteria established for entry, but on retrospective review after days or weeks of follow-up, 36 episodes involving 35 patients were diagnosed as due to another disease, such as pulmonary edema, pulmonary infarction, atelectasis, or tumor. Thus, for final analysis 198 patients with 204 episodes of pneumonia were studied and followed up to recovery or death.
DISCUSSION
It is distressing that, despite extensive laboratory testing and many invasive procedures done to obtain material for study, we were able to establish the pathogen in only 50 percent of the patients studied. However, our results are not substantially lower than those in other studies, in which an etiologic agent was found in only 67 percent, 55 percent, and 49 percent of patients.11, 12, 13, 14 There are several reasons why we found fewer pathogens than expected. Wishing to use very strict
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Supported in part by a grant from Abbott Laboratories, Abbott Park, Ill.
Manuscript received May 28; revision accepted July 24.