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Paediatric Pulmonology and Allergology
2005 October, Vol. VIII, No. 2 (3011-3018)
COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS: CONTROVERSIES OF DIAGNOSTICS AND TREATMENT
Virginija Sileikiene1, Edvardas Danila2, Remigijus Nargela2, Zinaida Logunova3
1 Center of Pulmonology and Allergology of Vilnius University Hospital
2 Clinic of Pulmonology and Radiology of Vilnius University;
3 Vilnius University Faculty of Medicine, Vilnius, Lithuania
Community-acquired pneumonia is a frequent disease both in children and adult. The aim of the study was to evaluate clinical symptoms, X-ray, laboratory investigations data and treatment efficacy in adult patients who suffered from community-acquired pneumonia and were treated in hospital. In total 91 patients (52 male and 39 female) were evaluated. Chronic respiratory diseases were the most frequent predisposing factors of community-acquired pneumonia. The patients with pneumonia most frequently complained with cough, dyspnoe and fatigue. The most common clinical signs were fever, increased respiratory rate and fine crackles. On the other hand, in every fifth patient there were no auscultation abnormalities and diagnosis was established only after chest X-ray performing. Total fever duration was from 1 till 38 days. Leucocytosis was observed in 50% and leucopenia in 2% of patients. 75% of evaluated persons recovered after treatment with amoxicillin, ampicillin or their combination with beta lactamasis inhibitor, 10 % – II, III or IV generation cephalosporin or carbapenem, 15% – ciprofloxacin. This study and other authors’ data show, that it is possible to make a diagnosis of pneumonia according to clinical symptoms, though accurate diagnosis of pneumonia is confirmed only by chest X-ray. Beta lactamic antibiotics are the best choice to treat majority patients with community-acquired pneumonia. Treatment efficacy was best reflected on clinical symptoms and blood oxygen saturation.