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Severe community-acquired pneumonia (CAP) treated at Srinagarind Hospital, Khon Kaen, Thailand.

Abstract

In Thailand, the death rate from community-acquired pneumonia (CAP), especially severe CAP, has increased steadily over the past decade. To optimize the outcome, rapid start of appropriate antibiotics and supportive care are the mainstay of management. We therefore assessed the local etiology and outcome of adult patients with severe CAP admitted between January 1, 1999 and December 31, 2001. One hundred and five of 383 patients (27.4%) met the ATS criteria for severe CAP. The mean age was 56.9 (SD 18.2) years. The male to female ratio was 60:45. Duration of symptoms before admission was 5.3 (SD 4.0) days. Most of them (91.4%) had co-morbidity, diabetes mellitus being most common. A microbiological pathogen was isolated in 62 patients (59%). The pathogens most commonly isolated were B. pseudomallei (29.4%), S. pneumoniae (20.6%), K. pneumoniae (19.1%), and H. influenzae (11.8%). Other less common pathogens were E. coli (5.9%), S. aureus (5.9%), M. pneumoniae (1.5%), M. catarrhalis (1.5%), P. aeruginosa (1.5%), P. fluorescens (1.5%), and S. stercoralis (1.5%). Hospitalization averaged 14.7 (SD 14.3) days and mortality was 21%. Clinicals in 17.1 % of patients did not improve and they transferred home. Most (81.9%) patients required mechanical ventilation, while 60 (57.1%) developed septic shock, and 13 (12.3%) acute renal failure. Severe CAP carried high mortality, despite intensive care. Empirical therapy for B. pseudomallei should be considered, where endemic, and for patients with diabetes mellitus or chronic renal failure.

Authors+Show Affiliations

Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15691151

Citation

Reechaipichitkul, Wipa, and Veeradej Pisprasert. "Severe Community-acquired Pneumonia (CAP) Treated at Srinagarind Hospital, Khon Kaen, Thailand." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 35, no. 2, 2004, pp. 430-3.
Reechaipichitkul W, Pisprasert V. Severe community-acquired pneumonia (CAP) treated at Srinagarind Hospital, Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health. 2004;35(2):430-3.
Reechaipichitkul, W., & Pisprasert, V. (2004). Severe community-acquired pneumonia (CAP) treated at Srinagarind Hospital, Khon Kaen, Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 35(2), 430-3.
Reechaipichitkul W, Pisprasert V. Severe Community-acquired Pneumonia (CAP) Treated at Srinagarind Hospital, Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health. 2004;35(2):430-3. PubMed PMID: 15691151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe community-acquired pneumonia (CAP) treated at Srinagarind Hospital, Khon Kaen, Thailand. AU - Reechaipichitkul,Wipa, AU - Pisprasert,Veeradej, PY - 2005/2/5/pubmed PY - 2005/5/10/medline PY - 2005/2/5/entrez SP - 430 EP - 3 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 35 IS - 2 N2 - In Thailand, the death rate from community-acquired pneumonia (CAP), especially severe CAP, has increased steadily over the past decade. To optimize the outcome, rapid start of appropriate antibiotics and supportive care are the mainstay of management. We therefore assessed the local etiology and outcome of adult patients with severe CAP admitted between January 1, 1999 and December 31, 2001. One hundred and five of 383 patients (27.4%) met the ATS criteria for severe CAP. The mean age was 56.9 (SD 18.2) years. The male to female ratio was 60:45. Duration of symptoms before admission was 5.3 (SD 4.0) days. Most of them (91.4%) had co-morbidity, diabetes mellitus being most common. A microbiological pathogen was isolated in 62 patients (59%). The pathogens most commonly isolated were B. pseudomallei (29.4%), S. pneumoniae (20.6%), K. pneumoniae (19.1%), and H. influenzae (11.8%). Other less common pathogens were E. coli (5.9%), S. aureus (5.9%), M. pneumoniae (1.5%), M. catarrhalis (1.5%), P. aeruginosa (1.5%), P. fluorescens (1.5%), and S. stercoralis (1.5%). Hospitalization averaged 14.7 (SD 14.3) days and mortality was 21%. Clinicals in 17.1 % of patients did not improve and they transferred home. Most (81.9%) patients required mechanical ventilation, while 60 (57.1%) developed septic shock, and 13 (12.3%) acute renal failure. Severe CAP carried high mortality, despite intensive care. Empirical therapy for B. pseudomallei should be considered, where endemic, and for patients with diabetes mellitus or chronic renal failure. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/15691151/Severe_community_acquired_pneumonia__CAP__treated_at_Srinagarind_Hospital_Khon_Kaen_Thailand_ DB - PRIME DP - Unbound Medicine ER -