       Document 0413
 DOCN  M9630413
 TI    Bacteremic pneumococcal pneumonia. A community hospital experience.
 DT    9603
 AU    Lippmann ML; Goldberg SK; Walkenstein MD; Herring W; Gordon M; Albert
       Einstein Medical Center, Philadelphia, PA 19141, USA.
 SO    Chest. 1995 Dec;108(6):1608-13. Unique Identifier : AIDSLINE
       MED/96098005
 AB    We reviewed our experience with bacteremic pneumococcal pneumonia (BPP)
       over a 1-year period at a 600-bed community teaching hospital; 26 cases
       were identified. The mean age was 57.5 years and there were 12 male and
       14 female subjects. Cough, sputum production, fever, and mental status
       changes were the most frequent symptoms. Risk factors included drug
       abuse in 10, HIV in 4, current smoking in 7, diabetes in 3, and cancer
       in 3. The mean PaO2/FIo2 ratio was 274. Radiographic features included a
       consolidation pattern in 7, bronchopneumonia in 15, combined in 1, and
       an initial normal film in 3. Average length of stay (LOS) was 11 days
       with an overall mortality of 11.5%. Four patients required mechanical
       ventilation, two meeting the criteria for ARDS (if this group were
       eliminated, LOS would be 8.4 days). Three of these survived. Four
       patients had organisms resistant to penicillin and all survived. We
       conclude that (1) BPP remains a serious but treatable infection
       particularly when utilizing full supportive care; (2) the
       bronchopneumonia x-ray film pattern was associated with all the
       mortality; and (3) the occurrence of penicillin resistance did not
       contribute to the mortality, since early recognition and the use of
       appropriate antibiotics saved all of these patients.
 DE    Adult  Aged  Aged, 80 and over  *Bacteremia/DIAGNOSIS/THERAPY  Female
       Hospitals, Community  Human  Length of Stay  Male  Middle Age
       *Pneumonia, Lobar/DIAGNOSIS/THERAPY  Retrospective Studies  Risk Factors
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

