Etiology and Patterns of Lungs Involvement in Community Acquired Pneumonia in Patients Presenting at Tertiary Care Centre in Lahore.

Abstract

As pneumonia is a group of specific infections, each having different epidemiology, pathogenesis, clinical presentations and clinical course. Objectives of this study were to determine the etiological organisms in Patients with community acquired pneumonia (CAP) and also to find out the pattern of consolidation in lobar versus bronchopneumonia, sides of lungs involved and percentage of patients developing Pleural effusion during course of the disease. Observational study with prospective data collection. This study was conducted in emergency department and West Medical Ward of Mayo Hospital, Lahore from 15^th July 2000 to 30^th Nov. 2000. Patients presenting in emergency, out patients departments of West Medical Ward Mayo Hospital, Lahore having features of lower respiratory tract infection clinically, were screened. Those who met inclusion and exclusion criteria were included, all concerned investigations especially x-ray chest, sputum gram staining and culture sensitivity were performed. All these patient were followed till complete recovery from pneumonia.

Total 38 patients with CAP were included in the study, 29 males 9 females. Mean age was 41.38 years, commonest symptom was cough 100%, 47% were smoker. Main outcome measure was positive sputum culture. Ail patients on gram staining of sputum showed gram positive cocci or Predominantly gram + ve cocci with gram—ye rods. Sputum culture was positive ¡n only 31.6% cases, commonest organism was streptococcus pneumonia (10.5%) followed by staph auraes (7.9%). H. influenzac, klebsiella, Pseudomonas, E. coil and Candida 2.6% each. Commonest pattern of consolidation was lobar 78.9%, bronchopneumonia 7.9% and mixed picture 13.2% 21% developed pleural effusion (luring the course of illness. Lobar pneumonia is the commonest pattern of lung involvement, commonest etiological agent is strep. pneumoniae. One fifth of the patients developed para—pneumonic effusion.