Abstract
Background: Pneumococcal pneumonia causes parapneumonic effusion (PPE) in 40%-57%. Severity can be influenced by both host characteristics e.g. co-morbidity, age and vaccination status and, bacterial factors.
Aims and objectives: To study the relationship between host characteristics (age, co-morbidity and previous vaccination) and disease severity in adults admitted with pneumococcal pneumonia.
Methods: A cohort of 21 inpatients with pneumococcal pneumonia between December 2010 to January 2011 were retrospectively studied using electronic patient records, medical notes and the PACS system. Uncomplicated PPE (UPPE) was defined as pleural fluid pH >7.2, complicated PPE (CPPE) as pH <7.2 and empyema as visible purulent fluid.
Results: 21 patients were admitted with pneumococcal pneumonia, 8 male and 13 female, median age 48 years (range 18-76). 9 (43%) had no associated co-morbidity, of which 7 were <65 years. 6/9 developed pleural effusion (1 UPPE, 4 CPPE and 1 empyema), 4 required chest drainage, none of these 4 were vaccinated.
All patients who developed pleural effusion or empyema, 8/21 (38%), had an admission CRP >100 (range 101->500) and albumin <35 (range 16-32).
7/21 (33%) patients were admitted to the intensive care unit (ICU). 4/7 had no associated co-morbidities, median age was 33 (range 29-48) and all 4 patients were not vaccinated.
Conclusion: Our study highlights that along with high risk groups, young unvaccinated adults with no co-morbidity are also at risk of developing severe pneumococcal pneumonia with complicating pleural effusion or empyema.
- © 2011 ERS
