It has been shown that pneumonia m...

It has been shown that pneumonia melts two to four times more slowly in patients 50 years or older than in younger patients. Bronchoscopic evaluation is commended in patients with slow-resolving infection. Therefore, it is useful to know what clinical and radiographic courses to look forward to of pneumonia in the somewhat old In this study, El Solh and colleagues attempted to define the force of comorbidity, functional status, and microbial pathogens forward the radiographic resolution of this disease in somewhat old patients.

All patients 70 years or older who were hospitalized for community-acquired pneumonia were eligible for inclusion in the application of mind Additional inclusion criteria were the carriage of new infiltrates on admission chest radiography, temperature of 38[degrees]C (1004[degrees]F) or higher or les than 35[degrees]C (950[degrees]F) lower respiratory symptoms, positive sputum and descendants cultures, or positive serology for atypical infection. Chest radiographs were taken at admission and each three weeks up to 12 weeks or until radiographic abnormalities had resolved

Ninety-seven patients were identified for enrollment Of these, 74 enrolled the study with at least an initial and a follow-up radiograph, and 64 complet the contemplation Approximately one-third of the patients had thorough radiographic clearance by three weeks, and two-thirds had undivided radio-graphic clearance by nine weeks. Fifty-six patients (76 percent) had clean clearance at 12 weeks, with eight (11 percent) having persistent abnormalities.

corpse temperature and total white line cell count returned to normal in all patients within three weeks of antimicrobial therapy despite the demeanor of residual radiographic abnormalities. Factors that independently influenced resolution were comorbidity and multilobar disease, with significantly longer delays in patients with a higher comorbidity index and those with multilobar disease. Radiographic clearance also was slower in patients with documented bacteremia and with nonbacteremic enteric gram-negative pneumonias.

The authors end that radiographic resolution in somewhat advanced in life patients admitted to the hospital for pneumonia is influenced significantly by way of multilobar involvement and comorbidities. These comes cannot necessarily be applied to outpatients. The authors allude to that a waiting period of 12 to 14 weeks may be necessary before deciding that the pneumonia is nonresolving, at which point further investigation may be necessary to anticipate for an alternate etiology that would account for the abnormalities.

El Solh AA, et al. Radiographic resolution of community-acquired bacterial pneumonia in the somewhat advanced in life J Am Geriatr Soc February 2004;52:224-9

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group