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KMID : 1004820130140030132
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Journal of Biomedical Research
2013 Volume.14 No. 3 p.132 ~ p.139
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Clinical and radiological findings in community-acquired pneumonia: A comparison between viral and bacterial infection
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Choi Young-Rak
Jung Heo-Won
Choi Young-Ki
Kim Si-Wook
Lee Ki-Man
Choe Kang-Hyeon
An Jin-Young
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Abstract
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Effective treatment for community-acquired pneumonia(CAP) requires administration of appropriate empiricaltherapy based on etiologic, clinical, and radiological features.However, in Korea, CAP is poorly characterized, anddata on viral CAP are particularly sparse. Therefore, improperuse of antibiotics is common, and is detrimental thepotential for development of bacterial. Thus, we investigatedclinical and radiological findings for discrimination of viralCAP from bacterial CAP. Etiologic, clinical, and radiologicaldata from 467 patients with CAP at Chungbuk NationalUniversity Hospital from October 2010 to September 2011were analyzed retrospectively. Viruses were identified in 23cases (11.4%); the influenza virus A was the most commonvirus detected (N=18, 25.4%), followed by the respiratorysyncytial virus A (N=14, 17.9%). Bacteria were identified in48 cases (23.8%); Streptococcus-pneumonia was the mostcommon (N=24, 25.5%), followed by Staphylococcus aureus(N=20, 21.3%). Depending on hospitalization time, the followingsignificant differences were observed between viraland bacterial CAP: on admission, (1) high fever (≥ 38.5°C),(2) purulent sputum, (3) white blood cell count, (4) Creactiveprotein levels, (5) and bilateral lung involvement onchest X-ray were higher in bacterial CAP; and at discharge,(1) duration of high fever and (2) radiologic improvementwithin three days were higher in viral CAP. Regarding seasonalpatterns, both viruses and bacteria have been identifiedwith relative frequency in the winter season. This studydescribed the etiological, clinical, and radiological findingsof viral and bacterial CAP. Conduct of additional largescale,prospective investigations will be required in order toimprove the appropriate treatment of CAP.
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KEYWORD
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community-acquired pneumonia, virus, bacteria
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