A Clinical, Bacteriological and Radiological Profile of Community Acquired Pneumonia in Navi Mumbai, India.

Abstract

Background: Pneumonia is a common illness affecting approximately 450 million people a year and occurring in all parts of the world. It is a major cause of death among all age groups resulting in 4 million deaths (7% of the world's total death) yearly. Objectives: This study was performed to understand the mode of presentation, its clinical features, bacteriological and radiological features for the early detection of disease, the causative agent and to study its complications. Patients And Methods: A cross sectional study was carried out in MGM Medical College and Hospital, NaviMumbai, Maharashtra, of 60 patients with the diagnosis of Community Acquired Pneumonia over a period of 2 years. All patients above the age of 14 years who presented with acute onset of fever, cough with expectoration, chest pain and dyspnoea were included in the study and were clinically examined and investigated. Results: The data showed 65% of the patients belonged to the age group of below 50 years with a slightly higher predominance in females, constituting 53.4% of all the cases. Demographically 88% of the patients were from urban population, belonging to the lower socio economic strata. The most common organism isolated from sputum culture were streptococcus pneumoniae in 34 cases (56%), followed by Pseudomonas in 7 patients (11.1%), E. Coli and Acinetobacter in 3 cases each (5%), Staphylococcus Aureus in 2 patients (3.3%) and Klebsiella in 1 patient (1.3%), while mixed infections were seen in 10 cases (16.7%). The chest x ray of patients with CAP demonstrated that, the commonest lobe to be involved was the Right Lower Zone in 17 patients (28%), followed by the Left Middle Zone in 7 patients (11.7%). Involvement of 2 zones was seen in 16 patients (26.7%) while bilateral involvement was seen only in 4 cases (6.7%). Most patients recovered without any complications (73.3%), while para-pneumonic effusion was noted in 4 patients (6.7%). There were 7 patients who developed ARDS of which only 2 patients survived, both requiring mechanical ventilation during the course of stay. There were 9 deaths out of the 60 patients with CAP. Conclusions: Early diagnosis, especially in high risk patients such as patients with COPD, Diabetes, Alcoholics, Smokers with early initiation of antibiotics based on the prevalence of organisms in that community can help reduce the morbidity and mortality in Community Acquired Pneumonia. Newer vaccines can help reduce the burden of the disease in the community.