Abstract
BackgroundA reliable prediction of the causative agent of community-acquired pneumonia (CAP) is not possible based on clinical features. Our aim was to test, whether the measurement of the expression of complement receptors or Fcγ receptors on neutrophils and monocytes would be a useful preliminary test to differentiate between bacterial and viral pneumonia.MethodsSixty-eight patients with CAP were studied prospectively. Thirteen patients had pneumococcal pneumonia; 13 patients, influenza A pneumonia; 5 patients, atypical pneumonia, and 37 patients, aetiologically undefined pneumonia. Leukocyte receptor expression was measured within 2 days of hospital admission.ResultsThe mean expression of complement receptor 1 (CR1) on neutrophils was significantly higher in the patients with pneumococcal pneumonia than in those with influenza A pneumonia. The mean expression of CR1 was also significantly higher in aetiologically undefined pneumonia than in influenza A pneumonia, but there was no difference between pneumococcal and undefined pneumonia.ConclusionOur results suggest that the expression of CR1 is higher in classical bacterial pneumonia than in viral pneumonia. Determination of the expression of CR1 may be of value as an additional rapid tool in the aetiological diagnosis, bacterial or viral infection, of CAP. These results are preliminary and more research is needed to assess the utility of this new method in the diagnostics of pneumonia.
Highlights
A reliable prediction of the causative agent of community-acquired pneumonia (CAP) is not possible based on clinical features
Atypical pneumonia was identified in 5 patients: 3 M. pneumoniae by serology, 1 C. pneumoniae by serology, and 1 L. pneumophila by polymerase chain reaction (PCR) and serology
The mean expression of complement receptor 1 (CR1) on neutrophils was significantly higher in the patients with pneumococcal pneumonia than in those with influenza A pneumonia
Summary
A reliable prediction of the causative agent of community-acquired pneumonia (CAP) is not possible based on clinical features. Our aim was to test, whether the measurement of the expression of complement receptors or Fcγ receptors on neutrophils and monocytes would be a useful preliminary test to differentiate between bacterial and viral pneumonia. Community-acquired pneumonia (CAP) is a common illness with a wide range of causative agents. The medical history of the patient and the clinical findings may be suggestive for the aetiology of CAP. A reliable prediction of the causative agent of CAP is not possible on grounds of clinical features [1,2]. It may even be difficult to differentiate between the bacterial and viral aetiology of pneumonia. There is some evidence suggesting that the serum C-reactive pro-
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