Prospective Study of the Immunologic Factors Affecting the Prognosis of Severe Community-Acquired Pneumonia

Abstract

Background : In the severe community-acquired pneumonia, it has been known that the immune status is occasionally suppressed. This study was performed to identify the immunologic markers related with the prognostic factors in severe community-acquired pneumonia. Methods : 23 patients with severe community-acquired pneumonia were involved in this study, and divided into survivor (16) and nonsurvivor (7) groups. In this study, the medical history, laboratory tests(complete blood counts, routine chemistry profile, immunoglobulins, complements, lymphocyte subsets, cytokines, sputum and blood culture, urine analysis), and chest radiographs were scrutinized. Results : 1) Both groups had lymphopenia(total lymphocyte count in the survivor and in the nonsurvivor group). 2) The T-lymphocyte count of the nonsurvivor group() was lower than the survivor group() (p in the survivor and in the nonsurvivor group. The BUN of the nonsurvivor group() was higher than that of the survivor group()(p) than that in the survivor group()(p) than in the nonsurvivor group() (p level was in the survivor group and in the nonsurvivor group. 6) A cytokine study showed an insignificant difference in both groups. 7) Chronic liver disease, DM, and COPD were major underlying diseases in both groups. Conclusion : These results suggest that decreased a T-lymphocyte count and immunoglobulin G level, and an increased BUN and creatinine level may be associated with the poor prognosis of severe community-acquired pneumonia.