Diagnosis of Pneumonia by Cultures, Bacterial and Viral Antigen Detection Tests, and Serology with Special Reference to Antibodies against Pneumococcal Antigens

• Published in: The Journal of infectious diseases Vol. 163; no. 5; pp. 1087 - 1093
• Main Authors: Burman, Lars Å., Trollfors, Birger, Andersson, Bengt, Henrichsen, Jörgen, Juto, Per, Kallings, Ingegerd, Lagergård, Teresa, Möllby, Roland, Norrby, Ragnar
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University Chicago Press 01-05-1991; University of Chicago Press
• Subjects: Adolescent; Adult; Agglutination Tests; Antibodies; Antibodies, Bacterial - blood; Antigens; Antigens, Bacterial - analysis; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Chlamydia psittaci; Etiology; Haemophilus Infections - diagnosis; Haemophilus influenzae; Human bacterial diseases; Humans; Infections; Infectious diseases; Major Articles; Medical sciences; Mycoplasma pneumoniae; Nasopharynx; Nasopharynx - microbiology; Pneumococcal pneumonia; Pneumonia - diagnosis; Pneumonia - etiology; Pneumonia, Mycoplasma - diagnosis; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Viral - diagnosis; Polysaccharides; Prospective Studies; Psittacosis - diagnosis; Sputum; Sputum - microbiology; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Streptococcus pneumoniae - isolation & purification; Urine; Viral pneumonia; Antigen; Human; Infection; Pneumonia; Antibody; Respiratory disease; Etiology; Immunological investigation; Microorganism culture; Diagnosis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/163.5.1087

In a prospective study of the etiology of pneumonia 196 adult patients were included. One of the following criteria was required for diagnosis of pneumococcal pneumonia: isolation of pneumococci from blood; isolation from transtracheal aspirate; isolation from sputum or nasopharynx or detection of capsular antigen in sputum in combination with a significant increase in antibodies against at least one pneumococcal antigen (type-specific capsular polysaccharide, C-polysaccharide, pneumolysin); or increase in antibodies against two pneumococcal antigens. Pneumococcal pneumonia wasdiagnosed in 63 patients (32%). Other diagnoses were nonencapsulated Haemophilus influenzae isolated from transtracheal aspirates, 9; Mycoplasma pneumoniae diagnosed by serology, 17; Chlamydia psittaci, 6; and viral infections, 42. Twenty-two patients (11%) had evidence of infection with more than one agent. The pathogen could not be determined in 70 (36%). Many patients were given antibiotics before admittance to the study, and in some cases a convalescent serum sample was not available.