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. 1993 Nov;4(6):328-32.
doi: 10.1155/1993/435350.

Serological investigation of pneumonia as it presents to the physician's office

D Langille  1 , L Yates, T Marrie
Affiliations

Serological investigation of pneumonia as it presents to the physician's office

D Langille et al. Can J Infect Dis. 1993 Nov.

Abstract
in English, French

Purpose: To define the etiology of pneumonia, using a battery of serological tests, among patients presenting to physicians' offices in Cumberland County, Nova Scotia from July 2, 1989 to July 1, 1990.

Methods: Patients presenting to their physician's office with symptoms suggestive of pneumonia were invited to participate in the study by completing a questionnaire, having a chest radiograph and providing acute and convalescent phase serum samples. These serum samples were tested for antibodies to Mycoplasma pneumoniae, Coxiella burnetii, Legionella pneumophila, adenovirus, and influenza viruses A and B. Some of the samples were tested for antibodies to Chlamydia pneumoniae.

Results: Seventy-five of the inception cohort of 203 patients had a chest radiograph compatible with pneumonia, a completed questionnaire and acute and convalescent phase serum samples. There were 39 females and 36 males with a mean age of 41.7 years. Twenty-six (35%) were admitted to hospital. The mortality rate was 3%. Forty-five per cent had a diagnosis made by serology: M pneumoniae, 22 (29%); influenza A virus, five (7%); C burnetii, L pneumophila, adenovirus, two (3%) each.

Conclusions: While it is not possible to generalize about these findings because of ascertainment bias, the data suggest that M pneumoniae is a common cause of pneumonia presenting to a physician's office and that mortality is low in this group of patients.

Objectif:: Définir l’étiologie de la pneumonie à l’aide d’une batterie de tests sérologiques chez les patients qui se présentèrent dans les cabinets médicaux du comté de Cumberland (Nouvelle-Écosse) entre juillet 1989 et le 1er juillet 1990.

Méthodes:: Des patients se présentant au cabinet de leur médecin avec des symptômes évocateurs de pneumonie ont été invités à participer à l’étude en remplissant un questionnaire, en subissant une radiographie pulmonaire et en fournissant des spécimens sériques durant la phase aiguë et la convalescence. Ces échantillons de sérum ont été analysés à l’égard des anticorps dirigés contre Mycoplasma pneumoniae, Coxiella burnettii, Legionella pneumophila, l’adénovirus et les virus de l’influenza A et B. Certains échantillons ont été analysés à l’égard des anticorps anti-Chlamydia pneumoniae.

Résultats:: Soixante-quinze pour cent de la cohorte d’inception de 203 patients qui présentaient des signes radiologiques de pneumonie ont rempli le questionnaire et soumis des échantillons de sérum durant la phase aiguë et la convalescence. Il y avait 39 femmes et 36 hommes, dont la moyenne d’âge était de 41,7 ans. Vingt-six (35 %) ont été admis à l’hôpital. Le taux de mortalité a été de 3 %. Quarante-cinq pour cent ont vu leur diagnostic confirmé par des analyses sérologiques: M pneumoniae, 22 (29 %); virus de l’influenza 5 (7 %); C burnetii, L pneumophila, adénovirus, 2 (3 %) chacun.

Conclusions:: Bien que l’on ne puisse généraliser, nos données suggèrent que M pneumoniae est une cause fréquente de pneumonie parmi les patients qui se présentent chez leur médecin et le taux de mortalité est faible dans ce groupe de patients.

Keywords: Coxiella burnetii; Epidemiology; Legionella; Mycoplasma; Pneumonia.

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Figures

Figure 1
Figure 1
Month of onset of pneumonia for 75 patients. The number of patients with pneumonia due to each of the indicated agents is also shown. Chl Chlamydia pneumoniae; Inf A Influenza A virus; Adenov Adenovirus; Leg Legionella pneumophila; QF Coxiella burnetii – Q fever; MPN Mycoplasma pneumoniae; dx Diagnosis; the clear space represents the number of patients who had no antibody rise to the agents indicated above
Figure 2
Figure 2
Month of onset of illness for 203 patients who had acute and convalescent serum samples collected. Chl Chlamydia pneumoniae; Inf A Influenza A virus; Adenov Adenovirus; Leg Legionella pneumophila; QF Coxiella burnetii – Q fever; MPN Mycoplasma pneumoniae; dx Diagnosis; the clear space represents the number of patients who had no antibody rise to the agents indicated above
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