NON-RESOLVING PNEUMONIA AETIOLOGY AND CLINICAL PROFILE: A PROSPECTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 19
Abstract
BACKGROUND Pneumonia is defined as the inflammation and consolidation of the lung tissue due to an infectious agent. In as many as half of cases, the pathogen remains unidentified which greatly hampers the evaluation of slowly resolving or non-resolving pneumonia. OBJECTIVE The main objective is to evaluate the aetiology and clinical profile of non-resolving pneumonia in a tertiary care center and to study the outcome of treatment of non-resolving pneumonia. DESIGN AND SETTING A prospective, observational study was carried out in the department of pulmonary medicine of a 700 bedded tertiary care teaching hospital, Kerala. MATERIALS AND METHODS The patients who were diagnosed as non-resolving pneumonia were included in the study. Various investigations were done on patients to identify the aetiology and clinical profile of their pneumonia which includes sputum gram stain, culture and sensitivity for bacterial infections, AFB culture, fungal culture, chest X-ray, CT thorax, fibrotic bronchoscopy (For selected patients only) and sputum cytology for malignant cells. STATISTICAL METHODS USED Descriptive statistical analysis was done with help of ‘Graph pad prism’. RESULTS With good clinical interpretations and appropriate treatment, about 31.8% of patients had good clinical improvement and complete chest X-ray clearance after 2 months of follow up where as 36.2% of study subjects had good clinical improvement with incomplete chest X-ray clearance. Majority of this group includes patients who were put on anti-tubercular treatment based on careful interpretation of chest X-ray findings of tuberculosis, Mantoux test and sputum AFB culture results. This implies the importance of early diagnosis of treatable diseases like tuberculosis in our population. Out of the total cases 21.2% of patients had poor clinical outcome whereas 4.4% patients were grabbed by death. CONCLUSION Tuberculosis was the commonest cause of non-resolving pneumonia followed by Malignancy. An open mind towards this disease is required and specific investigations are to be made more available.
Authors and Affiliations
Binuraj , Anil , Sruti Nivarthil , Ann Paul , Mrudhul Kallikadavil , Manas
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