Abstract

Background: Community Acquired pneumonia remains a major reason for admission to hospitals and a common cause of death in developing countries. Studies conducted in the developed countries forms the basis for various guidelines on this topic which is even more important problem in a country like India. Since the environmental and socioeconomic background of our area is different from those where the studies are carried out, there should be a difference in the pattern of Community Acquired Pneumonia in our area. This study is therefore carried out with the intention of identifying the clinoco-epidemiological profile of patients with Community Acquired Pneumonia in a hospital population in rural south kerala.

Objectives: To study the clinical profile of patients admitted with Community Acquired Pneumonia in a tertiary care centre and to assess the variability in presentations of Community Acquired Pneumonia in patients with Diabetes Mellitus compared to patients without Diabetes. Also to study the correlation of various presentations with the outcome.

Methods: This is an observational study which 150 patients satisfying the inclusion criteria were enrolled. The clinical features at the time of their presentation were noted. They were subjected to blood investigations which included routine investigations and chest radiograph, blood and/or sputum culture. A detailed analysis of the clinical features were studied with special reference to the difference in clinical presentations among diabetics and non diabetics. The final outcome of the patients were also studied and compared on the basis of their diabetic status.

Results: Out of the 150 patients, majority were males. The most common clinical manifestation was cough followed by fever. The clinical profile in diabetics were different in that fever was uncommon. Diabetics had a higher incidence of tachycardia and hypotension. Diabetics had higher serum creatinine at the time of presentation. 33% had culture positivity. Mortality rate was higher in multilobar pneumonia. Presence of diabetes and CVA were assoiated with adverse outcomes. Diabetic patients had higher CURB 65 score indicationg the severity of the disease at the time of admission.

Conclusions:  Clinical profile of patients with pneumonia differs according to their glycemic status.