Abstract
Our study focussed purely on bilateral pneumonitis (both infective and non-infective) which evolved in the community excluding all hospital acquired, aspiration pneumonitis developed in the hospital/ICU settings, malignancy and immunocompromised state where risk of bilateral involvement of lungs is very high.
Objectives: To analyse the clinical, etiological and radiological features of bilateral pneumonitis, to study mortality in patients with bilateral pneumonitis in relation to PSI grading.
Methodology:
Study Design: Observational study,
Study Population: All the patients who were diagnosed with bilateral Pneumonitis at OPD/emergency wards and later admitted in medical or disaster wards,
Study Setting: RL JALAPPA HOSPITAL, KOLAR,
Study Period: 4 months, Sample size: 300.
Results & Discussion: In the present study, the mean age group of the patients was 49.30 ± 13.47. Mahendra8 et al reported that mean age of the patients was 54.03 years. Nagesh kumar9 et al reported that the mean age of the patients studied was 56.07± 16.52 years. Bronchopneumonia was the commonest chest X-ray finding in the present study. Nagesh Kumar9 et al reported that the most common chest radiograph finding was lobar consolidation in 44.2% of all cases, followed by patchy consolidation in 39.3% of the cases. Interstitial pattern was observed in 4.9% of cases and cavitory lesions were seen in one case, which was positive for S. aureus. In the present study no mortality seen in PSI class II and III but it is around 23.35% (39 patients) in PSI class IV and 69.04% (29 patients) in PSI class V. More than 50% died in PSI class V due to dreadful complications of pneumonitis and MV/NIV adverse effects.Kim16 et al in their study on Pneumonia severity index in viral community acquired pneumonia in adults reported that In the PSI class V, the mortality rate was 27 times that of the PSI class I.
Keywords: Bilateral pneumonitis, PSI grading.
References
- "Pneumonitis - Symptoms and causes". com:1-2
- Heo JY, Seo YB, Choi WS, Lee J, Yoon JG, Lee SN, et al. Incidence and case fatality rates of community-acquired pneumonia and pneumococcal diseases among Korean adults: Catchment population-based analysis. PloS One. 2018;13(3):e0194598.
- Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet Lond Engl. 2012 Dec 15;380(9859):2095–128.
- Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax. 2013 Nov1;68(11):1057–65.
- Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, et al. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J RespirCrit Care Med. 2001Jun;163(7):1730–54.
- Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan 23;336(4):243–50.
- Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. Lancet Lond Engl. 2015 Sep 12;386(9998):1097–108.
- Mahendra M, Jayaraj BS, Limaye S, Chaya SK, Dhar R, Mahesh PA. Factors influencing severity of community-acquired pneumonia. Lung India. 2018 Jul1;35(4):284.
- Kumar TN, Rafiudeen R, Rashmi K. A study of clinical and etiological profile of community-acquired pneumonia with special reference to atypical pneumonia. Ann Niger Med. 2017 Jan 1;11(1):11.
- Quero BG, Fernandez LS, Moyano MG, Garrido IS, Bonilla AG, Crespo BG, et al. Differences in community acquired pneumonia according to gender. EurRespir J [Internet]. 2017 Sep 1.
- Shah BA, Singh G, Naik MA, Dhobi GN. Bacteriological and clinical profile of Community acquired pneumonia in hospitalized patients. Lung India. 2010 Apr1;27(2):54.
- Bansal S, Kashyap S, Pal LS, Goel A. Clinical and Bacteriological Profile of Community Acquired Pneumonia in Shimla, Himachal Pradesh. Indian J Chest Dis.46:6.
- Almirall J, Bolíbar I, Balanzó X, González CA. Risk factors for community-acquired pneumonia in adults: a population-based case- control study. EurRespir J. 1999Feb;13(2):349–55.
- Jain SK, Jain S, Trikha S. Hospitalized Patients of Gajra Raja Medical College, Gwalior, Central India.2014;2(6):5.
- Khawaja A, Zubairi ABS, Durrani FK, Zafar A. Etiology and outcome of severe community acquired pneumonia in immunocompetent adults. BMC Infect Dis. 2013 Feb20;13(1):94.
- Marcos PJ, Restrepo MI, González-Barcala FJ, Soni NJ, Vidal I, Sanjuàn P, et al. Discordance of physician clinical judgment vs . pneumonia severity index (PSI) score to admit patients with low risk community-acquired pneumonia: a prospective multicenter study. J Thorac Dis. 2017 Jul6;9(6):1538-1546–1546.
- Mac Farlance J. Community acquired pneumonia. Br J Dis Chest 1987; 81 :116-27.
- Ortqvist A, Hedlund J, Grillner L, et al. Aetiology outcome and prognostic factors in community acquired pneumonia requiring hospitaliztion. Eur Respir J 1990; 3 :1105-13.
- Pachon J, Prados MD, Capote F, Cuello JA, Garnacho J, Verano A. Severe Community acquired pneumonia : Etiology, prognosis and treatment. Am Rev Respir Dis 1990; 142 :369-73.
- Dey AB, Nagarkar KM, Kumar V. Clinical presentation andpredictors of outcome in adult patients with community-acquired pneumonia. Natl Med J India 1997; 10 :169-72.
Corresponding Author
Dr M Sasi Sekhar
MBBS, MD General Medicine, Post Graduate
DOI: https://dx.doi.org/10.18535/jmscr/v8i11.31
