Background: Community acquired pneumonia is one of the major health problem in India. Early diagnosis of patients with CAP and appropriate treatment are important features with impact on overall mortality.

Aims and Objectives: To study the causes and clinical profile of community acquired pneumonia  and to analyse the factors that contribute to clinical outcome of such patients.

Methods: This is a cross sectional study conducted at Sri Ramachandra Medical college and research institute. Cases are collected from the department of general medicine between april 2014 and april 2015. All patients presenting with symptoms of an acute lower respiratory tract illness (cough and at least one other lower respiratory tract symptom) were included in the study. A basic laboratory workup along with Chest X ray was done in all patients. Culture of sputum, blood, urine and trachea was done.

Results: A total of 216 consecutive patients with community acquired pneumonia (CAP) were studied. The most common presenting symptom in our study is cough 97.4% (n=210), followed by expectoration 75%( n=162), 70.4% (n=152) had fever, 33.3% (n=72) of patients had breathlessness. Among the comorbid conditions diabetes mellitus (33.7%; n=73) and hypertension (32.4%; n=70) were common. Viral etiology is much more common (proven H1 N1positive were 28%) than bacterial etiology. 75.4% (n=32) of patients of the patients had no complications. Pleural effusion was seen in 14.8% (n=32) of patients, ARDS in 7.4% (n=16) of patients. Commonest bacterial organisms found were Streptococcous pneumoniae 23.0% (n=3) and Klebsiella pneumoniae 23.0% (n=3), followed by Staphylococcous aureus 15.3% (n=2) and E.coli 15.3% (n=2).  Mortality seen in this study was 4.5% (n=10) among which 6 deaths were noted in patients diagnosed to have H1N1 positive status.

Conclusion: Community acquired pneumonia is common among young and middle aged males. Most common presenting feature is cough (97.4%) followed by expectoration (75%) and fever (70.4%). Viral etiology is much more common (proven H1 N1positive were 28%) than bacterial etiology. Most common complication noted was pleural effusion (14.8%). Mortality is noted more in patients aged more than 60 years of age, contributes to 50% of overall mortality.

Keywords: Community acquired pneumonia, H1N1, Klebsiella, Pleural effusion, Steptococcu.

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Dr Vasanthan. K

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