| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan, Republic of China
2 From the Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
Twenty-eight alcoholic patients with community-acquired pneumonia who were admitted to a referral medical center during a 3-year period were reviewed. All were men and with few exceptions were heavy smokers. The overall mortality was 64.3%. The most dramatic group was that of 11 patients (39.3%) with bacteremic Klebsiella pneumoniae pneumonia (BKPP), which had high mortality rate (100%), short onset of illness before hospital admission (42.6±8.2 h, mean±SD), and short survival time after the admission (24.6±7.9 h). All these 11 patients needed intensive care unit (ICU) management and ventilatory support. Arterial blood gas values showed marked hypoxemia and metabolic acidosis in most of these 11 patients, and presence of shock at arrival in the hospital was noted in 8 patients. Acute renal failure and disseminated intravascular coagulation developed in six patients. Chest radiographs showed pleural effusion and radiographic spread in nearly 50% of patients. Combination chemotherapy consisting of one aminoglycoside and one second- or third-generation cephalosporin was initiated in all patients. The rapidly fatal outcome of these 11 patients with BKPP despite management with adequate antibiotics and intensive care indicated the fulminant nature of this disease. High virulence of the microorganism, altered immune response, and increased susceptibility to infection may all have contributed to the fulminancy in this group of patients. The disease continues to present many difficulties in management.
Key Words: alcoholism • community-acquired pneumonia • Klebsiella pneumoniae pneumonia
Submitted on February 7, 1994
Accepted on April 28, 2007
This article has been cited by other articles:
|
|
 |
|
  P. C. Joshi, L. Applewhite, J. D. Ritzenthaler, J. Roman, A. L. Fernandez, D. C. Eaton, L. A. S. Brown, and D. M. Guidot Chronic Ethanol Ingestion in Rats Decreases Granulocyte-Macrophage Colony-Stimulating Factor Receptor Expression and Downstream Signaling in the Alveolar Macrophage J. Immunol., November 15, 2005; 175(10): 6837 - 6845. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Moore, M. L. Perry, A. G. Getsoian, C. L. Monteleon, A. L. Cogen, and T. J. Standiford Increased Mortality and Dysregulated Cytokine Production in Tumor Necrosis Factor Receptor 1-Deficient Mice following Systemic Klebsiella pneumoniae Infection Infect. Immun., September 1, 2003; 71(9): 4891 - 4900. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Metlay and M. J. Fine Testing Strategies in the Initial Management of Patients with Community-Acquired Pneumonia Ann Intern Med, January 21, 2003; 138(2): 109 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Moore, M. L. Perry, A. G. Getsoian, M. W. Newstead, and T. J. Standiford Divergent Role of Gamma Interferon in a Murine Model of Pulmonary versus Systemic Klebsiella pneumoniae Infection Infect. Immun., November 1, 2002; 70(11): 6310 - 6318. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-Z. Chen, P.-R. Hsueh, L.-N. Lee, C.-J. Yu, P.-C. Yang, and K.-T. Luh Severe Community-Acquired Pneumonia due to Acinetobacter baumannii Chest, October 1, 2001; 120(4): 1072 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. Held, N. R. M. Jendrike, T. Rukavina, R. Podschun, and M. Trautmann Binding to and Opsonophagocytic Activity of O-Antigen-Specific Monoclonal Antibodies against Encapsulated and Nonencapsulated Klebsiella pneumoniae Serotype O1 Strains Infect. Immun., May 1, 2000; 68(5): 2402 - 2409. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
