Friedlander's Pneumonia

A Report of 11 Cases and Appraisal of Antibiotic Therapy

¹ Medical Resident, Hennepin County General Hospital
² Instructor in Medicine, Hennepin County General Hospital, and the University of Minnesota; Director, Pulmonary Laboratory, St. Mary's Hospital

An analysis of 11 cases of Friedlander's pneumonia has been presented, and the clinical features and their relation to the radiographic and pathologic findings have been discussed. In our cases, alcoholism and debilitation appeared to be factors in the disease process. There was a high, early mortality and pneumococcal infection was often associated. The upper lobes were generally involved, the right more commonly involved than the left. Leukopenia was found in only three with parenteral streptomycin and chloramphenicol. With this therapy, our over-all mortality was 54 per cent, with most deaths occurring within the first 24 hours after admission. Recent reports from the literature indicate that other antibiotics, esepecially polymicin B, kanamycin, and colistimethate may be more effective in treating Klebsiella pneumoniae, due to its changing sensitivity pattern. Cephalothin also shows some promise in the treatment of this disease. Evidence showing that many strains of Klebsiella may be resistant to streptomycin and chloramphenicol is presented. In hopes of reducing the mortality of this disease, it seems reasonable to use kanamycin, colistimethate, cephalothin or polymixin B, as a first choice antibiotic until sensitivities are available.