CLINICAL PROFILE OF PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE STUDY

Abstract

Introduction: Community acquired pneumonia (CAP) is one of the most common and morbid conditions encountered in clinical practice. Changes in the epidemiology (both emergence of new pathogens and changing antimicrobial susceptibility of old ones) of the various pathogens, difculty in making an etiologic diagnosis and complex guidelines for management make this illness a challenge for both patients and their physicians. Hence the current study is done for better understanding of the pattern of the disease and the risk factors that are associated with fatal complications which allows for provision of the best possible treatment to the patients that would limit the morbidity and reduce the mortality. Material And Methods: After institutional ethical committee clearance a prospective observational study was done in 50 adult patients diagnosed with CAP in a tertiary care hospital from December 2018- July 2019 after obtaining patients consent. Patients with TB, other pneumonia, malignancy and HIV were excluded. All patients were subjected to complete history taking, detailed clinical examination and required investigations. Data entered in Excel represented in graphs and tables. Statistical analysis was done with chi-square test with P<0.05 as signicant using SPSS 22. Out of the 50 patients 32 were males and 18 were females. T Results: he mean age of the patients was 50.7 +/- 15.4yrs. The most common symptom was found to be cough which was found in all the 50(100%) patients, followed by expectoration (45/90%), fever ( 40/80%), dyspnea (28/56%) and chest pain (22/44%). The most common comorbidity was COPD (25/50%) followed by DM (16/32%). On sputum examination gram positive organisms was seen in 13(26%), gram negative in 12(24%), both staining in 3(6%) samples. On culture and sensitivity Streptococcus.pneumonie was the most common isolate in 22% followed by klebsiella pneumonia. Complications were identied in 10 patients. Mortality was seen in 7 (14%) patients. Mean age was more in patients w Conclusions: ith complications compared to patients without complications which were signicant. Patients with complications were signicantly associated with history of smoking and positive sputum culture. Out of the 50 patients only 5(10%) patients required intubation and ventilation, and 10(20%) patients required non-invasive ventilation.