Pneumonia. Dr Andrew Dodgson Consultant Microbiologist. Terminology. Histological/Radiological Lobar vs bronchopneumonia Lobar vs. interstitial Microbiological Bacterial, viral, fungal Clinical/ Microbiological Atypical vs. typical Clinical/epidemiological
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Dr Andrew Dodgson
Percentage of CasesPNEUMONIA AETIOLOGY
Data from 26 prospective studies (5961 adults) from 10 countries. *Data from 6 studies.
Woodhead MA. Chest. 1998;113:183S-187S.
Results in 2 -7 days
10% sensitivity vs serology
61% sensitivity vs DFA
Better if endotracheal/BAL
Results in 1 -6 hours
Can take ~ 5 days to turn pos
Can remain pos for up to 6 wk
Serogroup 1 specific
100% specificity (serogrp 1)
Direct Fluorescent Antibody Stain (DFA) of sputum
Need large numbers of orgs.
Sensitivity approx 50%
60 - 70% specificity for particular serotypes
Serology - ELISA
Acute & convalescent samples needed
4-12 weeks for AB response
Single titre of 1:256 = disease
20% have no AB response
Fast – sensitivity of ~ 70%
Can be used for sputum
Currently research use only
Need to consider:
Occurring ≥48 hrs post admission
However if severe or recently on ITU or recent Abx
Psitacosis or Q fever