CLINICAL PICTURE OF COMMUNITY-ACQUIRED CHLAMYDIA-PNEUMONIAE PNEUMONIAREQUIRING HOSPITAL TREATMENT - A COMPARISON BETWEEN CHLAMYDIAL AND PNEUMOCOCCAL PNEUMONIA

Background - The importance of Chlamydia pneumoniae as a cause of pneu monia has remained controversial. The clinical picture of C pneumoniae and Streptococcus pneumoniae in patients admitted to hospital with co mmunity-acquired pneumonia was compared during a C pneumoniae epidemic in Finland. Methods - Group I consisted of 24 patients in whom serolo gical testing and bacterial culture indicated an association with C pn eumoniae only, group II comprised nine patients with both C pneumoniae and S pneumoniae, and group III consisted of 13 patients with S pneum oniae only. Results - The patients with C pneumoniae suffered from hea dache more frequently than the other patients (group I, 46%; group II, 11%; and group III, 15%) and had received antimicrobial treatment mor e often before admission to hospital (group I, 54%; groups II and III, 0%). The patients with C pneumoniae produced few good sputum samples and had suffered from respiratory symptoms longer than those with S pn eumoniae (group I, 10 days; groups II and III, 4 days). C reactive pro tein values on admission were lowest in group I and highest in group I I. The antimicrobial treatment provided in hospital covered C pneumoni ae in 36% of cases in group I and 0% in group II, while S pneumoniae w as covered in all patients. C pneumoniae and S pneumoniae together wer e associated with more severe disease and a longer stay in hospital. C onclusions - Pneumonia caused by C pneumoniae was milder but clinicall y resembled that caused by S pneumoniae, and required hospital treatme nt even among young patients. Mixed infections were common and should be taken into account when planning antimicrobial treatment for commun ity-acquired pneumonia. Further studies with more patients are needed to evaluate the severity of C pneumoniae pneumonia.