HAEMOPHILUS PNEUMONIA IS A COMMON-CAUSE OF EARLY PULMONARY DYSFUNCTION FOLLOWING TRAUMA

Background: Haemophilus species are a common cause of community-acquir ed pneumonia; however, their significance in posttraumatic pneumonia i s unclear. Design: Case series. Setting: University hospital, level I trauma center. Patients: Two hundred fifty-seven consecutive patients with blunt and penetrating trauma treated for pneumonia. Main Outcome Measures: Length of stay in the in tensive care unit, duration of vent ilatory support, rate of recurrent or persistent pneumonia, and mortal ity. Results: Ninety-six (37%) of 257 patients treated for pneumonia h ad a Haemophilus species isolated on sputum culture. Of these 96 patie nts, 49 (51%) had only Haemophilus species, while 33 (34%) had associa ted grampositive organisms and 14 (15%) had gram-negative organisms. S eventeen pure cultures (29%) and seven mixed cultures (15%) (P<.05) we re beta-lactamase-positive trains. Compared with patients who had pneu monia caused by other bacteria, patients with Haemophilus species were younger (mean+/-SE, 35+/-1.7 vs 42+/-1.6 years; P<.05) and more sever ely injured (Injury Severity Score, 20.7+/-1.1 vs 17.5+/-0.9; P<.05). There were no differences in any outcome variables between the two gro ups. Only one (1%) of 96 patients had persistent Haemophilus species o n sputum, cultures after 7 days of treatment. Conclusions: Haemophilus species are a frequent cause of pneumonia following traumatic injury. This occurs primarily in the early postinjury phase and therefore sho uld be included in the differential diagnosis of early posttraumatic p ulmonary insufficiency.