1 40 1 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1001/archinte.157.17.1965" target="_blank" rel="noreferrer noopener">http://doi.org/10.1001/archinte.157.17.1965</a> Rights Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). Pages 1965-1971 Issue 17 Volume 157 Search for Full-text Locate full-text within NEOMED Library's e-journal collections <p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Adult bacteremic pneumococcal pneumonia in a community teaching hospital, 1992-1996 - A detailed analysis of 108 cases Publisher An entity responsible for making the resource available Archives of Internal Medicine Date A point or period of time associated with an event in the lifecycle of the resource 1997 1997-09 Subject The topic of the resource acquired pneumonia; antimicrobial resistance; diagnosis; disease; General & Internal Medicine; penicillin-resistant pneumococci; polysaccharide vaccine; risk-factors; sputum culture; Streptococcus pneumoniae; united-states Creator An entity primarily responsible for making the resource Watanakunakorn C; Bailey T A Description An account of the resource Objectives: To review the clinical and laboratory findings of 108 adult patients with bacteremic pneumococcal pneumonia admitted to a community hospital and to determine the value of sputum Gram stains and cultures in the diagnosis of pneumococcal pneumonia in this setting. Methods: Using the laboratory logbooks to identify adult inpatients with pneumococcal bacteremia from January 1, 1992, to June 30, 1996, we reviewed medical records. Results: We found 108 patients. There was an apparent increase in prevalence from 1995 to 1996 compared with 1992 to 1994. Patients included 44 men and 64 women. Ages ranged from 20 to 95 years (median, 70 years). The fatality rate was 24.1% and increased with advancing age (no patient younger than 45 years died, and 36.8% of patients aged 85-95 years died). Cigarette smoking, cardiovascular disease, chronic obstructive lung disease, malignant disease, and diabetes mellitus were major underlying conditions. Fever, dyspnea, and cough were the most common presenting symptoms. Sputum Gram stain was useful in the diagnosis when moderate to abundant Gram-positive diplococci were seen. Sputum culture was less useful. Factors associated with higher fatality rate were being 65 years of age or older, APACHE II (Acute Physiologic and Chronic Health Evaluation II) score greater than 15, intensive care unit admission, low or normal leukocyte count, thrombocytopenia, renal dysfunction, diffused infiltrates on chest radiography, bilateral pneumonia, and sputum culture positive for Streptococcus pneumoniae. Conclusions: We found a recent increase in the prevalence of bacteremic pneumococcal pneumonia in adults. Gram stain of sputum is useful, but sputum culture is less sensitive in the diagnosis of pneumococcal pneumonia. The fatality rate remains high. More effort should be made at prevention using pneumococcal immunization. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1001/archinte.157.17.1965" target="_blank" rel="noreferrer noopener">10.1001/archinte.157.17.1965</a> Format The file format, physical medium, or dimensions of the resource Journal Article 1997 acquired pneumonia Antimicrobial resistance Archives of internal medicine Bailey T A Diagnosis Disease General & Internal Medicine Journal Article penicillin-resistant pneumococci polysaccharide vaccine risk-factors sputum culture Streptococcus pneumoniae united-states Watanakunakorn C