Contribution of C-Reactive Protein to the Diagnosis and Assessment of Severity of Community-Acquired Pneumonia

摘要: Study objective To assess the usefulness of serum C-reactive protein (CRP) in diagnosis and treatment approach patients with community-acquired pneumonia (CAP). Design Population-based case-control study. Setting A mixed residential-industrial urban area 74,368 adult inhabitants Maresme region (Barcelona, Spain). Patients From December 1993 to November 1995, all subjects who were > 14 years age, living area, had received a CAP, which been confirmed by chest radiographs compatible clinical outcome, registered. from residential care facilities excluded. Serum samples assayed for CRP acute phase disease. Data 201 CAP compared 84 healthy control matched sex, municipality, as well 25 initially suspected that was not at follow-up. Median levels 110.7, 1.9, 31.9 mg/L, respectively. The thresholds test discriminating among these three groups 11.0 33.15 mg/L. Results Eighty-nine (44.8%) an identifiable etiology. most common pathogens Streptococcus pneumoniae, viruses, Chlamydia followed Mycoplasma Legionella pneumophila, Coxiella burnetii. There statistically significant differences median pneumococcal (166.0 mg/L) L pneumophila (178.0 etiologies other causative pathogens. Lower found caused viruses C burnetii negative microbiological findings. hospitalized significantly higher than outpatients (132.0 vs 76.9 respectively; p Conclusions level is useful marker establishing lower respiratory tract infections. High values are especially high pneumonias S pneumoniae or pneumophila. Moreover, suggestive severity, may be value deciding about appropriateness inpatient care.