A COMPARATIVE STUDY OF COMMUNITY ACQUIRED PNEUMONIA BETWEEN ADULTS AND ELDERLY PATIENTS

Dr.VASIREDDY ARUNA; Dr.ASHISH DEVALKAR.T; Dr.SABINKAR BABU LAL; Dr.D.PRAMEELA; Dr.SINDHUJA

Volume : IX, Issue : IX, September - 2019

A COMPARATIVE STUDY OF COMMUNITY ACQUIRED PNEUMONIA BETWEEN ADULTS AND ELDERLY PATIENTS

Dr. Vasireddy Aruna, Dr. Ashish Devalkar. T, Dr. Sabinkar Babu Lal, Dr. D. Prameela, Dr. Sindhuja

Abstract :

BACKGROUND: Community acquired pneumonia continues to be a leading infectious cause of mortality and morbidity.In elderly patients, the risk of acquiring infection and the severity of infection is higher when compared to adults. Elderly patients with community acquired pneumonia tend to have different clinical presentation when compared to adults,which may lead to delay in diagnosis and initiation of treatment. OBJECTIVES: To study and compare the clinical ,bacteriological and radiological profiles of Community acquired pneumonia(CAP) between elderly and adults and to study the outcome of management in both groups. METHODOLOGY: Prospective study of 60 patients attending Department of pulmonary medicine,Government general hospital,Siddhartha medical college, Vijayawada from January 2018 to June 2018 were selected with 30 patients in each group. One group with adults between 18 and 64 years and the other group with elderly patients with age 65 years and above RESULTS: The mean age of the cases in the adults‘ group was 44 ± 11.9 years, whereas it was 73.9 ± 5.8 years in elderly patients group. Males were affected more than females with overall and also in each group. The bacteriological positivity on gram staining was seen in 50 % overall, out of which 53%(16 patients) in adults group and 47%(14 patients) belong to the elderly group. Streptococcus Pneumonia was the most common etiological agent isolated overall and also in both groups. Lobar pneumonia was the most common radiological finding, which was noted in and also in both groups.The most common complication noted was septic shock followed by pleural effusion.In this study, overall out of 60 patients,88% (53 patients) improved, and 12% (7 patients) died. Mortality was higher in the elderly age group with 12%( 5 out of 30 patients) when compared to adults group ( 2 out of 30 patients). CONCLUSION : These atypical presentations may lead to delay in diagnosis and initiation of treatment and may be responsible for higher mortality if not recognized early. In elderly patients, special attention should be given for oral hygiene, correction of malnutrition and treatment of underlying comorbidities to reduce the mortality and morbidity associated with the disease.Adherence to guidelines for the initiation of empirical treatment is necessary. Vaccination with pneumococcal and influenza vaccines and smoking cessation should be recommended in all patients.