Community-acquired pneumonia at elderly and senile ages: the features of diagnosis and treatment


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Community-acquired pneumonia is often misdiagnosed and improperly treated. This disease can be caused by various microorganisms, the most common of which are pneumococcus, atypical pathogens, such as Mycoplasma pneumoniae and Chlamydophlla pneumoniae, Staphylococcus aureus and some gram-negative bacilli. To identify the causative agent of pneumonia in the elderly is a complex task because more than 50% of patients do not have a productive cough at diagnosis. Antimicrobial therapy should be Initiated as soon as possible, especially In cases that the patient requires hospitalization. Empirical therapy with antibacterial drugs is usually prescribed prior to a microbiological study to establish the causative agent of the disease. When establishing the pathogen and its antimicrobial susceptibility pattern, the drug can be switched to a more effective one. Elderly people (over 65 years of age) are recommended for annual influenza vaccination for prevention purposes.

Full Text

Restricted Access

About the authors

V. V Skvortsov

Volgograd State Medical University

Email: vskvortsov1@ya.ru

B. N Levitan

Astrakhan State Medical University

Professor

M. V Lunkov

VA. Almazov National Medical Research Centre

References

  1. Kolditz М., Tesch F., Mocke L. et al. Burden and risk factors of ambulatory or hospitalized CAP: a population based cohort study. Resplr Med. 2016; 121: 32-8. doi: 10.1016/j.rmed.2016.10.015
  2. Kolditz М., Ewig S. Community-Acquired Pneumonia in Adults. DtschArztebl Int. 2017; 114: 838-48. doi: 10.3238/arztebl.2017.0838
  3. Cilloniz C., Liapikou A., Martin-Loeches I. et al. Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia. PLoSOne. 2018; 13: e0200504. doi: 10.1371/joumal.pone.0200504
  4. Metlay J.P, Waterer G.W., Long A.C. et al. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019; 200 (7): e45-e67. doi: 10.1164/rccm.201908-1581 ST
  5. Агафонова O.B., Гриценко T.A., Богданова Ю.В. и др. Поликлиническая терапия: Учебник. Под ред. Д.И. Давыдкина, Ю.В. Щукина. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2020; 840 с. [Agafonova O.V., Gritsenko Т.А., Bogdanova Yu.V. et al. Poliklinicheskaya terapiya: Uchebnik. Pod red. D.l. Davydkina, Yu.V. Shchukina. 2-e izd., pererab. i dop. М.: GEOTAR-Media, 2020; 840 s. (in Russ.)] doi: 10.33029/9704-5545-6-PLT-2020-1-840
  6. Laporte L., Hermetet C., Jouan Y. et al. Ten-year trends in intensive care admissions for respiratory infections in the elderly. Ann Intensive Care. 2018; 8:84. doi: 10.1186/s13613-018-0430-6
  7. Krone C.L., van de Groep K., Trzcinski K. et al. Immunosenescence and pneumococcal disease: an imbalance in host-pathogen interactions. Lancet Respir Med. 2014; 2:141-53. doi: 10.1016/S2213-2600(13)70165-6
  8. Weir D.L., Majumdar S.R., McAlister F.A. et al. The impact of multimorbidity on short-term events in patients with community-acquired pneumonia: prospective cohort study. Clin Microbiol Infect. 2015; 21: 264.e7-264.e13. DOI: 10.1016/j. cmi.2014.11.002
  9. Cilloniz C., Dominedo C., Pericas J.M. et al. Community-acquired pneumonia in critically ill very old patients: a growing problem. Eur Respir Rev. 2020; 29: 190126. doi: 10.1183/16000617.0126-2019
  10. Vital Statistics. Ministry of Health, LaW, 2018.
  11. Wootton D. Feldman C. The diagnosis of pneumonia requires a chest radiograph (x-ray) - yes, no or sometimes? Pneumonia. 2014; 5 (1): 1-7. doi: 10.15172/pneu.2014.5/464
  12. Imber D.A., Pirrone М., Zhang C. et al. Respiratory management of perioperative obese patients. Respir Care. 2016; 61 (12): 1681-92. DOI: 10.4187/ respcare.04732
  13. Jain S., Self W.H., Wunderink R.G. Community-acquired pneumonia requiring hospitalization. N Engl J Med. 2015; 373 (24): 2382. doi: 10.1056/NEJMoa1500245
  14. Campbell S.J., Kynyk J.A, Davis J.A. Disseminated adenovirus infection causing severe ARDS. BMJ Case Rep. 2017: bcr2016217524. doi: 10.1136/bcr-2016-217524
  15. Lynch J.P., Fishbein М., Echavarria M. Adenovirus. Semin Respir Crlt Care Med. 2011; 32 (4): 494-511. doi: 10.1055/S-0031-1283287
  16. Lynch J.P., Kajon A.E. Adenovirus: epidemiology, global spread of novel serotypes, and advances in treatment and prevention. Semin Respir Crit Care Med. 2016; 37 (4): 586-602. doi: 10.1055/S-0036-1584923
  17. Яцышина С.Б., Самчук В.В., Васильев В.В. и др. Аденовирусная пневмония с летальным исходом у взрослых. Тер арх. 2014; 86 (11): 55-9 [Yatsyshina S.B., Samchuk MSI., Vasilyev V.V. et al. Adenovirus pneumonia with a fatal outcome in adults. Terarkh. 2014; 86 (11): 55-9 (in Russ.)].
  18. Hung K.H., Lin L.H. Adenovirus pneumonia complicated with acute respiratory distress syndrome: a case report. Medicine (Baltimore). 2015; 94 (20): e776. doi: 10.1097/MD.0000000000000776
  19. Kajon A.E., Hang J., Hawksworth A. et al. Molecular epidemiology of adenovirus type 21 respiratory strains isolated from US military trainees (1996- 2014). J Infect DIs. 2015; 212 (6):871-80. doi: 10.1093/infdis/jiv141
  20. Van Kerkhove M.D., Cooper M.J., Cost AA. et al. Risk factors for severe outcomes among members of the United States military hospitalized with pneumonia and influenza, 2000-2012. Vaccine. 2015; 33 (49): 6970-6. doi: 10.1016/j.vaccine.2015.09.115
  21. Park J.Y., Kim B.J., Lee E.J. et al. Clinical features and courses of adenovirus pneumonia in healthy young adults during an outbreak among Korean military personnel. PLoSOne. 2017; 12 (1): e0170592. doi: 10.1371/journal.pone.0170592
  22. Park P.K., Cannon J.W., Ye W. et al. Incidence, risk factors, and mortality associated with acute respiratory distress syndrome in combat casualty care. J Trauma Acute Care Surg. 2016; 81 (5 Suppl. 2 Proceedings of the 2015 Military Health System Research Symposium): S150-S156. doi: 10.1097/TA.0000000000001183
  23. Yoo H., Gu S.H., Jung J. et al. Febrile respiratory illness associated with human adenovirus type 55 in South Korea military, 2014-2016. Emerg Infect Dis. 2017; 23 (6): 1016-20. doi: 10.3201/eid2306.161848
  24. Yoon H., Jhun B.W., Kim H. et al. Characteristics of adenovirus pneumonia in Korean military personnel, 2012-2016. J Korean Med Sd. 2017; 32 (2): 287-95. doi: 10.3346/jkms.2017.32.2.287
  25. Cha M.J., Chung M.J., Lee K.S. et al. Clinical features and radiological findings of adenovirus pneumonia associated with progression to acute respiratory distress syndrome: a single center study in 19 adult patients. Korean J Radiol. 2016; 17 (6): 940-9. doi: 10.3348/kjr.2016.17.6.940
  26. Yoon H., Jhun B.W., Kim S.J. et al. Clinical characteristics and factors predicting respiratory failure in adenovirus pneumonia. Resplrology. 2016; 21 (7): 1243-50. doi: 10.1111/resp.12828
  27. Ho Z.J., Zhao X., Cook Y.A. et al. Clinical differences between respiratory viral and bacterial mono- and dual pathogen detected among Singapore military servicemen with febrile respiratory illness. Influenza Other Respir Viruses. 2015; 9 (4): 200-8. doi: 10.1111/lrv.12312
  28. Nouvenne A., Ticinesi A., Folesani G. et al. The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study. BMC Geriatr. 2016; 16:16. doi: 10.1186/s12877-016-0192-7

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Russkiy Vrach Publishing House

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies