Community-acquired Chlamydia pneumoniae Pneumonia in Japan: A Prospective Multicenter Community-acquired Pneumonia Study

Naoyuki MIYASHITA; Atsushi SAITO; Shigeru KOHNO; Kotaro OIZUMI; Keizo YAMAGUCHI; Akira WATANABE; Hiroshi ODA; Hiroshi FUKANO; Koichiro YOSHIDA; Yoshihito NIKI; Toshiharu MATSUSHIMA

doi:10.2169/internalmedicine.41.943

Community-acquired Chlamydia pneumoniae Pneumonia in Japan: A Prospective Multicenter Community-acquired Pneumonia Study

Naoyuki MIYASHITA, Atsushi SAITO, Shigeru KOHNO, Kotaro OIZUMI, Keizo YAMAGUCHI, Akira WATANABE, Hiroshi ODA, Hiroshi FUKANO, Koichiro YOSHIDA, Yoshihito NIKI, Toshiharu MATSUSHIMA

Author information

Naoyuki MIYASHITA
The Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School
Atsushi SAITO
The First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus
Shigeru KOHNO
The Second Department of Internal Medicine, Nagasaki University School of Medicine
Kotaro OIZUMI
The First Department of Internal Medicine, Kurume University School of Medicine
Keizo YAMAGUCHI
Department of Microbiology, Toho University School of Medicine
Akira WATANABE
Department of Respiratory Medicine, Division of Cancer Control, Institute of Development, Aging and Cancer, Tohoku University
Hiroshi ODA
Department of Bacteriology, Faculty of Medicine, Kagoshima University
Hiroshi FUKANO
The Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School
Koichiro YOSHIDA
The Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School
Yoshihito NIKI
The Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School
Toshiharu MATSUSHIMA
The Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School

Keywords: concomitant infection, clinical feature, CAP guideline, bacterial pneumonia, atypical pneumonia

JOURNAL FREE ACCESS

2002 Volume 41 Issue 11 Pages 943-949

DOI https://doi.org/10.2169/internalmedicine.41.943

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Abstract

Objective To investigate the clinical features of Chlamydia pneumoniae pneumoniae in Japan and to evaluate the newly created Japanese community-acquired pneumonia (CAP) guidelines.
Patients and Methods A multicenter CAP surveillance study was carried out in 20 hospitals between December 1999 and March 2000. The diagnosis of C. pneumoniae infection was based on isolation in cell culture, the polymerase chain reaction and serologic testing of antibodies by the microimmunofluorescence test.
Results Among 232 CAP cases, C. pneumoniae was identified as the etiologic agent in 15 cases (6.5 %). C. pneumoniae was the only pathogen identified in nine of these cases, while one or more additional etiological agents were found in the other six cases. Of the present and previously reported single agent C. pneumoniae pneumonia cases, about 50% were more than 60 years old and had underlying diseases. A relatively slow pulse rate in relation to fever was not seen in these patients. The mean WBC count of all patients was normal. No patient required respiratory support or admission to an intensive care unit and no deaths occurred among these patients.
Conclusion The clinical pictures of C. pneumoniae pneumonia as a single agent were mild to moderate and were remarkably different from those of cases of C. pneumoniae pneumonia concomitant with other bacteria. If the patient is less than 60 years old and some guideline headings are excluded, we think it would be possible to distinguish between C. pneumoniae and bacterial pneumonia.
(Internal Medicine 41: 943-949, 2002)

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