A Novel Diagnostic Scoring System to Differentiate between Legionella pneumophila Pneumonia and Streptococcus pneumoniae Pneumonia

Objective We investigated a novel diagnostic scoring system to differentiate Legionella pneumophila pneumonia from Streptococcus pneumoniae pneumonia. Methods We retrospectively reviewed the clinical data of 62 patients with L. pneumophila pneumonia (L-group) and 70 patients with S. pneumoniae pneum...

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Bibliographic Details
Published in:Internal Medicine 2018/09/01, Vol.57(17), pp.2479-2487
Main Authors: Saraya, Takeshi, Nunokawa, Hiroki, Ohkuma, Kosuke, Watanabe, Takayasu, Sada, Mitsuru, Inoue, Manami, Honda, Kojiro, Oda, Miku, Ogawa, Yukari, Tamura, Masaki, Yokoyama, Takuma, Kurai, Daisuke, Kimura, Hirokazu, Ishii, Haruyuki, Goto, Hajime, Takizawa, Hajime
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Blood pressure
Bradycardia
Bradycardia - etiology
C-reactive protein
C-Reactive Protein - metabolism
Community-Acquired Infections - diagnosis
Dehydration
diagnostic scoring system
Female
Humans
hyponatremia
Internal medicine
L-Lactate dehydrogenase
L-Lactate Dehydrogenase - blood
Lactic acid
Legionella pneumophila
Legionella pneumophila pneumonia
Legionnaires' Disease - blood
Legionnaires' Disease - diagnosis
Legionnaires' Disease - microbiology
Legionnaires' disease bacterium
Male
Middle Aged
Multivariate analysis
Original
Pneumonia
Pneumonia, Pneumococcal - blood
Pneumonia, Pneumococcal - diagnosis
Pneumonia, Pneumococcal - microbiology
Retrospective Studies
Sensitivity
Sensitivity and Specificity
Sodium
Sodium - blood
Streptococcus infections
Streptococcus pneumoniae
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Summary:Objective We investigated a novel diagnostic scoring system to differentiate Legionella pneumophila pneumonia from Streptococcus pneumoniae pneumonia. Methods We retrospectively reviewed the clinical data of 62 patients with L. pneumophila pneumonia (L-group) and 70 patients with S. pneumoniae pneumonia (S-group). Results The serum sodium (Na) levels tended to be lower according to the severity [age, dehydration, respiratory failure, orientation disturbance, low blood pressure (A-DROP)] score in the L-group. On a multivariate analysis, we found that four factors were independent predictive markers for inclusion in the L-group: relative bradycardia [hazard ratio (HR) 5.177, 95% confidence interval (CI): 1.072-24.993, p=0.041], lactate dehydrogenase (LDH) levels ≥292 IU/L (HR 6.804, 95% CI: 1.629-28.416, p=0.009), C-reactive protein (CRP) levels ≥21 mg/dL (HR 28.073, 95% CI: 5.654-139.462, p
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.0491-17