Validation of JRS atypical pneumonia score in patients with community-acquired Chlamydia psittaci pneumonia |
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| Affiliation: | 1. First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan;2. Department of Emergency Medicine, Kansai Medical University Medical Center, Japan;3. First Department of Internal Medicine, Division of Respiratory Medicine, Oncology and Allergology, Kansai Medical University Medical Center, Japan;1. Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan;2. Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan;3. Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan;1. Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan;2. Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;3. Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;4. Section of Clinical Laboratory, Department of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan;5. Division of Clinical Laboratory Medicine, Hiroshima University Hospital, Hiroshima, Japan;6. Translational Research Center, Hiroshima University, Hiroshima, Japan;7. Department of Biostatistics, Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan;1. Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan;2. Microbiology Division, Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan;1. Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Chiba, Japan;2. Department of Infectious Diseases, Kameda Medical Center, Chiba, Japan |
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| Abstract: | IntroductionThe Japanese Respiratory Society (JRS) atypical pneumonia score is a useful tool for the rapid presumptive diagnosis of atypical pneumonia. We investigated the clinical features of community-acquired pneumonia (CAP) due to Chlamydia psittaci and validated the JRS atypical pneumonia score in patients with C. psittaci CAP.MethodsThis study was conducted at 30 institutions and assessed a total of 72 sporadic cases with C. psittaci CAP, 412 cases with Mycoplasma pneumoniae CAP, and 576 cases with Streptococcus pneumoniae CAP.ResultsSixty-two of 72 patients with C. psittaci CAP had a history of avian exposure. Among the six parameters of the JRS score, matching rates of four parameters were significantly lower in the C. psittaci CAP than the M. pneumoniae CAP in the following parameters: age <60 years, no or minor comorbid illness, stubborn or paroxysmal cough, and absence of chest adventitious sounds. The sensitivity of the diagnosis of atypical pneumonia in patients with C. psittaci CAP was significantly lower than the M. pneumoniae CAP (65.3% and 87.4%, p < 0.0001). When the diagnostic sensitivity was analyzed for different ages, the diagnostic sensitivities for the C. psittaci CAP were 90.5% for non-elderly patients and 30.0% for elderly patients.ConclusionsThe JRS atypical pneumonia score is a useful tool for distinguishing between C. psittaci CAP and bacterial CAP in patients aged <60 years, but not in patients aged ≥60 years. A history of avian exposure in middle-aged patients with normal white blood cell count may be suggestive of C. psittaci pneumonia. |
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| Keywords: | Community-acquired pneumonia JRS guidelines Atypical pneumonia score |
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