Diagnosis of pneumococcal pneumonia: a comparison between microscopic examination of expectorate, antigen detection and cultural procedures. 1983

M Kalin, and A A Lindberg

Attempts to demonstrate Streptococcus pneumoniae, or its soluble type-specific polysaccharide antigen were made on specimens from 205 patients with acute community-acquired pneumonia by (i) blood, nasopharynx and sputum culture, (ii) counterimmunoelectrophoresis (CIE) of serum, urine and sputum specimens utilizing omni-, pool- and type-specific rabbit antisera, and (iii) microscopy of gram-stained sputum smears. Pneumococci could be cultured and/or pneumococcal antigen detected in specimens from 93 (45%) of the patients with the following frequencies in samples obtained before (and after) start of antimicrobial treatment: culture from blood 25% (6%), nasopharynx 59% (18%) and sputum 80% (13%), CIE on serum 3% (9%), urine 8% (18%), urine 20X concentrated 18% (24%), and sputum 56% (56%). Microscopy of sputum smears revealed pneumococci in 65% (17%) of the 93 patients. The value of cultures from blood and sputum was most evident when the samples were obtained early in the course of the disease. With nasopharynx culture and CIE on sputum the number of positive results was doubled if the sampling was repeated. For rapid diagnosis direct Gram stain and CIE on sputum were about equally effective and also strikingly complementary, alone diagnosing 42% and 48% of the patients, respectively, but together detecting 65% of them. Gram stain was most rewarding on early pretreatment samples and CIE on post-treatment samples.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009305 Nasopharynx The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function. Rhinopharynx,Choanae,Nasopharynges,Nasopharynxes,Rhinopharynges,Rhinopharynxes
D011018 Pneumonia, Pneumococcal A febrile disease caused by STREPTOCOCCUS PNEUMONIAE. Pneumococcal Pneumonia,Pneumococcal Pneumonias,Pneumonias, Pneumococcal
D003378 Counterimmunoelectrophoresis Immunoelectrophoresis in which immunoprecipitation occurs when antigen at the cathode is caused to migrate in an electric field through a suitable medium of diffusion against a stream of antibody migrating from the anode as a result of endosmotic flow. Electrosyneresis,Immunoelectroosmophoresis,Immunoelectrophoresis, Countercurrent,Immunoelectrophoresis, Crossover,Countercurrent Immunoelectrophoresis,Crossover Immunoelectrophoresis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000942 Antigens, Bacterial Substances elaborated by bacteria that have antigenic activity. Bacterial Antigen,Bacterial Antigens,Antigen, Bacterial
D013183 Sputum Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus. Sputum, Induced,Induced Sputum,Induced Sputums,Sputums,Sputums, Induced

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