Saturday, January 29, 2011

Diagnosing and treating pneumonia

Diagnosing and treating pneumonia in patients who are receiving mechanical ventilation is a challenge for physicians. For example, if the patient has a fever, it could be pneumonia or it could be a noninfectious problem. Now, new research finds certain cells in the patient’s fluid may be helpful in diagnosing bacterial or fungal pneumonia.

Close to 150 patients receiving mechanical ventilation were included in the research. Doctors suspected pneumonia in all study participants. They performed a test looking for the presence of a cell known as sTREM-1 in the patient’s bronchial fluid. This cell, researchers say, could be indicative of pneumonia. Two doctors who were not aware of the cell test results also diagnosed the patient’s with community-acquired pneumonia and ventilator-associated pneumonia.

Researchers say the final diagnosis was community-acquired pneumonia in 38 patients, ventilator-associated pneumonia in 46 patients and no pneumonia in 64 patients. Researchers say the presence of the sTREM-1 by itself was more accurate than any clinical findings or laboratory values in identifying pneumonia. In fact, researchers say sTREM-1 was the strongest independent predictor of pneumonia.

Study authors conclude testing the fluid in a patient on mechanical ventilation could be a rapid, accurate and inexpensive way to diagnose pneumonia.

SOURCE: New England Journal of Medicine, 2004;350:451-458

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