Abstract
From July 1981 to January 1983 502 adults were treated for lobar or segmental pneumonia in a general hospital in Northern Zambia. Consolidation was present in either the right or the left lower lobe in 78.8%, the right middle lobe in 10.2% and either the right or the left upper lobe in 10.7%. Penicillin treatment failed to give an improvement in 10.7%, many of whom recovered after receiving either gentamicin or kanamycin. A high risk of death was associated with an age of 65 years or over, absence of pyrexia, absence of a leucocyte response, disease affecting multiple lobes, irreversible hypotension, underlying neoplasm, and failure to respond to penicillin treatment (p less than 0.001 in all cases). Penicillin remains the initial treatment of choice for lobar pneumonia in rural central Africa. Mortality can probably be reduced by inpatient treatment of as many patients with pneumonia as local circumstances allow, and by adding broad spectrum treatment in patients who show no improvement after 48 hours of penicillin treatment.
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Selected References
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- Barrett-Connor E. The nonvalue of sputum culture in the diagnosis of pneumococcal pneumonia. Am Rev Respir Dis. 1971 Jun;103(6):845–848. doi: 10.1164/arrd.1971.103.6.845. [DOI] [PubMed] [Google Scholar]
- Brunner H., Greenberg H. B., James W. D., Horswood R. L., Couch R. B., Chanock R. M. Antibody to Mycoplasma pneumoniae in nasal secretions and sputa of experimentally infected human volunteers. Infect Immun. 1973 Oct;8(4):612–620. doi: 10.1128/iai.8.4.612-620.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davidson M., Tempest B., Palmer D. L. Bacteriologic diagnosis of acute pneumonia. Comparison of sputum, transtracheal aspirates, and lung aspirates. JAMA. 1976 Jan 12;235(2):158–163. [PubMed] [Google Scholar]
- Greenwood B. M., Hassan-King M., Onyemelukwe G., Macfarlane J. T., Tubbs H. R., Tugwell P. J., Whittle H. C., Denis F., Chiron J. P., M'boup S. Pneumococcal serotypes in West Africa. Lancet. 1980 Feb 16;1(8164):360–360. doi: 10.1016/s0140-6736(80)90900-9. [DOI] [PubMed] [Google Scholar]
- Macfarlane J. T., Adegboye D. S., Warrell M. J. Mycoplasma pneumoniae and the aetiology of lobar pneumonia in northern Nigeria. Thorax. 1979 Dec;34(6):713–719. doi: 10.1136/thx.34.6.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Macfarlane J. T., Finch R. G., Ward M. J., Macrae A. D. Hospital study of adult community-acquired pneumonia. Lancet. 1982 Jul 31;2(8292):255–258. doi: 10.1016/s0140-6736(82)90334-8. [DOI] [PubMed] [Google Scholar]
- Sofowora E. O., Onadeko B. O. Complications and prognostic factors in pneumonia among Nigerians. Niger Med J. 1973 Jul;3(3):144–145. [PubMed] [Google Scholar]
- Sutton D. R., Wicks A. C., Davidson L. One-day treatment for lobar pneumonia. Thorax. 1970 Mar;25(2):241–244. doi: 10.1136/thx.25.2.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tugwell P., Greenwood B. M. Pneumococcal antigen in lobar pneumonia. J Clin Pathol. 1975 Feb;28(2):118–123. doi: 10.1136/jcp.28.2.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Warrell D. A. Respiratory-tract infections in the tropics. Practitioner. 1975 Dec;215(1290):740–744. [PubMed] [Google Scholar]