A Clinical Profile ofChronic Bacterial Pneumonia* Report of115Cases

Objective: Toreview theclinical presentation, radiology, microbiology, andresponse totherapy ofpatients withchronic bacterial pneumonia. Design: Aretrospective analysis. Setting: Anurban tertiary caremedical center. Participants: Onehundred fifteen patients withpulmonary and/or constitutional symptoms ofatleast 1month's duration with 4,000 ormorecolony-forming units (CFUs) ofasingle bacterial species identified byquantitative culture obtained viafiberoptic bronchoscopy. Measurements: Charts wereanalyzed forpresence or absence ofanypredisposing illness, symptoms atpresentation, roentgenographic abnormalities, microbiologic results, findings atfiberoptic bronchoscopy, and results oftherapeutic intervention. Results: Sixty-five percent ofpatients withchronic bacterial pneumonia hadapredisposing disease, 35percent were"normal." Cough, fatigue, dyspnea, andweight Fromall ofthis itfollows, that thephysicians, whoconfine themselves, inthediseases ofthechest, totheexamination ofgeneral symptoms, mustoften mistake chronic peripneumony; particularly ifthey donotseethepatient 'till after thefirst days ofthecomplaint, orinthose cases where theperipneumonic affection supervenes inthecourse of another disease. R.T.H. Laennec, M.D., 1819' From 1911through 1967, there were15published series ofpatients withchronic bacterial pneumonia.2-16 Thenumberofpatients varied from3to17 andoften included individuals withlung abscess and bronchiectasis withsurgery orautopsy asthecommonmeansofdiagnosis. Subsequently, thedefinition ofchronic pneumonia wasmodified todesignate a clinical syndrome ofprolonged respiratory symptomsandpersistently abnormal chestroent