Community-acquired pneumonia in pacients with low body mass index

Abstract

Introduction: Community-acquired pneumonia (CAP) represents a serious medical and social problem. The criteria that place it among the main respiratory syndromes are high incidence, risk of severe evolution and complications. Some studies about severe CAP suggest that a body mass index (BMI) <18,5 is an important risk factor that influences negatively clinical and paraclinical manifestations of pneumonia. There is lack of data about mild-to-moderate CAP in patients with low BMI. Purpose and Objectives: Elucidation of etiological, clinical and paraclinical peculiarities of mild-to-moderate CAP in patients with low BMI. Materials and methods: The study included 60 patients with mild-to-moderate CAP, divided into two groups, the first group included 30 patients with a BMI<18,5 and mean age 46,3±20,4 years and the second one included 30 patients with a BMI=20,0-24,9 and mean age 50,7±17,4 years (p>0,05). The patients were examined clinically, biologically, microbiologically and performed chest X-ray. Results: The etiological agent was determined in 53,4% of patients with a low BMI and in 73,4% of those with a normal BMI, Streptococcus pneumoniae prevailed in both groups. We noticed a number of statistically significant differences between the two groups. The patients with a low BMI had a higher incidence of chest pain (23 (76,6%) vs 20 (66,6%) patients), a longer period of hospitalization due to a slower disappearance of symptoms and signs (10,9±3,6 vs 9,2±2,5 days), a lower percentage of lymphocytes (20,3±7,2 vs 25,5±11,8%), monocytes (6,1±3,4 vs 8,5±3,9 %), a lower number of erythrocytes (3,9±0,8 vs 4,3±0,4, xlO l2/l), a lower quantity of hemoglobin ( 1 16,1±25,2 vs 127,1±14,9 g/1), fibrinogen (3,6±0,7 vs 4,1±1,0 g/1), total cholesterol (3,9±1,0 vs 4,5±1,0 mmol/1) and blood glucose (4,4±0,93 vs 4,9±0,7 mmol/1). There were not significant differences between the groups in localization, extension and resolution of pneumonia. Conclusion: In our study no etiological and radiological peculiarities of mild-to-moderate CAP in patients with low BMI were found. The patients with a low BMI had a longer clinical course of CAP and a decreased systemic inflammatory response comparing to patients with a normal BMI.