Community-acquired pneumonia in the elderly: association of mortality with lack of fever and leukocytosis

South Med J. 1997 Mar;90(3):296-8. doi: 10.1097/00007611-199703000-00006.

Abstract

Elderly patients with community-acquired pneumonia may not have a systemic inflammatory response characterized by fever and leukocytosis. We compared lack of fever and leukocytosis with mortality in elderly patients with community-acquired pneumonia. Patients with fever and leukocytosis (group A, 47 patients) were compared with those without fever and leukocytosis (group B, 17 patients). Comparison of the two groups by unpaired, two-tailed t test showed that lack of fever and leukocytosis correlated with mortality. Hospitalized elderly patients who have community-acquired pneumonia without fever and leukocytosis are seven times more likely to die than those who have these symptoms. Future research in the adjunct use of immune modulators such as granulocyte colony-stimulating factor in these patients should be encouraged.

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Immunologic / therapeutic use
  • Age Factors
  • Aged
  • Alcohol Drinking / epidemiology
  • Bacteremia / immunology
  • Bacteremia / physiopathology
  • Community-Acquired Infections / immunology
  • Community-Acquired Infections / mortality*
  • Community-Acquired Infections / physiopathology
  • Community-Acquired Infections / therapy
  • Fever / immunology
  • Fever / physiopathology*
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Heart Failure / epidemiology
  • Hospitalization
  • Humans
  • Kentucky / epidemiology
  • Leukocytosis / immunology
  • Leukocytosis / physiopathology*
  • Lung Diseases, Obstructive / epidemiology
  • Pneumonia, Bacterial / immunology
  • Pneumonia, Bacterial / mortality*
  • Pneumonia, Bacterial / physiopathology
  • Pneumonia, Bacterial / therapy
  • Prospective Studies
  • Respiratory Insufficiency / epidemiology
  • Smoking / epidemiology
  • Survival Rate
  • Systemic Inflammatory Response Syndrome / immunology
  • Systemic Inflammatory Response Syndrome / physiopathology

Substances

  • Adjuvants, Immunologic
  • Granulocyte Colony-Stimulating Factor