introduction chlamydia pneumoniae and community-acquired pneumonia

The Relation between Blood Leucocyte Count, Erythrocyte Sedimentation Rate, High Sensitive C-Reactive Protein Levels and Pulmonary Parenchymal

Infiltration Rate in Young Male Patients with Chlamydia Pneumoniae Pneumonia

D. Taş1, E. Kunter1, H. Şevketbeyoğlu2, A.F.Aydın3, K. Çelik4, Z. Kartaloğlu1

1GATA Haydarpaşa Training Hospital, Department of Pulmonary Diseases 2Van Military Hospital, Department of Pulmonary Diseases 3İzmir Military Hospital, Department of Infectious Diseases 4İzmir Military Hospital, Department of Radiodiagnostics



Introduction

Chlamydia pneumoniae and community-acquired pneumonia

The significance of extensivity degree of lung parenchymal infiltration



Aim

To describe the levels of blood keucocyte count, erythrocyte sedimentation rate

(ESR), and high sensitive C-Reactive Protein (hs-CRP) and to investigate the

relation of these biomarkers with the rate of parenchymal infiltration (RPI) in

patients with Chlamydia pneumoniae pneumonia (CPP)



Material and Method

Patients

Diagnostic method of CPP

Patients characteristics

Number of CPP cases



Material and Method

High resolution computerised tomography

Imaging method and time

Characteristics of infiltration

Defining the distribution width of the infiltration

Rate of parenchymal infiltration(%) = Number of sections showing infiltration by HRCTx100 / total number of sections 2

In case of bilateral infiltrations in the same section, multiplied by 2



Statistical Analysis

Descriptive

Student t-Test

Pearson Correlation Analysis



Findings

Demographic data and leucocyte, ESR, hs-CRP levels of the patients

n Minimum Maximum MeanStd.

Deviation

Age 32 20,00 25,00 20,46 1,11

Smokers (Yes/No) 19/11 - - - -

Body mass index 32 16,62 24,38 20,84 2,15

Leucocyte count 32 4600,00 21000,0010131,2

54912,68

ESR 32 2,00 103,00 57,12 29,46

hs-CRP 32 ,04 10,24 3,17 3,64



Findings

Blood Leucocyte Count

High in 14 patients (43.7%), normal in 18 patients (56.3%)

Erythrocyte Sedimentation Rate


High Sensitive C-Reactive Protein Levels




Findings

The relation of leucocyte, sedimentation and hs-CRP with lung parenchymal infiltration rate

Leucocyte ESR hs-CRP

Lung parenvhymalinfiltration rate (%)

Correlation constant (r) 0,011 0,102 0,476

Probability (p) 0,952 0,580 0,006



Findings

The relation of hs-CRP and the lung parenchymal infiltration rate

Lung parenchymal infiltration rate (%)

60,0050,0040,0030,0020,0010,000,00

hs-CRP (mg/L)

12,00

10,00

8,00

6,00

4,00

2,00

0,00

Observed

Linear

n=32 r=0,476 p=0,006



Discussion

In CPP, sedimentation (%84.3) and hs-CRP (%81.2) had a high sensitivity while sensitivity of leucocyte count (%43.7) was moderate.

There was only one patient with normal sedimentation and hs-CRP levels. These two biomarkers together had a sensitivity of 96.8% for CPP

Although patients were not different in terms of ESH and hs-CRP (p = 0,23), studying these two biomarkers together as acute phase reactants may be

more useful in detecting infectious inflammation



Discussion

We found a moderately significant correlation between hs-CRP parenchymal infiltration

However, the correlation of blood leucocye count and ESH with parenchymal infiltration was not significant statistically

These findings suggest that the increment of hs-CRP may be partially parallel to the rate of lung parenchymal infiltration



Conclusion

hs-CRP and ESR had an acceptable sensitivity while leucocyte count had a moderate sensitivity in patients with CPP

These two acute phase reactants can be used as screening tests especially in crowded living conditions with the risk of epidemia

We found that hs-CRP showed a moderately positive and significant correlation with lung parenchymal infiltration while leucocyte and ESR levels were not correlated significantly.

According to our findings hs-CRP and ESR were succesfull in detecting infection but only hs-CRP was correlated with the rate of lung infiltration. So, hs-CRP can be used as a parameter defining the severity of CPP, but to confirm these findings study of larger series is needed.

introduction chlamydia pneumoniae and community-acquired pneumonia

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