陰影吸収の遷延する肺炎に関する検討--特に急性期の病像について
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Of the 71 patients with community acquired bacterial pneumonia in our clinic between April, 1982and July, 1983, 67 were followed up radiographically.<BR>In 7 of them (10.4%), clearing of radiographic densities was protracted for more than 8 weeks afterimprovement of pyrexia and leucocytosis. The background of these patients and their roentgenogramswere studied. They comprised 6 males and 1 female and their ages averaged 68. 1 years. Five of themhad an underlying disease, which was mostly chronic obstructive pulmonary disease (4 cases). Furtherstudies were made on causative organisms, level of body temperature, leucocyte counts, CRP, erythrocyte sedimentation rate (ESR), and early-stage response to the treatment. Causative organismswere undetectable in most cases, and the roentgenograms obtained during manifestation of symptomsshowed nothing peculiar.<BR>The findings on pyrexia, leucocyte count, CRP, or ESR were not notably different from those in theentire cases or old-age group (32 cases). The mean duration of pyrexic, leucocytotic, and CRP-positivestates since the start of chemotherapy, which are considered to represent the earlystage response of thepatients to the treatment, were 5.8, 7.8, and 11.7 days in the entire cases. Thus, pyrexia and positive-CRP persisted approximately twice as long as the respective conditions in the entire cases. However, thedifferences involved were within 10 days and, in addition, the duration of leucocytosis did not appreciablydiffer between this group and the entire group.<BR>From the above, it was inferred that the protraction of shadow resolution was due to an abnormalprocess in a healing stage, which might possibly be associated with the fact that the remission ofleucocytosis in peripheral blood occurred earlier than the aleviation of fever and reversal of CRP.
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