P2609 Distribution of respiratory manifestations during the chlamidiaee psittaci infections

Aims: To evaluate Legionella urinary antigen detection in relation to the compli- cations in L. pneumophila CAP. Methods: A prospective multicenter study over 1,314 CAP was carried out in 10 hospitals during 12-month period. Aetiological diagnosis was established by serological tests, pleural and blood cultures, L. pneumophila and S. pneumoniae urinary antigen tests. Results: An aetiological diagnosis was obtained 579 cases (44.1%) and L. pneu- mophila was found in 154 (26.6%) of them. Using Pneumonia Severity Index (PSI) risk classes: 47 (30.5%) belonged to classes I, II, 42 (27.3%) to class III and 65 pa- tients (42.2%) to classes IV, V. Overall hospital admission was high, 136 (89.6%), even in low risk classes (I, II), 35 (74.5%) although they were significantly lower than in higher risk classes (IV, V), 64 patients (98,5%) (p=0,01). L. pneumophila was diagnosed by urinary antigen (UA) in 86 cases and in 65 of them by serology too. Serology was the only diagnosis method in 68 cases (44,2%) mainly applied in outpatients. UA test positivity rate was higher in groups III, IV,V (91,6%), than in I, II (74,5%) (p=0,03). Complications were similar in both groups (26 patients): I, II: 4 (2,6%), III, IV, V: 22 (20,5%) (p=0,06). The mortality was low 3,2% (5 cases in high risk classes) Conclusion: Legionella urinary antigen detection established diagnosis more in high risk classes than in the lower ones We didn't find differences regarding complications between high and low risk classes, probably due to the number of patients of our study In the previously period of 6 years we analysed patiens with improved, clinical, radiographic and laboratory pneumonias. The leading symptom and indication for hospitalizations in 29 (5,3%) patiens were haemoptysis. Patiens were in ages from 15-45 years, and mainly males: 18 (62,1%) and 11 (37,9%) females. Besides haemoptysis in 14 (48,2%) patiens dominated high temperatures, caugh, headache, chest pain and myalgia. 20 (41,3%) patiens had subfebrile states. In (10,3%) patiens haemoptysis were the only symptom of illness. Radiographic manifestations on admission to the hospital, showed hilar lymphadenopathies accompanied with non - homogenous shadows in the upper right lung in 5 (17,2%) patiens and almost the same lesions on the right were find in 4 (13,5%)on the left side. 10 (34,4%) patiens had inhomogenous shadows in lower lobe. Prominent reticular findings were localised in the middle lobe in 2(6,8%) patiens. Basal spot shadows on the left with ipsilateral pleural effusion were find out in 3(10,3%) patiens. Round shaped shadowings in the left upper lobe were reported in 5(17,2%) patiens. In all 29 patiens serologic reactions of complement binding confirmed Mycoplasma pneumoniaee with antibody IgM titres. The effects of macrolides therapies were good in all potiens after average period of 19,4 days.