الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pneumonia remains an important public health problem, associated with significant health care costs. The prevalence, morbidity and mortality rates of pneumonia seem to be on the rise. Understanding the risk factors and the natural history of pneumonia are important for evaluation and appropriate treatment of the disease.
The risk of pneumonia is higher in the following cases: younger than 1 year or more than 65 years, smoking, the presence of a cold or flu, a weakened immune system due to cancer treatment, infection with HIV, surgical treatment, an addiction to alcohol, chronic conditions like heart diseases or diabetes and chronic lung diseases e.g. bronchial asthma or chronic obstructive pulmonary disease (COPD).
Bacterial pneumonia can be treated with antibiotics. It is extremely important to take antibiotics exactly as prescribed by doctors and finish the treatment completely. There is no cure for most viral infections, we must simply wait until the body gets rid of it. Fungal infections can be treated with antifungal drugs.
C.pneumoniae is newly discovered as an important respiratory pathogen with worldwide distribution. It is endemic in many countries. Its prevalence seems to vary from region to another. It is an intracellular pathogen with a unique life cycle. It can infect many types of human cells, can produce tissue scarring and can elaborate immune responses. It causes upper and lower respiratory tract diseases and invades the epithelial cells of the respiratory tract and lung tissue. Involvement of C.pneumoniae infection has been described in 10% of pneumonias, 5% of acute bronchitis, common cold, persistent cough, 1% of pharyngitis, sinusitis and otitis media.
Our study aims to evaluate the prevalence of C.pneumoniae in patients suffering from pneumonia in the Main University hospital in Alexandria and and El Maamoura Chest Hospital.
Our study was conducted on 60 patients with pneumonia divided into 2 groups; group includes 30 patients with HAP (patients admitted to the hospital with chest diseases other than pneumonia then pneumonia occurred after 48 hours of hospital admission) and the other group includes 30 patients with CAP ( patients admitted to the hospital diagnosed as cases of pneumonia). Patients were selected from who have been admitted to department of chest diseases in the Main University hospital in Alexandria (55 patients) and also from El Maamoura Chest Hospital (5 patients). All patients were subjected to detailed history taking, complete physical examination and plain X-ray chest in a posteroanterior view and WBCs count then sputum samples were collected for DNA extraction and PCR analysis for C.pneumoniae and serum samples were taken for serological study (ELISA). This study included ten sex and age matched healthy individuals as a control group.
Comparing the results of this study with other similar published studies and collected information about pneumonia and C.pneumoniae; the following results were obtained:
1) Pneumonia was significantly higher in males than in females.
2) HAP was significantly higher in older age group (>60) while CAP was significantly higher in middle age group (30-60).
3) Pneumonia was significantly higher in smokers than in non-smokers.
4) It was significant that all patients with pneumonia on healthy lung were with CAP while all patients with COPD were with HAP.
5) Mucoid sputum was significantly higher in patients with CAP while muco-purulent sputum was significantly higher in patients with HAP.
6) Dyspnea degree I, II were significantly higher in patients with CAP while dyspnea degree III, IV were significantly higher in patients with HAP.
7) HAP was significantly higher in patients on mechanical ventilator.
8) HAP was significantly higher in diabetic patients than non diabetic patients.
9) Continuous fever was significantly higher in patients with HAP while intermittent fever was significantly higher in patients with CAP.
10) PCR was positive in three patients out of 60 (5%).
11) ELISA was positive in five patients out of 60 (8.3%).
12) All the 3 positive PCR cases were also positive ELISA while 2 positive ELISA cases were negative PCR.
13) All 3 positive PCR cases were diabetics.
from our results we can conclude that:
• C.pneumoniae can’t be ignored as a cause of pneumonia.
• ELISA is an excellent screening test because of its high sensitivity for detection of C.pneumoniae while PCR is more accurate because of its high sensitivity and high specificity in diagnosis of C.pneumoniae infection.
• DM is a risk factor for C.pneumoniae infection.