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Recurrent Pneumonia: Predisposing Illness and Clinical Patterns in 158 Patients

RICHARD H. WINTERBAUER, M.D.; GEORGE A. BEDON, M.D.; and WILMOT C. BALL JR., M.D.
Ann Intern Med. 1969;70(4):689-700. doi:10.7326/0003-4819-70-4-689
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SUMMARY:

Review of 158 patients with recurrent pneumonia seen over an 11-year period showed 1 or more major associated diseases in 147. Diseases with extrathoracic manifestations were associated with recurrent pneumonia as commonly as primary thoracic diseases, with alcoholism, chronic obstructive airway disease, congestive heart failure, diabetes mellitus, and bronchiectasis being the commonest associated illnesses. Such time-honored causes of recurrent pneumonia as bronchogenic carcinoma, multiple myeloma, and hypogammaglobulinemia were diagnosed very infrequently. The associated illness clearly antedated the recurrent pneumonias in virtually all cases, and 74.5% of these were readily recognized through history or physical examination.

The pattern of recurrent pneumonia, including location of recurrence, number of recurrences, and organisms responsible for infection, were essentially identical for the various specific associated illnesses. The only exception to this was a higher frequency of recurrent pneumonia in the same area in patients with localized intrathoracic disease. Despite the strong association with severe, chronic, underlying illness, recurrent pneumonia had a low case fatality rate.

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