ホームレスに発症した市中肺炎についての検討 [in Japanese] Pneumonia among the Homeless [in Japanese]
Access this Article
Search this Article
路上生活者, あるいはいわゆるホームレスにおける結核症の実態については, 本邦でもいくつかの検討がなされている.しかしながら非結核性の呼吸器感染症については, 今までほとんど検討されていない.われわれは1993年8月当院開設時より1996年7月までの3年間に当院に入院した, いわゆるホームレスのうち, 臨床的に肺炎と診断された症例について検討した.患者は18例, 平均年齢51歳全例が救急車で来院し, 入院は冬季の夜間に集中していた.呼吸不全や重篤な合併症を有する例が多く, 入院後の集中的な治療にかかわらず, 1/3以上が死の転帰をとった.起炎菌が肺炎球菌と推定された例が多く, 重症の肺炎球菌肺炎が多いことが特徴的であった.
Although there are some studies concerning tuberculosis among the homeless persons in Japan, almost no detailed analysis is available about non-tuberculous lung infections in this population .<BR>We retrospectively studied the clinical features and microbial etiology of pneumonia among the homeless. This series included twenty so-called homeless persons, 19 male and one female, who were admitted to our hospital with a clinical diagnosis of pneumonia from April 1993 to July 1996. The average age was 56 years-old. All patients were transferred by ambulance. Most of them were admitted night in the winters, and had respiratory failure together with othoer serious complications such as gastrointestinal disease, liver failure and cerebrovascular disease. Chest X ray revealed so-called lobar pneumonia in 8 of 20 cases (40%). Microbial etiologic agents were found in 14 patients (70%). Pneumococcus amounted to 80% of all the speculated pathogens. Despite intensive care after admission, 6 of 20 patients (30%) died subsequently. Although fatal pneumococcal pneumonia were reported to have decreased in the general population in Japan, morbidity and mortality of pneumococcal pneumonia was very high in this series.
- Kansenshogaku Zasshi
Kansenshogaku Zasshi 73(8), 717-721, 1999-08-20
The Japanese Association for Infectious Diseases