The microbiologic etiology of severe pneumonia in hospitalized patients is rarely known in sub-Saharan Africa. Through a comprehensive diagnostic work-up, we aimed to identify the causative agent in severely ill patients with a clinical picture of pneumonia admitted to a high-dependency unit. A final diagnosis was made and categorized as confirmed or probable by using predefined criteria. Fifty-one patients were recruited (45% females), with a mean age of 35 years (range = 17-88 years), of whom 11(22%) died. Forty-eight (94%) of the patients were seropositive for human immunodeficiency virus; 14 (29%) of these patients were receiving antiretroviral treatment. Final diagnoses were bacterial pneumonia (29%), Pneumocystis jirovecii pneumonia (27%), pulmonary tuberculosis (22%), and pulmonary Kaposi's sarcoma (16%); 39 (77%) of these cases were confirmed cases. Fifteen (29%) patients had multiple isolates. At least 3 of 11 viral-positive polymerase chain reaction (PCR) results of bronchoalveolar lavage fluid were attributed clinical relevance. No atypical bacterial organisms were found. Copyright,
American Journal of Tropical Medicine and Hygiene
Erasmus MC: University Medical Center Rotterdam

Hartung, T.K, Chimbayo, D, van Oosterhout, J.J.G, Chikaonda, T, van Doornum, G.J.J, Claas, E.C.J, … Zijlstra, E.E. (2011). Etiology of suspected pneumonia in adults admitted to a high-dependency unit in Blantyre, Malawi. American Journal of Tropical Medicine and Hygiene, 85(1), 105–112. doi:10.4269/ajtmh.2011.10-0640