TMSS Medical College Journal

Abstract Background: Platelets play an essential role in both coagulation system and the host immune defenses against infection including community-acquired pneumonia (CAP). Its response in antimicrobial host defense is similar, in many ways, to the leukocyte response as both cell types contain antimicrobial peptides that act against a broad range of pathogens. Objective: The aim of this study was to detect whether platelet count could be used as a marker for severity of community acquired pneumonia (CAP) or not. Materials and Methods: This observational cross-sectional study was carried out at Medicine ward in Mymensingh Medical College Hospital (MMCH) from July 2018 to December 2018. In total 100 cases were selected as per a pre-defined exclusion and inclusion criteria. All cases were subjected to the following: full history taking, thorough clinical examination and necessary investigations including compete blood picture. CURB-65 score was considered as a marker for severity of CAP. Data were processed, analyzed and disseminated by MS Office and SPSS programs as per need. Results: According to platelet count at admission, 29% patients showed thrombocytopenia and 59% normal platelet count, while 12% patients showed thrombocytosis. Significant correlation between both thrombocytopenia and thrombocytosis and the CURB-65 score was found in this study. There was also found a significant relation between both thrombocytopenia and thrombocytosis with confusion and hypotension among the patients with CAP. Conclusion: A better understanding of the role of platelets in the severity of patients with CAP may generate new prognostic and therapeutic modalities for patients with severe disease.

Community-acquired pneumonia (CAP) is a common and potentially serious illness." It is defined as an acute infection of the pulmonary parenchyma, occurring outside the hospital, with clinical symptoms accompanied by the presence of pulmonary infiltrates on chest radiograph. With a prevalence estimated at nearly five million cases annually in United States, emergency physicians and general practitioners diagnose and treat CAP on a regular basis.” Nearly one third of CAP patients arrived by emergency medical services, and half eventually were admitted.’ Despite the availability of potent antibiotics, community- acquired pneumonia (CAP) remains common and serious illness with significant morbidity and mortality, both in developing and developed countries. In the United State, pneumonia is the sixth leading cause of death.* Many clinicians are concerned about the severity of CAP and its associated mortality. The Pneumonia Patients Outcome Research Team score was introduced in 1997 to assess the severity of CAP after a study including more than 50,000 patients.’ Established by the American Thoracic Society/ Infectious Diseases Society of America, this scoring system is called the Pneumonia Severity Index (PSI) and is the recom mended severity scoring system for CAP. More simple severity scores for CAP, such as CURB-65, have also been documented.® CURB-65 is a five-point scoring system for CAP, recommended by the British Thoracic Society, and includes confusion, urea >7 mmol/L (19 mg/dL), respiratory rate >30 breaths per minute, low blood pressure (systolic blood pressure < 90 mmHg and/or diastolic blood pressure < 60 mmHg) and age >65 years. But these scoring systems may be affected by subjectivity on the part of the individual clinician.