• Rafael Perelló, Oscar Miró, José M Miró, Elisabeth Massó, Miquel Sánchez, Silvia Camón, Jordi Puig de la Bellacasa, Asunción Moreno, and María de Los Angeles Marcos.
• aDepartments of Emergency bMicrobiology cInfectious Diseases, Hospital Clinic, Barcelona, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
• Eur J Emerg Med. 2011 Feb 1;18(1):50-4.

AbstractThe aim of our study was to determine the usefulness of pneumococcal urinary antigen (UA) collected in the emergency department (ED) for the microbiologic diagnosis of community-acquired pneumonia (CAP) in HIV patients and to compare it with other diagnostic tests. Prospective study from 1 January 2007 to 31 December 2008 included HIV-infected patients admitted at the ED with respiratory symptoms and who were diagnosed of CAP. UA, two blood cultures and sputum sample for culture determination were collected from every patient. Sixty-four patients were included. The mean age was 42 years. A total of 31 (48%) UA tests, 12 (19%) blood cultures and 21 (33%) sputum cultures tested positive. A microbiological diagnosis was obtained in 38 (59%) cases. Pneumococcal pneumonia was diagnosed in 32 cases. The statistical analysis showed that the test with best performance was the UA, both in relation to blood and sputum cultures (P<0.05). Two patients died during hospitalization (series mortality of 3%). In conclusion, given its good diagnostic performance, UA should be requested in the ED for the aetiological diagnosis of CAP.

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