A clinical study on non-resolving pneumonia in tertiary care centre


  • Ramesh P. M. Department of Pulmonary Medicine, Kilpauk Medical College, Kilpauk, Chennai, Tamil Nadu, India
  • Saravanan M. Department of Pulmonary Medicine, Kilpauk Medical College, Kilpauk, Chennai, Tamil Nadu, India




Etiology, Fibre-optic bronchoscopy, Non-resolving pneumonia


Background: Non-resolving pneumonia is a problem not only for the patient but also to the treating physician because establishing the cause for the non-resolution of pneumonia takes time and requires invasive investigations. The present study was done with the aim to evaluate the etiology and clinical outcome of non-resolving pneumonia by using fibre-optic bronchoscopy (FOB).

Methods: This prospective study was done on 45 patients with symptoms and signs of non-resolving pneumonia attending the Govt. Thiruvotteeswarar Hospital of Thoracic Medicine, Otteri, Chennai, a tertiary care teaching centre, during the period January 2016 to December 2016. All the patients were investigated systematically to find out the etiological factors for non-resolution pneumonia

Results: Males preponderance was seen in the study (80%). Patients of age group 51-60 years are more affected (26.6%). Bacterial pneumonia not responding to empirical antibiotics (42.2%) was the most common cause followed by pulmonary tuberculosis (28.8%) and malignancy (24.4%). On FOB, inflammation with secretions was noticed in most of the patients (66.6%).

Conclusion: The findings of the study concluded that apart from bacterial pneumonia not responding to empirical antibiotics, tuberculosis and malignancy were found to be the major causes of non-resolving pneumonia. Hence, it is necessary to observe every patients for the adequate response to treatment and to utilize other modalities of investigations like FOB,CT guided FNAC/biopsy whenever required to offer exact management to the patients.


Steel HC, Cockeran R, Anderson R, Feldman C. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediators Inflamm. 2013;2013:490346.

Kirtland SH, Winterbauer RH. Slowly resolving chronic and recurrent Pneumonia. Clin Chest Med. 199l;12:303-18.

Ruiz M, Ewig S, Marcos MA, Martinez JA, Arancibia F, Mensa J, et al. Etiology of community- Acquired pneumonia: Impact of age, comortbidity, and severity. Am J Respir Crit Care Med. 1999;160:397-405.

Brown JS. Community-acquired pneumonia. Clin Med. 2012;12(6):538–43.

Blasi F, Mantero M, PierAchille S, Tarsia P. Understanding the burden of pneumococcal disease in adults. Clin Microbiol Infections. 2012;18(5):7–14.

Jayaprakash B, Varkey V, Anithakumari K. Etiology and clinical outcome of non-resolving pneumonia in a tertiary care centre. JAPI. 2012;60:98-101.

Chaudhuri AD, Mukherjee S, Nandi S, Bhuniya S, Tapadar SR, Saha M. A study on non-resolving pneumonia with special reference to role of fiberoptic bronchoscopy. Lung India. 2013;30(1):27-32.

El Solh AA, Aquilina AT, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly. J Am Geriatr Soc. 2004;52:224-9.

Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67(1):71-9.

Chathamparamb B, Antony A, Nivarthil SU, Paul AM, Kallikadavil MA, Joshi M. Non-resolving pneumonia aetiology and clinical profile: a prospective study. J Evolution Med Dent Sci. 2016;5(19):954-8.

Begamy T. Thoracic empyema. Is its microbiology changing? Pul Rev Com. 2000;5:10.

Feinsilver SH, Fein AM, Niedeman MS, Schuttz DE, Fougenberg DH. Utility of fiberoptic bronchoscopy in nonresolving pneumonia. Chest. 1990;98:1322-6.






Original Research Articles