Clinical, radiological, and microbiological profile of non-resolving pneumonia in adults: a hospital-based cross-sectional observational study.

Pallavi Reddy; Manda Srujana; Naga Sravya Jaladi

doi:10.51168/sjhrafrica.v7i2.2755

Authors

Dr. Pallavi Reddy Assistant Professor, Department of Respiratory Medicine, CMR Institute of Medical Sciences, Kandlakoya, Medchal, Telangana, India.
Dr. Manda Srujana Assistant Professor, Department of Respiratory Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Medchal,Telangana, India.
Dr. Naga Sravya Jaladi Assistant Professor, Department of Respiratory Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Medchal,Telangana, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2755

Keywords:

Non-resolving pneumonia, Bronchoscopy, High-resolution computed tomography, Tuberculosis, Lung malignancy, Microbiological profile

Abstract

Background

Non-resolving pneumonia is a clinically important condition in which pulmonary infiltrates and symptoms persist despite initial antimicrobial therapy. It requires structured evaluation because the underlying cause includes resistant bacterial infection, tuberculosis, fungal disease, bronchiectasis, aspiration, inflammatory lung disease, and malignancy.

Objectives

To assess the clinical, radiological, microbiological, and etiological profile of non-resolving pneumonia among adult patients.

Methods

This hospital-based cross-sectional observational study consecutively enrolled 100 adults with non-resolving pneumonia at CMR Institute of Medical Sciences from August 2025 to January 2026. Participants underwent structured clinical assessment, chest radiography, high-resolution computed tomography, sputum microbiology, tuberculosis testing, bronchoscopy with bronchoalveolar lavage, and tissue diagnosis when indicated.

Results

Of 118 adults examined for eligibility, 108 fulfilled the eligibility criteria and 100 consented, completed the diagnostic evaluation, and were analyzed. The mean age was 56.8 ± 14.2 years, and males accounted for 64.0% of cases. Smoking, diabetes mellitus, chronic obstructive pulmonary disease, and previous pulmonary tuberculosis were common risk factors. Lobar consolidation was the leading radiological finding. Microbiological diagnosis was obtained in 62.0% of patients; bacterial infection was most common, followed by pulmonary tuberculosis, fungal infection, and mixed infection. Bacterial pneumonia with delayed resolution was the leading final diagnosis, followed by tuberculosis, bronchiectasis-associated infection, lung malignancy, and inflammatory lung disease.

Conclusion

Non-resolving pneumonia in adults showed heterogeneous causes, with infections forming the major group and malignancy remaining an important hidden diagnosis.

Recommendations

Adults with persistent clinical or radiological pneumonia should undergo early stepwise evaluation using HRCT, microbiological testing, tuberculosis work-up, bronchoscopy, and biopsy when clinically indicated.

Author Biographies

Dr. Pallavi Reddy , Assistant Professor, Department of Respiratory Medicine, CMR Institute of Medical Sciences, Kandlakoya, Medchal, Telangana, India.

is an Assistant Professor in the Department of Respiratory Medicine at CMR Institute of Medical Sciences, Kandlakoya, Medchal, Telangana, India. She is actively involved in undergraduate and postgraduate teaching, clinical respiratory care, and academic research in pulmonary medicine. Her areas of professional interest include respiratory infections, obstructive airway diseases, and evidence-based clinical practice. ORCID iD: https://orcid.org/0009-0002-2281-6209

Dr. Manda Srujana, Assistant Professor, Department of Respiratory Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Medchal,Telangana, India.

is an Assistant Professor in the Department of Respiratory Medicine at Mediciti Institute of Medical Sciences, Telangana, India. She is engaged in clinical teaching, patient care, and research activities in respiratory medicine. Her academic interests include pulmonary infections, asthma, chronic obstructive pulmonary disease, and applied clinical research.

Dr. Naga Sravya Jaladi, Assistant Professor, Department of Respiratory Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Medchal,Telangana, India.

is an Assistant Professor in the Department of Respiratory Medicine at Mediciti Institute of Medical Sciences, Telangana, India. She contributes to medical education, respiratory outpatient and inpatient care, and departmental academic activities. Her professional interests include pulmonary medicine, respiratory diagnostics, and clinical research.

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