Neumonías adquiridas en la comunidad en adultos: Un estudio etiológico prospectivo con énfasis en el diagnóstico

Neumonías adquiridas en la comunidad en adultos: Un estudio etiológico prospectivo con énfasis en el diagnóstico

Objectives: To define prospective/y in adults the etiology of acquired pneumonia in the community (NAC) in three hospitals of the city of Medellin. 

Materials and methods: The entrance was carried out with clinical diagnosis of NAC and compatible thorax x-ray. Sample of blood was obtained for blood count, sedimentation and protein C it reactivates (PCR), 2-3 blood culture and serum for antibodies antim ycoplasm, anti-legionella and anti-Chlamydia pneumoniae. Breathing sample was obtained for Gramand /egione/la cultivation and other conventional pathogenics. 

Results: 76 patients were studied, 37 women, average 46. 6± 17 years. The symptoms and more frequent signs were cough, fever, taquipnea and stertors. The Rx showed alveolar pattern in 73.3%, interstitial in 10.5% and mixed in 15.8%. The most important laboratory parameters were leucocytosis (16.3±8.2), neutrofilia (14±7.6), sedimentation (41±36) and PCR {26.8±45.4). The etio/ogy was defined in 47.3% of the cases, 21.0% probable and unknown was in 31.5%. In 81.5% of the sputa it was recovered a pathology, in alone blood culture S. was isolated pneumoniae {21.3%), in24% theserologypositive was (22.3% M. pneumoniae and 1.7% C. pneumoniae), H. influenza was isolated in 3 patients, M. tuberculosis in 2 patients, 36.9% of the isolations was associate, M. pneumoniae, H. influenza and S. pneumoniae in 1 O, 5 and 5 patients respective/y. 

Conclusions: The etiology of NAC in the studied group doesn't vary of the one reported in other countries, the pneumococo frequency and M. pneumoniae, suggests that the empiric therapies should contemplate these two pathogenies, the resource toasted by the microbiology laboratory allows to define the etiology and the specific treatment.