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Imagen clínica
Bulla pulmonar gigante sobreinfectada
Giant Pulmonary Bulla Superinfection
Ana I. Córdoba Alonsoa,
Corresponding author
acordoba@humv.es

Autor para correspondencia.
, Maite Arlabán Carpinterob, José M. Olmos Martíneza
a Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Cantabria, España
b Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria, España
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B&#41; Radiograf&#237;a simple de t&#243;rax postero-anterior y lateral que muestran lesi&#243;n qu&#237;stica con paredes calcificadas que ocupa pr&#225;cticamente la totalidad del hemit&#243;rax derecho con nivel hidroa&#233;reo en su interior&#46; C y D&#41; TAC de t&#243;rax donde se objetiva que dicha imagen qu&#237;stica condiciona atelectasia de gran parte del par&#233;nquima pulmonar del hemit&#243;rax derecho y desplazamiento del mediastino hacia la izquierda&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paciente de 40 a&#241;os sin antecedentes personales relevantes que consult&#243; por disnea y fiebre&#46; Anal&#237;ticamente presentaba leucocitosis con desviaci&#243;n izquierda y elevaci&#243;n de reactantes de fase aguda&#46; La radiograf&#237;a &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; A y B</a>&#41; y la TAC de t&#243;rax &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1 <span class="elsevierStyleSmallCaps">C</span> y D</a>&#41; revelaron una imagen qu&#237;stica con paredes calcificadas y contenido hidroa&#233;reo&#44; que ocupaba pr&#225;cticamente todo el hemit&#243;rax derecho&#44; provocando una atelectasia del par&#233;nquima y desplazando el mediastino contralateralmente&#46; Se inici&#243; tratamiento con antibioterapia emp&#237;rica y ante la falta de respuesta se decidi&#243; realizar el drenaje de la colecci&#243;n mediante toracotom&#237;a&#44; con mejor&#237;a cl&#237;nica posterior&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Se define como bulla pulmonar gigante a un espacio aireado en el pulm&#243;n mayor del 30&#37; del hemit&#243;rax&#46; Algunos factores de riesgo son&#58; tabaquismo&#44; enfermedad pulmonar obstructiva cr&#243;nica y d&#233;ficit de alfa-1-antitripsina&#46; Una de las complicaciones es la sobreinfecci&#243;n&#44; con aislamientos microbiol&#243;gicos diversos &#40;<span class="elsevierStyleItalic">Staphylococcus aureus</span> resistente a meticilina&#44; <span class="elsevierStyleItalic">Bacteroides</span>&#44; <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; etc&#46;&#41;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>&#46; No est&#225; indicada la realizaci&#243;n de broncoscopia de forma rutinaria<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>&#46; No obstante&#44; es importante descartar el origen neopl&#225;sico&#44; las enfermedades autoinmunes&#44; principalmente granulomatosis con poliangitis&#44; sarcoidosis y s&#237;ndrome de Sj&#246;gren&#59; as&#237; como los embolismos pulmonares&#46; El drenaje del contenido ayuda a la resoluci&#243;n&#44; debido a la escasa penetraci&#243;n de los antibi&#243;ticos en el interior<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>&#46;</p></span>"
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Article information
ISSN: 03002896
Original language: Spanish
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