Journal Information
Vol. 33. Issue 5.
Pages 230-234 (May 1997)
Share
Share
Download PDF
More article options
Vol. 33. Issue 5.
Pages 230-234 (May 1997)
Full text access
Neumonía adquirida en la comunidad (NAC) con tratamiento hospitalario. Interés de la clínica y exámenes complementarios en la predicción de la etiología
Community acquired pneumonia treated in hospital. Usefulness of physical examination and ancillary tests for predicting etiology
Visits
5213
L. Molinos*, R. Fernández, J.A. Gullón, G. Rubinos, M.A. Alonso, C. Escudero, A. Bango, S. Ramos, J. Martínez
Servicio de Neumología I. Hospital Central de Asturias. Oviedo
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

Hemos estudiado de manera prospectiva a 162 pacientes con neumonías adquiridas en la comunidad (NAC) ingresados para tratamiento hospitalario, con el objetivo de conocer la rentabilidad de la clínica y los exámenes complementarios para predecir la etiología y así pautar un tratamiento empírico más adecuado.

El comienzo agudo de los síntomas, la expectoración purulenta, la auscultación propia de la condensación pulmonar, el dolor torácico pleurítico y la leucocitosis superior a 12.500/ml fueron variables estadísticamente significativas a la hora de delimitar entre neumonías de comportamiento típico y atípico, siendo las dos últimas las más relevantes como demostró el análisis multivariante.

Concluimos, de acuerdo con los resultados de este trabajo, que una historia clínica cuidadosa y un examen hematológico elemental siguen teniendo vigencia y no deben considerarse como “anacrónicos” en el diagnóstico diferencial de la NAC.

Palabras clave:
Neumonía adquirida en la comunidad
Neumonía atípica

We studied 162 patients with community acquired pneumonia admitted for hospital treatment, in order to determine the utility of clinical and ancillary examinations for predicting etiology and guiding the most appropriate empirical treatment.

Acute first appearance of symptoms, purulent expectoration, chest sounds indicating lung condensation, pleuritic chest pain and leukocytosis over 12,500/ml were statistically significant in differentiating typical pneumonias from those with atypical behavior patterns. The last two features were the most relevant according to multivariate analysis.

We conclude that careful taking of case histories and basic blood testing continue to be relevant and must not be considered anachronistic for the differential diagnosis of community acquired pneumonias.

Key words:
Community acquired pneumonia
Atypical pneumonia
Full text is only aviable in PDF
Bibliografía
[1.]
R.A. Garibaldi.
Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology, and impact.
Am J Med, 78 (1985), pp. 32-37
[2.]
J. MacFarlane.
Community-acquired pneumonia.
Br J Dis Chest, 81 (1987), pp. 116-127
[3.]
British Thoracic Society.
Community-acquired pneumonia in adults in British Hospitals in 1982-1983: a survey of aetiology, mortality, prognostic factors and outcome.
Q J Med, 62 (1987), pp. 195-220
[4.]
A. Torres, J. Serra-Batlles, A. Ferrer, P. Jiménez, R. Celis, E. Cobo, et al.
Severe community-acquired pneumonia. Epidemiology and prognostic factors.
Am Rev Respir Dis, 144 (1991), pp. 312-318
[5.]
L. Molinos, J.A. Tapias, J.P. García, F. Díez, E. Alonso, J.M. González, et al.
Symposium regional: Neumonías en Castilla-León. Palencia:XIII Congreso Anual de la SOCALPAR.
Libro del Congreso, (1994), pp. 22-24
[6.]
American Thoracic Society.
Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assement of severity, and initial antimicrobial therapy.
Am Rev Respir Dis, 148 (1993), pp. 1.418-1.426
[7.]
E.M. Cotton, M.J. Strampfer, B.A. Cunha.
Legionella and Mycoplasma pneumoniae –a community hospital experience with atypical pneumonias.
Clin Chest Med, 8 (1987), pp. 441-453
[8.]
G.-D. Fang, M. Fine, J. Orloff, D. Arisnmi, L. Yu, W. Kapoor, et al.
New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases.
Medicine, 69 (1990), pp. 307-315
[9.]
B.M. Farr, D.L. Kaiser, B.D.W. Harrison, C.K. Connolly.
Prediction of microbial aetiology at admision to hospital for pneumonia from the presenting clinical features.
Thorax, 44 (1989), pp. 1.031-1.035
[10.]
M.A. Woodhead, J.T. Macfarlane.
Comparative clinical and laboratory features of Legionella with pneumococcal and Mycoplasma pneumonias.
Br J Dis Chest, 81 (1987), pp. 133-139
[11.]
T.J. Marrie.
Community-acquired pneumonia.
Clin Infect Dis, 18 (1994), pp. 501-515
[12.]
P.F. Griner, R.J. Mayewski, A.I. Mushlin, P. Grunland.
Selection and interpretation of diagnostic tests and procedures.
Ann Intem Med, 94 (1981), pp. 533-600
[13.]
C.M. Wollschlager, F.A. Khan, A. Khan.
Utility of radiography and clinical features in the diagnosis of community-acquired pneumonia.
Clin Chest Med, 8 (1987), pp. 393-404
[14.]
E.A. Freundt.
General principies of laboratory diagnosis of Mycoplasma infections.
Isr Med Sci, 17 (1981), pp. 644-647
[15.]
C.U. Tuazon, H.W. Murray.
Atypical pneumonias..
Respiratory infections. Diagnosis and management, pp. 407-433
[16.]
P. Ansola, V. Sobradillo, F. Baranda, L. Gaztelurrieta, J.L. Llorente, J.M. Antoñana.
Neumonías adquiridas en la comunidad de Vizcaya.
Arch Bronconeumol, 26 (1990), pp. 103-107
[17.]
D.C. Levin, M.I. Schwartz, R.A. Matthay, F.M. LaForce.
Bacteremic Haemophilus influenzae pneumonia in adults: a report of 24 cases and a review of the literature.
Am J Med, 62 (1977), pp. 219-224
Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?