Las afecciones pulmonares recurrentes en niños / Recurrent pulmonary illnesses

INTRODUCCIÓN: los estudios sobre las afecciones pulmonares recurrentes en niños son escasos; el mayor porcentaje de ellos se realizó en escenarios fuera de la atención primaria, y los datos acerca de las causas subyacentes y los factores de riesgo para esas afecciones son inconsistentes. OBJETIVO: analizar las causas subyacentes y los posibles factores de riesgo de la recurrencia de afecciones pulmonares en niños. MÉTODOS: se realizó un estudio de casos y controles. 63 niños, previamente identificados por médicos de la atención primaria, fueron investigados a partir de un algoritmo para el diagnóstico clínico en la consulta especializada sobre neumopatías recurrentes y crónicas de la provincia Sancti Spíritus, desde el 1º de enero de 2011 al 30 de abril de 2014. En igual período, 104 niños sin antecedentes de afecciones pulmonares recurrentes, fueron incluidos como controles. Se compararon las características demográficas y clínicas de ambos grupos. RESULTADOS: en el 84,1 % de los niños con afecciones pulmonares recurrentes se identificó alguna causa subyacente; prevalecieron el asma, las inmunodeficiencias, las bronquiectasias y la enfermedad por reflujo gastroesofágico. El antecedente de ser bajo peso al nacer tuvo asociación con la recurrencia de las afecciones pulmonares, mientras que la presencia de tabaquismo intradomiciliario se asoció a la no recurrencia. CONCLUSIONES: un adecuado enfoque diagnóstico de los niños con afecciones pulmonares recurrentes puede ser realizado a partir de la integración de los niveles de atención sanitaria, y debe tener como eje central la búsqueda de las causas subyacentes responsables de la recurrencia de esas afecciones.

INTRODUCTION: the studies conducted on recurrent pulmonary illnesses in children are scanty; the highest percentage of them has been made in settings other than the primary health care and data on the underlying causes and the risk factors for these illnesses are inconsistent. OBJECTIVE: to analyze the underlying causes and the possible risk factors of recurrent pulmonary illnesses in children. METHODS: a case-control study was conducted in which 63 children, previously selected by physicians at the primary health care, were examined on the basis of an algorithm for clinical diagnosis in a specialized service for chronic recurrent pneumopathies. It was carried out in Sancti Spiritus province from January 1st 2011 to April 30th 2014. One hundred and four children without a history of recurrent pulmonary problems were included as controls in the same period of time. The demographic and clinical characteristics of both groups were then compared. RESULTS: in the study group, 84.1 % of children showed some underlying cause for recurrent pulmonary illnesses; asthma, immunodeficiencies, brochiectasy and gastroesophageal reflux disease prevailed. Being a low birthweighed infant was associated to recurrence in pulmonary illnesses whereas smoking at home was associated to non-recurrence. CONCLUSIONS: adequate diagnosis of children with recurrent pulmonary illnesses may be made on the basis of integration of all the health care levels and should be focused on identifying the underlying causes of recurrence.

Rothia mucilaginosa Pneumonia Diagnosed by Quantitative Cultures and Intracellular Organisms of Bronchoalveolar Lavage in a Lymphoma Patient

Rothia mucilaginosa is a gram-positive coccus of the family Micrococcaceae. R. mucilaginosa is considered a part of the normal flora of the human oropharynx and upper respiratory tract and lower respiratory tract infections attributable to R. mucilaginosa are not frequent. We present a case of pneumonia, in which the R. mucilaginosa infection was diagnosed by quantitative cultures of a bronchoalveolar lavage (BAL) specimen. A 46-yr-old woman with B lymphoblastic lymphoma was admitted to the hospital for scheduled chemotherapy. Her chest computed tomography (CT) scan revealed bilateral multifocal nodular and patchy consolidation in both lungs. Investigation of the BAL specimen revealed that 7% of leukocytes had intracellular gram-positive cocci. The quantitative cultures of the BAL specimen grew mucoid, non-hemolytic, and grayish convex colonies on blood agar at a count of approximately 200,000 colony-forming units/mL. The colonies were identified as R. mucilaginosa. The patient was empirically treated with levofloxacin for 7 days, after which findings on the chest radiograph and CT scan improved. She was discharged with improvement on hospital day 46. To our knowledge, this is the first report of R. mucilaginosa pneumonia diagnosed in Korea. Quantitative culture of BAL specimen and examination of intracellular organisms are crucial for assessing the clinical significance of R. mucilaginosa recovered from the lower respiratory tract.

Clinical study of low dose continuous infusion of ceftazidime (CAZ)forthe treatment of low respiratory tract infections / 中国临床药理学与治疗学

0.05). Conclusions Low dose continuous infusion of CAZ to treat low respiratory infections is efficacious ,safe and economical.