Complicaciones respiratorias asociadas a neumonía bacteriana / Respiratory complications associated to bacterial pneumonia

En las últimas décadas ha sido reportado en varios países un aumento en el número de hospitalizaciones por neumonía bacteriana y también por complicaciones supurativas en niños. Se ha señalado al Streptococcus pneumoniae como el principal agente causal y también se ha advertido un aumento en la resistencia de éste a penicilina; sin embargo, no se ha logrado establecer una relación de causalidad. Se postula que el fenómeno de resistencia no tiene incidencia en la mayor frecuencia de complicaciones observadas y que éstas si podrían tener relación con el serotipo de S. pneumoniae (principalmente serotipos 1, 3 y 14). La neumonía necrotizante o excavada es considerada una complicación grave de la neumonía bacteriana, se asocia a fiebre prolongada, más días de hospitalización y mayor frecuencia de complicaciones (insuficiencia respiratoria, síndrome séptico). En su diagnóstico la radiografía de tórax ha demostrado ser menos sensible que la tomografía. La disminución de la impregnación del medio de contraste del parénquima pulmonar observada por hipoperfusión pueden ir posteriormente a la necrosis. El mecanismo de la necrosis está relacionado con la oclusión trombótica de los capilares alveolares. A pesar que la necrosis y la formación de cavidades pueden comprometer extensas zonas de lóbulos del pulmón, la indicación de resección quirúrgica en niños es excepcional y el seguimiento radiológico muestra resolución completa.

Mycotic infection in various cavitary lung diseases

This study was conduced on 50 cases from Chest Clinic in Benha University Hospital with various cavitary lung abscess, 5 bronchiectasis and 4 bronchogenic carcinoma for the presence of mycotic infection. Patients were investigated clinically and radiologically. Sputum samples were collected and examined by direct microscopic examination using 20% [KOH] and by culture on different media selective for Aspergillus and the isolated fungi were identified by conventional methods. The sera of the patients were also tested for antiaspergillar antibodies by double immunodiffusion [DID]. Aspergillus niger was isolated from sputum of 6 patients [12%] and Aspergillus flavus from one patient only [2%], while aspergillus fumigatus was not detected at all by culture. Candida species were isolated from 21 cases [42%]. The precipitation test [DID] was positive only in one patient [2%] denoting the presence of antibodies against Aspergillus fumigatus

Klebsiella pneumonia with lung abscess in a male child.

An unusual presentation of Klebsiella pneumonia with lung abscess in a male child with no apparent predisposing factor is described.

Abcesses in previously unaffected adult's lungs. 100 cases

The authors recall the main clinical radiological, bacteriological and therapeutic characteristics of a 100 cases of abcesses in previously unaffected adults lungs observed over a period of 10 years [1968-1977]. They note the young age of a great number of patients, the long evolution preceeding the first consultation illustrated by the frequency of the vomica and the dyspnea. The radiological aspect is typical in 89% of the cases. The bacteriological study, not quite conclusive is in fact not necessary to conduct the treatment. Recovery is achieved in 94% of the cases

The occurrence of Candida in hospital patients and normal subjects.

The distribution of different Candida species and different serogroups of C. albicans have been analysed. C. albicans is by far the most predominant species isolated from all clinical specimens. Group A of C. albicans was isolated 10 times more frequently than group B strains from patients who had respiratory infection and 4.4 times more frequently from those who had other clinical conditions. However, both serogroups were isolated at comparable frequencies from the genitals. In the instances where repeated isolation were made, colonization by one serogroup often occurs to the exclusion of the other serogroup and species. Thus, it was frequently observed that individual patients often gave repeated isolation of one serogroup of C. albicans only. These findings are of obvious diagnostic relevance and may facilitate the evaluation of possible clinical significance of laboratory studies.