Gérmenes atípicos en niños con neumonía adquirida en la comunidad: Hospital de Emergencias Grau EsSalud - Período 2008 / Atypical microorganisms in children with community acquired pneumonia: EsSalud Grau Emergency Hospital - period 2008

Objetivos: Determinar prevalencia y perfil clínico de infección por agentes atípicos en niños con Neumonía Adquirida en la Comunidad en el Hospital de Emergencias Grau Essalud, período 2008. Material y Métodos: Estudio prospectivo, de corte transversal, durante el año 2008, con una muestra de 70 pacientes, entre 1 mes a 14 años de edad, con diagnóstico clínico y radiológico de Neumonía Adquirida en la Comunidad (NAC), hospitalizados en el Servicio de Pediatría del Hospital Emergencias Grau; se les realizó Inmunoensayo Indirecto: ELISA Ig M para Chlamydia pneumoniae y Mycoplasma pneumonaie. Resultados: El 31.4% (22/70) de los niños con NAC presentaron serología positiva para agentes atípicos, correspondiendo a Chlamydia pneumoniae 17.1 % (12/70), Mycoplasma pneumoniae 7.1% (5/70) e infección mixta (ambos gérmenes) el 7.1% (5/70). Tendencia al aumento de la infección según la edad (p= 0,01): en lactantes fue 14,29%, preescolares 27,27%, escolares y adolescentes 48,15%. No hubo diferencia significativa en relación a sexo (p= 0,242), antecedente de asma 54,5% (p=0,131), presencia de sibilancias 72,7% (p= 0,141), ni estancia hospitalaria 8,1±3,1 (p= 0,198). En hemograma destacan: Segmentados 77,41 ± 12,43% (p= 0,037) y Linfocitos 12,59 ± 7,01% (p= 0,001). PCR fue 3,40 ± 2,11 UI/dL (p= 0,138). La radiografía mostró Infiltrado intersticial 59,09%, Hiperinflación 40,91 %, consolidación lobar 40,91%, y Atelectasia en 18,18%. Conclusiones:Este estudio sugiere un rol importante de C. pneumoniae y M. pneumoniae, en la etiopatogenia de la neumonía adquirida en la comunidad en niños, en nuestro medio. Debemos sospechar en escolar levemente febril, con neumonía con predominio del componente espástico y radiografía con infiltrado intersticial o signos de atrapamiento aéreo. ...

Objective: The objective of the present study was to determine the clinical-serological profile of atypical agent in children with community-acquired pneumonia at Emergency Hospital "Grau" period 2008. Material and Methods: The present study has a prospective design of cross sectional, was carried out during the year 200S, including a sample of 70 patients between 1 month to 14 years old with clinical and radiological diagnosis of community-acquired pneumonia, hospitalized at the Service of Paediatrics, Emergency Hospital "Grau ". They were screened by IgM ELlSA for acute M. pneumoniae C and pneumoniae infection. Results: We obtained that 31.4 % (22/70) of the children with community-acquired pneumonia presented positive serology for atypical agents, corresponding to Mycoplasma pneumoniae 7.1 %(5/70), for Chlamydia pneumoniae 17.1% (12/70), and a mixedinfection (M. pneumoniae and C. pneumoniae) in 7.1 % (5/70), we alsofound that infection for atypical agents increased with age (p= 0.01)thus it has a frequency of infants aged 1 months- 2 years was 14,29% preschool-aged children, 27,27% school-aged children and adolescents, 48,15%; no statistically significant difference was found between both sex (p=0,242). History of asthma was found in 54,5 %(12/22), (p=0, 131). The clinical examination revealed wheezing in 72,7% of positive serologically patient (p=0,141). About complete blood count we found a mean leukocytes count of 14,61 +-8,53 x 1000 cel/dL, Neutrophil in 77,41+-12,43% (p=0,037) and Lymphocytes in 12,59+-7,01%(p=0,001). PCR mean of 3, 40+-2,11 UI/dL(p=0,138). Chest x-rays were classified into Interstitial infiltrations (59,09%), followed by Hyperaereation (40,91%), Lobar consolidation(40,91%) and Atelectasis in 18,18%.Conclusions: The results of this study suggest the important role of C. ...

[Diagnosis and treatment of Lophomonas blattarum infection in 26 patients with bacterial pneumonia].

The clinical features of Lophomonas blattarum infection in 26 patients with bacterial pneumonia were analyzed. Common manifestation included fever, cough and breathlessness. Computed tomography (CT) showed interstitial change and alveolar exudation. The parasites were found in sputum smear and from the bronchoalveolar lavage fluid (BALF). Metronidazole was effectively used to cure the pulmonary infection of L. blattarum.