Neumonia

El  objetivo  principal  del  estudio  fue  describir  las  lesiones pulmonares en ovinos faenados. Se realizó un  estudio  descriptivo  transversal  que  incluyó  26  pulmones  de  ovinos  faenados  sin  signos  clínicos  de  la  enfermedad,  en  el  norte  del  departamento  de  Bolívar,  Colombia.  Se  estableció  la  frecuencia  relativa  de  las  lesiones  pulmonares  macroscópicas  y  microscópicas,  así  como  la  asociación  entre  las  lesiones  macroscópicas  y  la  condición  corporal.  El  92  %  de  ovinos  presentó  lesiones  macroscópicas  y microscópicas. Se encontraron 32 lesiones macros-cópicas:  pleuritis  (34  %),  neumonía  intersticial  (32  %),  neumonía  embólica  (13  %),  neumonía  granulomatosa  (6  %),  bula  enfisematosa  (6  %),  neumonía    verminosa    (3    %),    bronconeumonía    supurativa  (3  %)  y  atelectasia  (3  %).  La  pleuritis  mostró  una  relación  altamente  significativa  con  la  condición  corporal  (p  <0,01).  Se  observaron  41  lesiones  microscópicas,  agrupadas  en  disturbios  inflamatorios  (63  %),  disturbios  de  insuflación  que  son  enfisema  y  atelectasia  (7  %),  trastornos  del  crecimiento  celular  (22  %)  y  disturbios  de  la  microcirculación  (8  %).  En  cuanto  a  la  cronicidad  de las lesiones microscópicas, se encontraron lesiones agudas  (29  %),  subagudas  (32  %),  crónicas  (37  %)  y crónicas activas (2 %). La mayoría de casos presen-tados del complejo respiratorio es de tipo subclínico, por tanto, es necesario fortalecer el uso de medidas de  diagnóstico  y  control  para  reducir  la  tasa  de  infección y las pérdidas económicas.

Legionnaires&#39; disease is a severe form of pneumonia, with worldwide relevance, caused by Legionella spp. Approximately 90% of all cases of legionellosis are caused by Legionella pneumophila, but other species can also be responsible for this infection. These bacteria are transmitted by inhalation of aerosols or aspiration of contaminated water. In Spain, environmental studies have demonstrated the presence of Legionella non-pneumophila species in drinking water treatment plants and water distribution networks. Aware that this evidence indicates a risk factor and the lack of routine assays designed to detect simultaneously diverse Legionella species, we analyzed 210 urine samples from patients presenting clinical manifestations of pneumonia using a semi-nested PCR for partial amplification of the 16S rDNA gene of Legionella and a diagnostic method used in hospitals for Legionella antigen detection. In this study, we detected a total of 15 cases of legionellosis (7.1%) and the fir...

Objetivo: explorar los aspectos de no calidad en la atención clínica de pacientes con neumonia asociada al uso del ventilador (nav) en una Unidad de Cuidados Intesivos de adultos en Medellín. Metodología: se desarrolló una investigación de enfoque cualitativo empleando como estrategia el estudio de caso y adoptando como fuente de categorías analíticas el Modelo Organizacional de Causalidad y Eventos Adversos de Reason bajo condiciones de operación institucional no controlables por el equipo investigador. Resultados: durante la fase analítica, a través de la codificación abierta, se identificaron 441 códigos en las entrevistas y 25 en las historias clínicas. Se reorganizaron mediante codificación axial en 14 subcategorías y 4 categorías analíticas, encontrando que una decisión de la gerencia (límites a la contratación de personal idóneo para el cuidado de la vía aérea de los pacientes sometidos a ventialción mecánicaa y su reemplazo por personal auxiliar) fue percibida como un factor determinante para la generación de condiciones propicias para la incidencia de nav, aun en presencia de un enfoque pertinente y de sólidas barreras de seguridad.

Rhodococcus equi pneumonia in an
AIDS patient. Report of a case and literature
review. Rhodococcus equi infection is a rare
complication in patients infected with the
human immunodeficiency virus. In the
majority of cases, R. equi caused samples obtained by bronchoscopy are the better materials to achieve the etiological
diagnosis. The most common radiological
findings includes are of consolidation with
cavitation. R. equi pneumonia is associated
with a poor outcome and a high mortality
rate, over than 30%. Recommended
treatment includes the combination of
antimicrobial agents with a good intracellular
activity as vancomycin, rifampicin,
imipenem, ciprofloxacin and macrolides
during a long time. Better survival can be
associated with the use of highly active antiretroviral
therapy.
Here we present a case of an AIDS patient
who developed an extensive cavitary
necrotizing pneumonia.
pulmonary lesions. Sputum specimens and

Legionnaires' disease is a severe form of pneumonia, with worldwide relevance, caused by Legionella spp. Approximately 90% of all cases of legionellosis are caused by Legionella pneumophila, but other species can also be responsible for this infection. These bacteria are transmitted by inhalation of aerosols or aspiration of contaminated water. In Spain, environmental studies have demonstrated the presence of Legionella non-pneumophila species in drinking water treatment plants and water distribution networks. Aware that this evidence indicates a risk factor and the lack of routine assays designed to detect simultaneously diverse Legionella species, we analyzed 210 urine samples from patients presenting clinical manifestations of pneumonia using a semi-nested PCR for partial amplification of the 16S rDNA gene of Legionella and a diagnostic method used in hospitals for Legionella antigen detection. In this study, we detected a total of 15 cases of legionellosis (7.1%) and the first case of Legionnaires' disease caused by L. anisa in Spain. While the conventional method used in hospitals could only detect four cases (1.9%) produced by L. pneumophila serogroup 1, using PCR, the following species were identified: Legionella spp. (10/15), L. pneumophila (4/15) and L. anisa (1/15). These results suggest the need to change hospital diagnostic strategies regarding the identification of Legionella species associated with this disease. Therefore, the detection of Legionella DNA by PCR in urine samples seems to be a suitable alternative method for a sensitive, accurate and rapid diagnosis of Legionella pneumonia, caused by L. pneumophila and also for L. non-pneumophila species

Background: Bacterial pneumonia (BN) is one of the most
frequent opportunistic infections (OI) in patients infected with human immunodeficiency virus (HIV) and Aids. Since
the advent of highly active antiretroviral therapy
(HAART), the incidence of the majority of OI declined
but BN represents the second most common Aids -
defining illness in our setting of HIV/Aids disease.
Objective: To determine the incidence, radiological
patterns, microbiological and laboratory findings
and prognostic factors of BN in a cohort of HIV/Aids
patients. Methods: We conducted a retrospective
study of adults HIV/Aids patients with diagnosis of
BN from may 2003 to june 2006 in an infectious
diseases hospital of Buenos Aires, Argentina. Results:
During the period study we identified 283 episodes
of BN. All the patients were men. The median of age
was 36 years and the median of CD4 T cell counts
at the time of diagnosis of BN was 91 cell/μL. Microbiological
diagnosis was confirmed in 151 cases
(54,9%). The three most common causative agents
were: Streptococcus pneumoniae (accounted for
77 cases), Haemophilus influenzae (accounted for
21 cases) and meticillin resistant Staphylococcus
aureus (MRSA isolated in 18 cases). Mortality was
statistically significant associated with infection due
to MRSA, Pseudomonas aeruginosa and Acinetobacter
baumannii and with the presence of very low CD4 T
lymphocytes (< 200 cell/μL). Conclusion: Although
the incidence of OI has decreased considerably in
the HAART era, BN represents and important cause
of morbimortality. MRSA and intranosocomial bacilli
were seen in a large proportion of cases.