Llorente J L, Zalacaín R, Gaztelurrutia L, Talayero N, Antoñana J M, Sobradillo V
Servicio de Neumología, Hospital de Cruces, Vizcaya.
Arch Bronconeumol. 1994 Mar;30(3):136-40. doi: 10.1016/s0300-2896(15)31106-6.
Twenty-four alcoholic patients with community-acquired pneumonia were studied for 2 years in order to define clinical signs and etiology. Blood cultures and serological profiles were done for all patients in addition to standard blood analyses. All had an invasive procedure -transthoracic puncture with an ultrafine 25G needle (20 patients) or telescopic catheter with bacteriologic brush (4 patients). When we were unable to obtain a good sputum sample (5 patients), a culture was grown. The patients' mean age was 48 and 83% had an acute clinical profile (< or = 7 days with symptoms) with "typical" signs. The X-rays showed an alveolar pattern in all patients, with cavitation in 29%. Etiological diagnosis was reached in 17 (71%) cases, with St. Pneumoniae (25%), anaerobic microorganisms (20%) and C. burnetii (12.5%) being the germs found most frequently. The invasive techniques were more useful (54%) than the blood cultures (17%) or sputum cultures (4%), and they were well tolerated and uncomplicated. Empirical antibiotic treatment was modified for 12 patients (50%). Seventeen percent required intensive care treatment and mortality was 12.5%.
对24例社区获得性肺炎的酒精性患者进行了为期2年的研究，以明确临床体征和病因。除了标准血液分析外，还对所有患者进行了血培养和血清学检测。所有患者均接受了侵入性检查——20例患者采用25G超细针经胸穿刺，4例患者采用带细菌刷的伸缩导管。当我们无法获得优质痰液样本时（5例患者），进行了培养。患者的平均年龄为48岁，83%的患者具有急性临床特征（症状出现≤7天）且有“典型”体征。X线显示所有患者均有肺泡型，29%有空洞形成。17例（71%）患者获得了病因诊断，最常见的病原菌为肺炎链球菌（25%）、厌氧微生物（20%）和伯纳特立克次体（12.5%）。侵入性技术比血培养（17%）或痰培养（4%）更有用（54%），且耐受性良好，并发症少。12例（50%）患者的经验性抗生素治疗进行了调整。17%的患者需要重症监护治疗，死亡率为12.5%。
