Diagnóstico y tratamiento empírico de la neumonía adquirida en la comunidad en situaciones especialespacientes inmunocomprometidos sin infección por el VIH y ancianos

  1. Girón Ortega, J.A.
  2. Pérez Galera, S.
  3. Girón González, J.A.
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2018

Serie: 12

Número: 53

Páxinas: 3168-3173

Tipo: Artigo

DOI: HTTPS://DOI.ORG/10.1016/J.MED.2018.03.027 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumo

In the elderly, pneumonia often has a less florid clinical presentation and is frequently complicated by decompensation of concomitant diseases. Elderly patients have special characteristics in terms of the pathogens involved in pneumonia; they are at greater risk of multiresistant bacterial infections because of their frequent contact with the health services. Lung infections in immunosuppressed individuals have different causes depending on the immune deficiency in question. Admission to hospital or ambulatory treatment will be decided after stratifying the risk; this treatment will be determined by the characteristics at the time of onset of the pneumonia, the local epidemiological situation in terms of the percentage of antibiotic resistance in the area, and the clinical particularities.

Referencias bibliográficas

  • Prina E, Ranzani OT, Torres A. Community acquired pneumonia. Lancet. 2015;386:1097-108.
  • Donowitz GR, Cox HL. Bacterial community acquired pneumonia in older patients. Clin Geriatr Med. 2007;23:515-34.
  • Fernández-Sabe N, Carratala J, Roson B, Dorca J, Verdaguer R, Manresa F. Community acquired pneumonia in very elderly patients: causative organism, clinical characteristics and outcomes. Medicine. 2003;82:159-69.
  • Faverio P, Aliberti S, Bellelli G, Suigo G, Lonni S, Pesci A. The management of community acquired pneumonia in the elderly. Eur J Intern Med. 2014;25:312-9.
  • Letourneau AR, Issa NC, Baden LR. Pneumonia in the immunocompromised host. Curr Opin Pulm Med. 2014;20:272-9.
  • Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med. 2004;170:22-48.
  • Hirsch HH, Martino R, Ward KN, Boeckh M, Einsele H, Ljungman P. Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Clin Infect Dis. 2013;56:258-66.
  • Pagano L, Caira M, Candoni A, Offideani M, Mertino B, Specchia G. Invasive aspergillosis in patients with acute myeloid leukemia: a SEIF-EM-2008 registry study. Haematologica. 2010;95:644-50.
  • Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46:327-60.
  • Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175:367-416.
  • Wallis RS, Schluger NW. Pulmonary infectious complications of tumor necrosis factor blockade. Infect Dis Clin North Am. 2010;24:681-92.
  • Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52:e56-e93.
  • Castagnola E, Mikulska M, Viscoli C. Profilaxis y tratamiento empírico de las infecciones en los pacientes con cáncer. Principios y práctica. 8ª ed. Barcelona: Elsevier; 2016. p. 3586-607.