Protocolo diagnóstico de las neumonías de lenta resolución o recidivantes
ISSN: 0304-5412
Ano de publicación: 2022
Título do exemplar: Patología respiratoria (IV)
Serie: 13
Número: 66
Páxinas: 3905-3908
Tipo: Artigo
Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado
Resumo
Poor progress is considered to be the persistence or progression of clinical, analytical, or radiological manifestations related to pneumonia despite treatment. When the failure is early, the cause tends to be related to the severity of the initial infection. When the failure is late, the causes tend to be the factors related to the host, complications or superinfections, unusual germs, or non-infectious causes. Management requires reviewing microbiological tests, assessing and intensifying treatment, indicating a computed tomography scan of the chest, and considering a fibrobronchoscopy. Recurrent pneumonia in different locations tends to be due to comorbidities, immunodeficiency, aspiration, or non-infectious diseases. When it is in the same location, local causes must be ruled out. We propose a sequential management algorithm for poorly progressing community-acquired pneumonia.
Referencias bibliográficas
- Aliberti S, Blasi F. Clinical stability versus clinical failure in patients with community-acquired pneumonia. Semin Respir Crit Care Med. 2012; 33(3):284-91.
- Arab T, Malekzadegan MR, Morante J, Cervellione KL, Fein AM. Non-resolving pneumonia in the setting of malignancy. Curr Opin Pulm Med. 2019;25(4):331-5.
- Black AD. Non-infectious mimics of community-acquired pneumonia. Pneumonia (Nathan). 2016;8:2.
- Dang TT, Majumdar SR, Marrie TJ, Eurich DT. Recurrent pneumonia: a review with focus on clinical epidemiology and modifiable risk factors in elderly patients. Drugs Aging. 2015;32(1):13-9.
- Menéndez. R, Cilloniz. C, E paña. PP, Almiralle J, Urangad A, Méndez R. Neumonía adquirida en la comunidad. Normativa de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Actualización 2020. Arch Bronconeumol. 2020;56:1-10.
- Montella S, Corcione A, Santamaria F. Recurrent pneumonia in children: A reasoned diagnostic approach and a single centre experience. Int J Mol Sci. 2017;18(2):296.
- Sialer S, Liapikou A, Torres A. What is the best approach to the nonresponding patient with community-acquired pneumonia? Infect Dis Clin North Am. 2013;27(1):189-203.
- Verhagen LM, de Groot R. Recurrent, protracted and persistent lower respiratory tract infection: A neglected clinical entity. J Infect. 2015; 71Suppl1:S106-11.