Chest Infections |

Clinical Profile of Infectious Cavitary Disease in a General Hospital FREE TO VIEW

Hugo Ruben Andr Karlen, MD; Jaime Guillen, MD; Hernan Difilippo, MD; Marco Solis, MD; Marcos Hernandez, MD; marcela heres, MD; Silvia Quadrelli, MD
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Fundacion Sanatorio Guemes, Buenos Aires Argentina, La Plata, Argentina

Chest. 2015;148(4_MeetingAbstracts):131A. doi:10.1378/chest.2281605
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SESSION TITLE: Chest Infections Posters: Tuberculosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The presence of cavities focus evaluation to certain diagnoses (Dx), some diseases are most commonly associated with cavities. In the case of infectious diseases, cavitation is the result of complex interactions between the host and the germ that lead to tissue necrosis and entail greater severity of illness.

METHODS: Patients with acute community acquired pneumonia (CAP) (fever, leukocytosis, chest pain) admitted from February 2013 to February 2014 and pulmonary cavitary lesions with clinical and bacteriological data completed.

RESULTS: 35 patients (54.3% male, 47.8 ± 19.2 years) were included. 75.8% had fever and 57.6% cough, 60.6% weight loss and 2.8% had hemoptysis. 45.5% of patients were active smokers, 18.2% were drug users and 27.3% had a history of malignancy. 21.2% was diagnoses with COPD and 9.1% were diabetic, only 20.6% had no pathological history. HRCT showed multiple lesions in 51.4% and the most frequent location was the right upper lobe (77.1%). The wall thickness was ≥4mm in 25.4% and was associated with peripheral consolidation in 65.7%. Sputum was representative in 61.8% but gave diagnoses in only 29.2% (4 patients with tb). Fibrobronchoscopy was performed in 54.2% (38.4% with transbronchial biopsy) but was diagnoses only in 10 patients (30%). The fibrobronchoscopy allowed diagnoses in two unsuspected malignancy. In 57.6% the cavities were completely resolved within 3 months. The bacteriological and endoscopic findings were diagnoses in 60.6% patients with CAP, tuberculosis in 33.3% and malignancy in 6.6%. Two patients were lost to follow-up

CONCLUSIONS: The cavitary pneumonia may occur in patients without comorbidities and the presence of unsuspected underlying malignancy is almost 10%. The bronchoscopy does not contribute significantly to find the bacterial etiology due to the presence of prior treatment but can help in suspect of tuberculosis and no bacterial diseases.

CLINICAL IMPLICATIONS: The importance of knowing the characteristics of patients who develop pneumonia cavitated is in use appropriate methods in the etiologic diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Hugo Ruben Andr Karlen, Jaime Guillen, Hernan Difilippo, Marco Solis, Marcos Hernandez, marcela heres, Silvia Quadrelli

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