Etiologia infecciosa de las exacerbaciones en EPOC.

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Universidad El Bosque. Facultad de Medicina, Bogota, 1992 - 25 pages
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Para determinar la etiologia de las exacerbaciones en EPOC se estudiaron 15 pacientes con EPOC que ingresaron por exacerbaciones infecciosas. A todos los pacientes se les realizo hemograma, hemocultivos, gram y cultivo de esputo, crioglutininas, radiografia de torax y estudios para virus con cultivos, inmunogluoresencia indirecta e inhibicion de hemaglutinacion. En ningun caso se considero inicialmente la eriologia viral. En 4 pacientes se aislo neumococo (26.6 por ciento) y en 1 (6,6 por ciento) estreptococo viridam. A tres pacientes se les demostro inyeccion por virus influenza a (20 por ciento). Nosostros concluimos que el neumococo es el agente etiologico mas frecuente de exacerbaciones de EPOC, seguido por los virus, especialmente el influenza A. Estos hallazgos indican la utilidad de inmunoprofilaxis para neumococo y virus de influenza A. De otra manera, etiologia viral debe considerarse en pacientes con EPOC y exacerbaciones radiologicas y crioaglutininas levemente positivas. SUMMARY:To determine the ethiology of the exacerbations in Chronic Obstructive Pulmonary Disease (COPD), 15 patients which presented exacerbations due to COPD were studied. Blood test, blood culture, gram and sputum culture, cold agglutinins, torax roentgenographic, viral culture studies, indirect inmmunofluorescence and inhibition of blood agglutination were taken from all these patients. It no case it was initially considered a viral ethiologu. Four patients were possitive for pneumococcus (26.6 portage) and one (6.6 portage)for viridans streptococcus. Three patients (20 portage) were found with viral ethiology diagnosis with virus influenza A. We onclude that the pneumococcus is the most frequent ethiological a gent of exacerbations in chronic abstructive pulmonary disease (COPD) followed by viruses specially that of influenza A. These findings suggest the importance of pneumoccus and virus influenza inmunoprophilaxis. On the other hand, viral ethiology must be considered, in patients with COPD and exacerbation no fever, without leucocitosis, few Roentgenographic findings and possitive cold agglutinins in lower titles.

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