Evolución clínico-radiológica de la neumonía grave adquirida en la comunidad

Introduccion: la neumonia es una de las causas mas importantes de mortalidad entre la poblacion menor de 5 anos en los paises en desarrollo. Objetivo: analizar la expresion clinico-radiologica y la evolucion de los pacientes en un quinquenio. Metodos: se realizo un trabajo prospectivo descriptivo de corte transversal, con los pacientes que ingresaron con neumonia grave adquirida en la comunidad en el Servicio de Enfermedades Respiratorias, en un quinquenio (2003-2007), que fueron seguidos por consulta externa al egreso, hasta su alta medica. Se practico un analisis de las variables clinico-radiologicas. Se procesaron los datos utilizando la prueba de chi cuadrado. Resultados: de los 217 pacientes analizados, 149 (68,6 por ciento) tenian de 1 a 4 anos, y el 53 por ciento era del sexo masculino. La fiebre, la polipnea y el tiraje estuvo presente en todos los pacientes. Las complicaciones mas frecuentes fueron: el derrame pleural y el absceso pulmonar en 60,7 y 27,6 por ciento respectivamente. El pulmon derecho resulto el mas afectado, pero el que mas se complico fue el izquierdo. Conclusiones: todos los pacientes tuvieron una evolucion favorable, a pesar de que mas de la mitad se complicaron. Se encontro que los pacientes con afectacion en un solo pulmon, tienen mas posibilidades de complicarse que cuando la afectacion es bilateral Introduction: pneumonia is one of the most important causes of mortality in the population under 5 years of age in the developing countries. Objective: to analyze the clinical and radiological expression and the progression of patients in a five-year period. Methods: a prospective, descriptive and cross-sectional study was performed on patients who had suffered severe community-acquired pneumonia and had been admitted to the respiratory disease center in the 2003 through 2007 period. They had been followed up at the outpatient service up to their discharge from hospital. The clinical and radiological variables were analyzed. Data were processed with the Chi-square test. Results: of 217 analyzed patients, 149 (68.6 percent) were one to 4 years-old and 53 percent were males. Fever, polypnea, and tirage were observed in patients. The most frequent complications comprised pleural effusion and pulmonary abscess in 60.7 and 27.6 percent of cases, respectively. The right lung was the most affected but complications were more common in the left lung. Conclusions: all the patients had favorable progression, although more than a half suffered complications. It was found that those patients with only one lung affected, were more likely to get complicated than those with both lungs affected by the disease