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INTRODUCTION: Patients with respiratory diseases face adverse situations such as symptom management, general condition deterioration, and a hostile perception of the hospital environment, favoring the appearance of anxiety and depression. METHODS: A total of 317 patients hospitalized for a disease of pulmonary origin were analyzed and divided into the following subgroups: infectious, oncological, acute, and chronic diseases. Patients over 18 years of age with preserved cognitive capacity were included in the study. The Hospital Anxiety and Depression Scale (HADS) was applied to them on the second or fourth day of their hospital stay and five days after the first evaluation. Multiple linear regression models were carried out to analyze the association between anxiety and depression measured over two different periods. The models present the statistically significant variables with a 95% confidence level. RESULTS: The patients presented with anxiety in 74.4% of cases, mainly those with acute respiratory diseases (42.4%) and neoplastic diseases (27.5%). A total of 69.5% presented with depression, with symptoms more significant in those with chronic and oncological pulmonary diseases and those with no job. Patients with at least one comorbidity presented with anxiety in 53.9% of cases and depression in 52.1% of cases. Linear regression models were carried out and showed that anxiety was 1.75 and 1.84 times more frequent in patients with chronic diseases compared to those with infectious pathologies in the first and second reviews, respectively. The linear regression model also showed a higher frequency of depressive symptoms in patients with chronic conditions (1.62 times) compared to the group with infectious and contagious pathologies, and prolonged hospital stays were associated with depressive symptoms 1.37 times more than short stays. CONCLUSIONS: Anxiety and depression are frequent disorders in patients with respiratory diseases, negatively affecting the prognosis. Routine mental health screening and multidisciplinary management are essential in this population.

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Extrapulmonary tuberculosis is defined as that case of tuberculosis clinically diagnosed and confirmed by bacteriological studies that affects tissues and organs outside the lung parenchyma. Mexico is in third place among Latin American countries in terms of the incidence of pulmonary and extrapulmonary tuberculosis. Culture methods are still the gold standard for the diagnosis of extrapulmonary tuberculosis since they identify the species and susceptibility to drugs.

La tuberculosis extrapulmonar es aquella tuberculosis diagnosticada clínicamente y confirmada por estudios bacteriológicos que afecta a tejidos y órganos fuera del parénquima pulmonar. México es el tercer lugar en América Latina en incidencia de tuberculosis pulmonar y extrapulmonar. Los métodos de cultivo siguen siendo el método de referencia para el diagnóstico de tuberculosis extrapulmonar, ya que identifican la especie y la sensibilidad a los fármacos.

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Pulmonary histoplasmosis is caused by inhaling Histoplasma capsulatum. Less than 1% develops the disease. Risk factors in immunocompetent individuals are environmental exposures in endemic areas. The objective of this study is to determine the frequency, clinical, and microbiological characteristics in immunocompetent patients. A retrospective case series study of patients diagnosed with pulmonary histoplasmosis was performed in a respiratory care unit in Mexico City from 2000 to 2020. Each patient had bronchial lavage, and three patients underwent thoracoscopy for the lung tissue sample taken for the culture in Sabouraud Dextrose Agar. Twelve patients were identified, 8 males and 4 females; the predominant symptoms were fever (83%), dyspnea (75%), chest pain (66%), hemoptysis (41%), and weight loss (33%). The computed tomography of the chest showed the following findings: patchy consolidation 12 (100%), hilar adenopathy 6 (50%), pleural effusion 6 (50%), caverns 3 (25%), and solitary pulmonary nodule in one patient (8%). Histoplasma capsulatum was found in the culture of all twelve patients. The signs and symptoms of the disease are mediated by the immune status of the host. The clinical picture is often confused with systemic diseases. It is important to have a high degree of clinical suspicion to make a timely diagnosis.

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INTRODUCTION: Pulmonary aspergilloma is commonly associated with comorbidities that cause immunodeficiency such as diabetes mellitus, tuberculosis, human immunodeficiency virus/acquired immunodeficiency syndrome and/or a pre-existing parenchymal lung disease such as chronic obstructive pulmonary disease. Predisposing factors can further increase the risk of acquiring this mycosis. Our objective was to determine the frequency, clinical and microbiological characteristics of pulmonary aspergilloma in immunocompromised patients. METHODOLOGY: Retrospective case series of patients diagnosed with pulmonary aspergilloma in a respiratory care unit in Mexico City from 2000 to 2019 was studied. Bronchoalveolar lavage cultures on Sabouraud-dextrose agar and serum galactomannan determination were performed on each patient. RESULTS: We identified twenty-four patients with pulmonary aspergilloma (sixteen male and eight female), thirteen had a history of tuberculosis (54%), seven of diabetes mellitus (29%), three of human immunodeficiency virus/acquired immunodeficiency syndrome (13%) and one of chronic obstructive pulmonary disease (4%). The most commonly reported symptoms were hemoptysis in eighteen patients (75%), dyspnea in sixteen patients (67%) and chest pain in thirteen patients (54%). Aspergillus fumigatus was identified in all cultures and galactomannan was positive in 21 serum samples (87%). CONCLUSIONS: Coexistence of diseases that could suppress the immune system predispose to pulmonary aspergilloma; clinical presentation is often confused with other systemic diseases. A high degree of clinical suspicion is important for early detection.

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