Asunto(s)
Tos/etiología , Fiebre/etiología , Neumonía por Rickettsiaceae/diagnóstico , Tifus por Ácaros/diagnóstico , Servicio de Urgencia en Hospital , Humanos , Pulmón/diagnóstico por imagen , Masculino , Orientia tsutsugamushi , Neumonía por Rickettsiaceae/complicaciones , Neumonía por Rickettsiaceae/diagnóstico por imagen , Radiografía , Tifus por Ácaros/complicaciones , Tifus por Ácaros/diagnóstico por imagen , Adulto JovenRESUMEN
In a prospective study of 1269 patients with community-acquired pneumonia, 25 (1.97%) were found to have carcinoma of the lung. In 23 cases, the diagnosis was confirmed histologically. For nine of the 23 patients, this episode of pneumonia was the initial manifestation of carcinoma of the lung. The diagnosis of carcinoma was first suggested by the radiologist as the result of a chest radiograph in five of the nine cases. One patient with bronchoalveolar cell carcinoma presented with rapidly progressive diffuse airspace disease. The diagnosis in this case was made by means of open lung biopsy. Two of the 25 patients (8%) had pneumonia caused by Coxiella burnetii, a rate that was 2.4 times higher than that for the other patients with pneumonia. We conclude that pneumonia is uncommonly the presenting manifestation of carcinoma of the lung but is usually evident before the patient leaves hospital. The rate of pneumonia caused by C. burnetii among patients with carcinoma of the lung seems to be higher than that among patients who have pneumonia without carcinoma of the lung.
Asunto(s)
Carcinoma/complicaciones , Infecciones Comunitarias Adquiridas/complicaciones , Neoplasias Pulmonares/complicaciones , Neumonía/complicaciones , Adulto , Anciano , Bacterias/aislamiento & purificación , Infecciones Comunitarias Adquiridas/epidemiología , Coxiella burnetii/aislamiento & purificación , Femenino , Hospitales Generales , Humanos , Masculino , Persona de Mediana Edad , Nueva Escocia/epidemiología , Neumonía/epidemiología , Neumonía/microbiología , Neumonía por Rickettsiaceae/complicaciones , Neumonía por Rickettsiaceae/epidemiología , Neumonía por Rickettsiaceae/microbiología , Prevalencia , Estudios Prospectivos , Esputo/microbiologíaRESUMEN
Acute respiratory failure secondary to Coxiella burnetii infection is an extremely rare but serious complication that usually has a good prognosis after appropriate treatment. We describe a female patient who developed acute respiratory failure secondary to Coxiella burnetii pneumonia requiring mechanical ventilation and antibiotic therapy.
Asunto(s)
Neumonía por Rickettsiaceae/complicaciones , Fiebre Q/complicaciones , Insuficiencia Respiratoria/etiología , Enfermedad Aguda , Adulto , Doxiciclina/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Neumonía por Rickettsiaceae/diagnóstico , Neumonía por Rickettsiaceae/tratamiento farmacológico , Fiebre Q/diagnóstico , Fiebre Q/tratamiento farmacológico , Insuficiencia Respiratoria/diagnóstico , Insuficiencia Respiratoria/tratamiento farmacológicoRESUMEN
Acute Q-fever is a systemic illness which rarely has a fatal outcome. Fatal cases do occur with the chronic form of the disease and associated with endocarditis. This report presents the case of a fatal, acute Q-fever pneumonia in an 11-year-old patient with chronic granulomatous disease. Complement fixation antibody titer rose to 1:1,024 with positive IgM in immunofluorescence. Giemsa stained lung sections and indirect immunofluorescence demonstrated the microorganisms in the tissues. The Coxiella burnetii infection was probably contracted during a holiday trip to rural France. Despite the fact that the patient received a variety of antimicrobial agents with broad spectrum activity against bacteria and fungi, coverage for Q-fever, i.e. chloramphenicol or tetracyclines, was not included.