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To compare clinical and radiological aspects, as well as aspects regarding the course of the disease, of elderly inpatients clinically diagnosed with community-acquired pneumonia, with or without radiological confirmation.
A total of 141 patients over the age of 60 were retrospectively studied.
Radiological findings corroborated the clinical diagno...
Citations
... In the study, (16) there was a predominance of elderly patients (geriatric population), among whom the risk of aspiration of oropharyngeal secretions and food particles is increased. (25) There is evidence in the literature that the frequency of dysphagia is higher in the elderly, and aspiration is an important etiologic factor leading to pneumonia in this population. (26) One of the studies analyzed in the present review did not use ancillary tests to assess swallowing or detect dysphagia; the presence of acute aspiration of large food particles was identified solely by bronchoscopy. ...
The objective of this systematic review was to characterize chest CT findings in patients with dysphagia and pulmonary aspiration, identifying the characteristics and the methods used. The studies were selected from among those indexed in the Brazilian Virtual Library of Health, LILACS, Indice Bibliográfico Español de Ciencias de la Salud, Medline, Cochrane Library, SciELO, and PubMed databases. The search was carried out between June and July of 2016. Five articles were included and reviewed, all of them carried out in the last five years, published in English, and coming from different countries. The sample size in the selected studies ranged from 43 to 56 patients, with a predominance of adult and elderly subjects. The tomographic findings in patients with dysphagia-related aspiration were varied, including bronchiectasis, bronchial wall thickening, pulmonary nodules, consolidations, pleural effusion, ground-glass attenuation, atelectasis, septal thickening, fibrosis, and air trapping. Evidence suggests that chest CT findings in patients with aspiration are diverse. In this review, it was not possible to establish a consensus that could characterize a pattern of pulmonary aspiration in patients with dysphagia, further studies of the topic being needed.
... Alguns autores chamam a atenção para a ocorrência de complicações e descompensações clínicas de doenças crônicas na vigência da infecção pulmonar, levando a uma maior gravidade dos casos. (1)(2)(3) Os resultados deste estudo reafirmam a expressão clínica inespecífica da infecção pulmonar em idosos, (25,26) particularmente o baixo percentual de febre entre esses pacientes. vacinais registradas na região de procedência dos pacientes idosos, reforçando a importância da imunobiologia na prevenção de internações devido a pneumonias. ...
To analyze the clinical, etiological, and epidemiological aspects of community-acquired pneumonia (CAP) in hospitalized individuals.
We prospectively studied 66 patients (> 14 years of age) with CAP admitted to the Hospital Estadual Sumaré, located in the Sumaré microregion of Brazil, between October of 2005 and September of 2007. We collected data related to clinical history, physical examination, pneumonia severity index (PSI) scores, and laboratory tests (blood culture; sputum smear microscopy and culture; serology for Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila; and detection of Legionella sp. and Streptococcus pneumoniae antigens in urine).
The mean age of patients was 53 years. Most had a low level of education, and 55.7% presented with at least one comorbidity at the time of hospitalization. The proportion of elderly people vaccinated against influenza was significantly lower among the inpatients than in the general population of the Sumaré microregion (52.6% vs. > 70%). Fever was less common among the elderly patients (p < 0.05). The clinical evolution was associated with the PSI scores but not with age. The etiology was confirmed in 31 cases (50.8%) and was attributed to S. pneumoniae, principally detected by the urinary antigen test, in 21 (34.4%), followed by C. pneumoniae, in 5 (8.2%). The mortality rate was 4.9%, and 80.3% of the patients were classified as cured at discharge.
The knowledge of the etiologic profile of CAP at the regional level favors the appropriate choice of empirical treatment, which is particularly relevant in elderly patients and in those with comorbidities. The lack of influenza vaccination in elderly patients is a risk factor for hospitalization due to CAP.
