[Transthoracic aspiration punction with ultrafine needle in high risk community acquired pneumonia].
BACKGROUND
The identification of etiologic agents of pneumonias acquired in the community (PAC) with risk factors is difficult. The classical diagnostic methods are not profitable and thus invasive techniques are used. In this study the diagnostic use of an invasive technique such as aspirative transthoracic puncture (ATP) was evaluated in this type of pneumonias.


METHODS
In 94 patients of high risk suspect of PAC the ATP was carried out. This was performed with an ultrafine needle (25G) without radioscopic control. In all cases blood cultures, serology (Legionella, Mycoplasma pneumoniae, Coxiella burnetti, Chlamydia psittaci) were performed when atypical clinical manifestations were presented and sputum examination (Gram, Ziehl, culture) was undertaken when possible.


RESULTS
The sensitivity of ATP was 36% and increased to 54.6% in cases previously untreated with antibiotics. Specificity was 96.4%. The sensitivity of blood culture was 8% and sputum 13.6%. ATP was well tolerated in 97.9% with complication in only 4 (4.3%). The results of ATP led to changes in treatment in 23.1% of the cases with definitive diagnosis of pneumonia.


CONCLUSIONS
Aspirative transthoracic puncture with ultrafine needle without fluoroscopic control was a very well tolerated technique with a minimum number of complications, easy to perform at the patients bedside and was used to modify treatment in 23.1% of the cases.
Servicio de Neumología, Hospital de Cruces, Vizcaya.
R
R
Zalacaín
J L
JL
Llorente
L
L
Gaztelurrutia
E
E
Zenarruzabeitia
F
F
Uresandi
V
V
Sobradillo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology; D011446:Prospective Studies; D011677:Punctures / Q000295:instrumentation* / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013396:Suction / Q000295:instrumentation*; D013909:Thorax
La punción transtorácica aspirativa con aguja ultrafina en las neumonías de alto riesgo adquiridas en la comunidad.