[Prospective study of 221 community acquired pneumonias followed up in an outpatient clinic. Etiology and clinical-radiological progression].
BACKGROUND
All the community acquired pneumonia followed up in an outpatient clinic were prospectively studied in order to determine: etiology, clinical-radiological characteristics and its progression with diagnostic and therapeutic protocols.


METHODS
We arranged clinical evaluation protocols, etiological diagnosis by means of serology (in the first visit and three weeks later); and when necessary, by means of fiberbronchoscopy (protected microbiological brush), as well as clinical and radiological progression (up to three visits) after empirical treatment.


RESULTS
Initially, 240 patients were included, of which 221 were fully followed up. Etiological diagnosis was obtained in 86 patients (39%). The bacteria most frequently isolated was Coxiella burnetii (12.2%), followed up Mycoplasma pneumoniae and Legionella pneumophila. Two cases of Strepcococus pneumoniae were diagnosed. The most frequent radiological onset was alveolar infiltrate (86%). The initial empiric treatment were macrolids (71%) or second generation cephalosporines (22%). Most patients presented a favourable clinical and radiological progression. Only 2 patients needed admission to the hospital (< 1%).


CONCLUSIONS
In community acquired pneumonias studied in our outpatient clinic we found a high number of "atypical" agents. Treatment with macrolids or second generation cephalosporines are appropriate for these patients.
Unidad de Enfermedad Pulmonar Obstructiva Crónica e Infecciones Respiratorias. Centro de Especialidades Dr. Fleming. Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío. Sevilla. fag01se@nacom.es
F
F
Javier Alvarez Gutiérrez
D
D
del Castillo Otero
A
A
García Fernández
B
B
Romero Romero
J
J
José del Rey Pérez
G
G
Soto Campos
J
J
Castillo Gómez
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies; D013030:Spain
D000900:Anti-Bacterial Agents