Bovine Respiratory Disease (BRD) complex as a signal for Bovine Viral Diarrhea Virus (BVDV) presence in the herd

Background: Infections are caused by Bovine Viral Diarrhea Virus and still continue to be a worldwide plague in cattle industry. It is responsible for sudden death syndromes in adult cattle with high mortality rates, abortions, acute gastrointestinal and respiratory diseases. The BVDV infection occurs in early pregnancy (40-142 days), in immunosuppressed females or cows results in 100% of persistently infected (PI) calves that are seronegative and asymptomatic at birth. Evidences suggests that BVDV contributes to BRD complex potentiating secondary infections caused by Mannheimia haemolytica e Pasteurella multocida due to its immunosuppressive action. However, the farmers have often associated the respiratory syndrome with other infectious agents. This paper reports the attendance of dairy calves manifesting clinical signs of bronchopneumonia, which led to the screening of the persistently infected animals to control of the BVDV infection in the herd. Materials, Methods & Results: During the technical assistance, ten calves manifesting bronchopneumonia were selected to trans-tracheal lavage (TL) in order to identify possible infectious agents. Reverse transcription polymerase chain reaction (RT-PCR) detected the presence of BVDV in two heifers. Pasteurella multocida was the unique bacterial agent isolated from TL (5/10, 50%). These data motivated the technical team and [...]

Bovine Respiratory Disease (BRD) complex as a signal for Bovine Viral Diarrhea Virus (BVDV) presence in the herd

Background: Infections are caused by Bovine Viral Diarrhea Virus and still continue to be a worldwide plague in cattle industry. It is responsible for sudden death syndromes in adult cattle with high mortality rates, abortions, acute gastrointestinal and respiratory diseases. The BVDV infection occurs in early pregnancy (40-142 days), in immunosuppressed females or cows results in 100% of persistently infected (PI) calves that are seronegative and asymptomatic at birth. Evidences suggests that BVDV contributes to BRD complex potentiating secondary infections caused by Mannheimia haemolytica e Pasteurella multocida due to its immunosuppressive action. However, the farmers have often associated the respiratory syndrome with other infectious agents. This paper reports the attendance of dairy calves manifesting clinical signs of bronchopneumonia, which led to the screening of the persistently infected animals to control of the BVDV infection in the herd. Materials, Methods & Results: During the technical assistance, ten calves manifesting bronchopneumonia were selected to trans-tracheal lavage (TL) in order to identify possible infectious agents. Reverse transcription polymerase chain reaction (RT-PCR) detected the presence of BVDV in two heifers. Pasteurella multocida was the unique bacterial agent isolated from TL (5/10, 50%). These data motivated the technical team and [...](AU)

[Association of chronic pulmonary obstructive disease (COPD) and complications in head and neck surgery]. / Associação de doença pulmonar obstrutiva crônica (DPOC) e complicações em cirurgia de cabeça e pescoço.

UNLABELLED: COPD presents in a variety of forms patients with head and neck cancer; it may affect therapeutic decision-making or postoperative outcomes due to its complications. AIM: To correlate the severity of COPD in patients with head and neck SCC treated with surgery, who present postoperative complications. METHOD: A retrospective analysis of 31 patients undergoing en bloc resections, from 2008 to 2009. All cases were evaluated and classified using the GOLD scale. The COPD grade, intubation period, ICU stay and hospital stay were studied. RESULTS: The mean age was 64.8 years; COPD was mild in 24 cases, moderate in 6 and severe in 1 case. ICU stay was 2.7 days and the intubation period was 1,12 days. The mean hospital stay was 24.4 days. There was no relation between COPD grade and brochopneumonia, intubation period, ICU stay and hospital stay. CONCLUSION: Patients with head and neck SCC have a tendency to acquire COPD; its severity was not related with postoperative pulmonary complications, prolonged intubation period, ICU stay and hospital stay.

Associação de doença pulmonar obstrutiva crônica (DPOC) e complicações em cirurgia de cabeça e pescoço / Association of chronic pulmonary obstructive disease (COPD) and complications in head and neck surgery

A DPOC está presente em graus variados em pacientes portadores de câncer de cabeça e pescoço e pode influenciar na decisão terapêutica ou alterar a evolução no PO por eventuais complicações relacionadas. OBJETIVO: Correlacionar o grau de DPOC em pacientes com de CEC de cabeça e pescoço tratados com cirurgia com complicações no PO. MÉTODO: Estudo retrospectivo de pacientes submetidos a cirurgias em monobloco entre 2008 e 2009. Todos os pacientes foram avaliados e classificados pela escala de GOLD. Foram relacionados o grau de DPOC, tempo de intubação, permanência em UTI e tempo de internação. RESULTADOS: O n foi 31 casos com idade média de 64,8 anos. O grau de DPOC foi leve em 24 casos, moderado em 6 e grave em 1. A permanência em UTI no PO imediato foi 2,7 e o tempo de intubação foi 1,12 dias. A média de internação foi 24,4 dias. Não houve correlação entre grau de DPOC e incidência de broncopneumonia, tempo de IOT, permanência em UTI e permanência hospitalar. CONCLUSÃO: Os pacientes com CEC de vias aerodigestivas superiores têm uma tendência a apresentar DPOC cuja gravidade não teve relação com complicações pulmonares no PO, tempo prolongado de intubação, permanência em UTI ou tempo de internação.

COPD presents in a variety of forms patients with head and neck cancer; it may affect therapeutic decision-making or postoperative outcomes due to its complications. AIM: To correlate the severity of COPD in patients with head and neck SCC treated with surgery, who present postoperative complications. METHOD: A retrospective analysis of 31 patients undergoing en bloc resections, from 2008 to 2009. All cases were evaluated and classified using the GOLD scale. The COPD grade, intubation period, ICU stay and hospital stay were studied. RESULTS: The mean age was 64.8 years; COPD was mild in 24 cases, moderate in 6 and severe in 1 case. ICU stay was 2.7 days and the intubation period was 1,12 days. The mean hospital stay was 24.4 days. There was no relation between COPD grade and brochopneumonia, intubation period, ICU stay and hospital stay. CONCLUSION: Patients with head and neck SCC have a tendency to acquire COPD; its severity was not related with postoperative pulmonary complications, prolonged intubation period, ICU stay and hospital stay.

Neumotórax en pacientes con SIDA: Actualización sobre el tema / Pneumothorax in patients with AIDS: Update on the theme

La aparición de neumotórax como complicación de la neumonía por Pneumocistis carinii (PCP) en pacientes con SIDA, es muy frecuente desde los inicios de la pandemia en 1982, y comporta gran mortalidad. En este trabajo se reporta una serie de 25 pacientes con neumotórax como complicación de la Pneumocistis carinii en pacientes con SIDA, tratado por los autores durante cinco a ños de trabajo discontinuos en el cono sur africano: tres en Sudáfrica y dos en Zimbabwe. Se reportan los datos demográficos y el estado de los mismos al llegar a la sala de cirugía y su evolución después de tratados quirúrgicamente. La toracotomía fue necesaria en ocho pacientes (32 por ciento), diez pacientes necesitaron cuidados de terapia intensiva (40 por ciento), y la mortalidad global fue del 32 por ciento. Se revisa la información actualizada sobre el tema, destacando las pautas terapéuticas más aceptadas internacionalmente. Conflictos de interés: Los autores no declaran conflicto de interés con editores, patrocinadores ni otros autores.

Pneumothorax as a Pneumocistis carinii pneumonia complication in patients with AIDS is very frequent since the pandemic beginnings in 1982, and it is accompanied by a high mortality. In this work we report a series of 25 patients with Pneumothorax as a Pneumocistis carinii pneumonia complication in patients with AIDS, treated by the authors during five years of discontinuous work in the Southern Africa cone: three years in South Africa and two years in Zimbabwe. We report demographic data, the status of the patients when they arrived to the Surgery Service and their evolution after surgery. Thoracotomy was needed in eight patients (32 percent), ten patients needed intensive care (40 percent), and the global mortality was 32 percent. We review the updated information on the theme, emphasizing the most accepted therapeutic guidelines at the international level.

Ocorrência de pneumonia associada à infecção por Mannheimia haemolytica em ovinos de Minas Gerais / Occurrence of pneumonia associated to infection by Mannheimia haemolytica in sheep of Minas Gerais

O trabalho descreve um surto de pneumonia em ovinos em uma propriedade na região central de Minas Gerais. Clinicamente os animais apresentavam apatia, mostravam dificuldade respiratória durante dois ou três dias ou morriam subitamente. À necropsia as alterações pulmonares eram similares em todos os ovinos. Havia consolidação dos lobos craniais e da parte ventral dos lobos caudais e ao corte fluía exsudato mucopurulento da traquéia e dos brônquios. No parênquima dos lobos craniais havia áreas brancas multifocais a coalescentes com 0,2-0,5cm de diâmetro, levemente proeminentes e intercaladas por áreas vermelho-escuras. Pleurite fibrinosa foi observada nos Ovinos 1, 2 e 3. As lesões de consolidação ocupavam cerca de 70-80 por cento da extensão pulmonar. Microscopicamente, as alterações eram de broncopneumonia fibrinopurulenta com intensa hiperemia, áreas com hemorragia intra-alveolar e espessamento dos septos interlobulares por inúmeros neutrófilos, restos celulares e intensa exsudação de fibrina. Áreas multifocais com necrose de liquefação contendo numerosas colônias bacterianas foram observadas no Ovino 3. Nos lobos craniais dos Ovinos 1, 2 e 3, haviam áreas com neutrófilos degenerados formando aglomerados de células alongadas com formato de "grãos de aveia" associados a colônias bacterianas. As alterações histológicas foram características de pneumonia causada por Mannheimia (M.) haemolytica. Amostras dos lobos craniais de todos os ovinos foram encaminhadas para cultivo bacteriológico e M. haemolytica foi isolada e identificada em todos os animais. Este é o primeiro relato correlacionando os achados patológicos e o isolamento de M. haemolytica como causa de broncopneumonia em ovinos no Brasil.(AU)

This paper describes an outbreak of pneumonia in a sheep herd in the central region of Minas Gerais, Brazil. Clinically, the animals presented apathy, exhibited respiratory difficulty during 2 to 3 days or sudden death. The animals were not medicated and found dead. Grossly, the pulmonary findings were similar in all sheep. The pulmonary cranial lobes and the ventral portion of caudal lobes were consolidated and purulent exsudate streamed out of the airways. In the parenchyma of the cranial lobes there were white slightly prominent multifocal to coalescent areas with 0.2 to 0.5cm in diameter intercalated with dark red areas. Consolidated lesions occupied 70 to 80 percent of the lungs. Fibrinous pleuritis was observed in sheep 1, 2 and 3. Microscopically, the findings were fibrinopurulent bronchopneumonia with intense hyperemia, areas with intra-alveolar hemorrhage and thickening of interlobular septa with numerous neutrophils, cellular rests and scattering fibrin. Multifocal areas with liquefaction necrosis containing numerous bacterial colonies were observed in sheep 1, 2 and 3. In the cranial lobes of these sheep, there were areas with degenerated neutrophils forming clusters of basophilic cells with alongated nuclei ("oat cells") associated with bacterial colonies. The histological findings were characteristic of pneumonia caused by Mannheimia (M.) haemolytica. Samples of the cranial lobes were sent for bacterial culture, and M. haemolytica was isolated and identified in all animals. This is the first report correlating pathological findings and the isolation of M. haemolytica as cause of bronchopneumonia in sheep in the country.(AU)

Ocorrência de pneumonia associada à infecção por Mannheimia haemolytica em ovinos de Minas Gerais / Occurrence of pneumonia associated to infection by Mannheimia haemolytica in sheep of Minas Gerais

O trabalho descreve um surto de pneumonia em ovinos em uma propriedade na região central de Minas Gerais. Clinicamente os animais apresentavam apatia, mostravam dificuldade respiratória durante dois ou três dias ou morriam subitamente. À necropsia as alterações pulmonares eram similares em todos os ovinos. Havia consolidação dos lobos craniais e da parte ventral dos lobos caudais e ao corte fluía exsudato mucopurulento da traquéia e dos brônquios. No parênquima dos lobos craniais havia áreas brancas multifocais a coalescentes com 0,2-0,5cm de diâmetro, levemente proeminentes e intercaladas por áreas vermelho-escuras. Pleurite fibrinosa foi observada nos Ovinos 1, 2 e 3. As lesões de consolidação ocupavam cerca de 70-80 por cento da extensão pulmonar. Microscopicamente, as alterações eram de broncopneumonia fibrinopurulenta com intensa hiperemia, áreas com hemorragia intra-alveolar e espessamento dos septos interlobulares por inúmeros neutrófilos, restos celulares e intensa exsudação de fibrina. Áreas multifocais com necrose de liquefação contendo numerosas colônias bacterianas foram observadas no Ovino 3. Nos lobos craniais dos Ovinos 1, 2 e 3, haviam áreas com neutrófilos degenerados formando aglomerados de células alongadas com formato de "grãos de aveia" associados a colônias bacterianas. As alterações histológicas foram características de pneumonia causada por Mannheimia (M.) haemolytica. Amostras dos lobos craniais de todos os ovinos foram encaminhadas para cultivo bacteriológico e M. haemolytica foi isolada e identificada em todos os animais. Este é o primeiro relato correlacionando os achados patológicos e o isolamento de M. haemolytica como causa de broncopneumonia em ovinos no Brasil.

This paper describes an outbreak of pneumonia in a sheep herd in the central region of Minas Gerais, Brazil. Clinically, the animals presented apathy, exhibited respiratory difficulty during 2 to 3 days or sudden death. The animals were not medicated and found dead. Grossly, the pulmonary findings were similar in all sheep. The pulmonary cranial lobes and the ventral portion of caudal lobes were consolidated and purulent exsudate streamed out of the airways. In the parenchyma of the cranial lobes there were white slightly prominent multifocal to coalescent areas with 0.2 to 0.5cm in diameter intercalated with dark red areas. Consolidated lesions occupied 70 to 80 percent of the lungs. Fibrinous pleuritis was observed in sheep 1, 2 and 3. Microscopically, the findings were fibrinopurulent bronchopneumonia with intense hyperemia, areas with intra-alveolar hemorrhage and thickening of interlobular septa with numerous neutrophils, cellular rests and scattering fibrin. Multifocal areas with liquefaction necrosis containing numerous bacterial colonies were observed in sheep 1, 2 and 3. In the cranial lobes of these sheep, there were areas with degenerated neutrophils forming clusters of basophilic cells with alongated nuclei ("oat cells") associated with bacterial colonies. The histological findings were characteristic of pneumonia caused by Mannheimia (M.) haemolytica. Samples of the cranial lobes were sent for bacterial culture, and M. haemolytica was isolated and identified in all animals. This is the first report correlating pathological findings and the isolation of M. haemolytica as cause of bronchopneumonia in sheep in the country.

[Pneumothorax in human immunodeficiency virus infected patients]. / Neumotórax en pacientes infectados con el virus de la inmunodeficiencia humana.

INTRODUCTION: The respiratory system still continues to be a common place which deteriorates in HIV patients. Among the signs and symptoms, is the occurrence of a pneumothorax due to trauma and infections and is a cause of aggravation for these patients. The present study attempts to identify and characterise the behaviour of a group of variables in HIV patients with this complication. MATERIAL AND METHOD: An observational, descriptive case series study was carried out. The desired variables were obtained from clinical records. RESULTS: Of the total number, 91.67% were males, and the mean age was 32.17 years. The main causes of pneumothorax were infections, particularly due to Pneumocystis jirovecii and deep venous catheterisation. A persistent statistically significant air leak was present in 33.3% of patients and two cases of pleural sepsis. Four patients died, all with acute respiratory failure and bacterial bronchopneumonia. CONCLUSIONS: The majority were males in the third decade of life, AIDS patients. The main causes of the pneumothorax were infections and catheterisation of the subclavian vein. Immunodepression played a significant prognostic role in the progression and outcome of the patient. Minimum pleurotomy continues to be the first treatment option in these patients, due to their precarious general state which contraindicates a major procedure. The most frequent complication was the persistent air leak, being a significant indicator of a poor prognosis in the progress of these patients. Causes of death such as acute respiratory failure and bilateral bronchopneumonia prevailed.

Corticosteroid therapy for refractory infections in chronic granulomatous disease: case reports and review of the literature.

BACKGROUND: Chronic granulomatous disease (CGD) is a primary phagocyte immunodeficiency. It is often accompanied by an exuberant and aberrant inflammatory response, with granulomata and obstruction of the gastrointestinal and genitourinary tracts and inflammatory bowel disease. Although corticosteroids are successful in managing the obstructive and inflammatory disorders of CGD, they are not ordinarily used for the management of infection because of the possibility of further compromising the patient's immune system. OBJECTIVES: To discuss the pros and cons of the use of corticosteroids for the treatment of infections in CGD. METHODS: We describe 2 patients with CGD and refractory infections who were successfully treated with systemic corticosteroids in addition to antimicrobial agents. We also review the medical literature in which corticosteroids have been used for CGD infection. RESULTS: Our cases add to 3 other reports in which antibiotics and corticosteroids were used successfully in patients with CGD. However, in the presence of a potential pathogen, notably, aspergilla, corticosteroids may mask or favor dissemination of the fungus, especially in adults. CONCLUSIONS: Corticosteroids may play an important adjunctive role in CGD refractory infections.

Involvement of antibody, complement and cellular immunity in the pathogenesis of enhanced respiratory syncytial virus disease.

In 1966, infants and children in the USA were immunized with a formalin-inactivated vaccine against respiratory syncytial virus. The vaccine was immunogenic but elicited mainly nonprotective antibody. Upon exposure to respiratory syncytial virus in the community, immunized children developed severe pulmonary disease characterized by bronchoconstriction and pneumonia. Two immunized infants died as toddlers after respiratory syncytial virus infection. Exploration of the mechanisms of disease has dominated the literature for decades. In this review, the pathogenesis of enhanced respiratory disease is discussed and the characteristics of protective and pathogenic respiratory syncytial virus vaccines are examined.

Programa IRA en un hospital tipo IV del Servicio de Salud Metropolitano Norte, 2003 / IRA Program in a type IV hospital of the North Metropolitan Health Service, 2003

El objetivo de este estudio es analizar el Programa IRA, según morbimortalidad y factores de riesgo (FR) de menores de un año de un hospital rural, comparándolo con cifras nacionales. Es un estudio descriptivo de todos los recién nacidos entre diciembre de 2002 y diciembre de 2003 que asisten a control sano en Hospital Til Til, categorizando fichas según score de riesgo de morir por bronconeumonía (BNM), analizando morbimortalidad y FR de cada grupo. Se analizaron 108 fichas, 17 por ciento riesgo grave de morir por BNM, 23 por ciento moderado y 60 por ciento leve, sin diferencias significativas en sexo, desarrollo psicomotor ni estado nutricional. Destacan diferencias en lactancia materna (LM) insuficiente para distintos grupos de riesgo: 66,6 por ciento severo, 44 por ciento moderado y 13,84 por ciento leve. En cuanto a morbilidad, hubo diferencias significativas en el número de episodios de SBO por niño, grupo de riesgo severo con 1,6 versus 0,96 y 0,4 moderado y leve, respectivamente. Respecto a hospitalizaciones, ocurrieron en 100 por ciento de niños en riesgo grave de morir por BNM, predominando causas respiratorias (CR) 53,8 por ciento versus 36 por ciento riesgo moderado, 75 por ciento CR. Sin diferencias significativas en perfil de morbilidad en relación con estadísticas nacionales, ya que la mayor morbilidad y hospitalizaciones se registran en grupos de mayor riesgo de morir por BNM y demuestran que el score es válido y predice efectivamente riesgo, por esto sería conveniente reforzar su aplicación en centros de salud. Hubo diferencias significativas en LM y morbilidad, importante promover LM exclusiva hasta los seis meses, destacando su rol protector.

Mucolipidosis tipo II: comunicación de un caso / Mucolipidoses type II: case report

We report a female newborn with type II mucolipidoses. This condition is characterized clinically by Hurler like features, progressive psychomotor retardation and death during the first or second year of life. Most cases present during the first year of life, with poor weight gain and coarse facies features. The cause of this rare autosomal recessive hereditary disease is the deficiency of the enzyme N-acetylglucosamine-1-phosphotransferase, required for the synthesis of mannose-6-phosphate, the ligand that allows the transport of acid hydrolases into lysosomes. The patient had clinical features commonly found in mucolipidosis II, including disproportionate dwarfism, retarded psychomotor development, coarse facies features, gibbous and restricted joint mobility. The diagnosis was proved by an extremely elevated activity of lysosomal enzymes in the serum, secondary to non-regulated secretion and subsequent intracellular depletion of these proteins. The child suffered recurrent pneumonia and died at 22 months of age

Radioquimioterapia preoperatoria en cáncer de recto: resultados iniciales / Preoperative radiochemotherapy in rectal cancer

El cáncer de recto localmente avanzado sigue presentando el desafío de la recidiva local. La radioquimioterapia preoperatoria ha demostrado disminución del tamaño tumoral y a veces desaparición de éste, sumada a menor recidiva local. Nuestro objetivo fue evaluar el uso de radioquimioterapia preoperatoria para pacientes con cáncer de recto localmente avanzados en nuestro medio. Se estableció un protocolo prospectivo para pacientes con cáncer de recto etapas II y III. Se administró FU 600 mg/m² la 1ª y 5ª semanas y 300 mg/m² la 2ª, 3ª y 4ª semanas, asociada a radioterapia de 4.500 cGy por 5 semanas. Después de 6 semanas se realizó la cirugía resectiva, completándose en el postoperatorio 6 ciclos de 5FU con Leucovorina. Entre abril de 1999 y agosto de 2001 se trataron 20 pacientes. Complicaciones graves de la radioquimioterapia ocurrieron en dos pacientes (10 por ciento). NO hubo complicaciones intraoperatorias, las postoperatorias ocurrieron en 7 casos y falleció un paciente por una bronconeumonía. En el estudio histológico de la pieza operatoria se comprobó desaparición del tumor en tres pacientes (15,7 por cientos). En una mediana de seguimiento de 15 meses no se ha detectado recidiva local

Canine distemper virus infection with secondary Bordetella bronchiseptica pneumonia in dogs

Canine distemper virus infection and secondary Bordetella bronchiseptica pneumonia are described in mongrel dogs. Canine distemper was characterised by nonsuppurative demyelinating encephalitis with typical inclusion bodies in astrocytes. B. bronchiseptica was isolated from areas of purulent bronchopneumonia.

Effect of atmospheric pollution on the respiratory system.

Santiago de Chile has a high level of air pollution with ozone (O3), carbon monoxide (CO) and particles equal or smaller than 10 microns (PM10) usually exceeding the accepted standards. This situation should be noxious for the exposed population and particularly--in the case of O3 and PM10--for the respiratory system. However, such an effect is rather difficult to demonstrate and it depends on the type of population under study.

Effect of atmospheric pollution on the respiratory system

Santiago de Chile has a high level of air pollutiom with ozone (O3), carbon monoxide (CO) and particles equal of smaller than 16 mum (PM(10)) usually exceeding the accepted standards. This situation should be noxious for the exposed population and particularly -in the case of O3 and PM(10-) for the respiratory system. However, such an effect is rather difficult to demonstrate and it depends on the type of population under study.

Infecciones respiratorias: agentes etiológicos / Respiratory infections: etiologic agents

Se estudiaron 119 pacientes de los Departamentos de Neumología Pediátrica y de Adultos del Hospital General del Centro Médico Nacional La Raza (IMSS), con diagnóstico clínico y radiológico de neumonía/bronconeumonía (63 casos), bronquitis/enfisema pulmonar (31 casos) y neumonía complicada (25 casos). Se obtuvieron 125 muestras de secreciones broncopulmonares mediante técnicas invasivas y no-invasivas: aspirado bronquial (44), lavado broncoalveolar (20), cepillado bronquial (29), punción pulmonar (18) y expectoración (14). A todas las muestras se les practicaron estudios bacteriológicos, micológicos y a los anaerobios facultativos sensibilidad a los antimicrobianos. Además, se realizaron 100 hemocultivos. Se aislaron 211 cepas bacterianas. Gram negativas 37.2 por ciento, Gram positivas 26.1 por ciento, anaerobios obligados 13.7 por ciento, mycoplasma sp 13.3 por ciento y levaduras 10.9 por ciento. Entre las bacterias Gram negativas predominó Pseudomonas aeruginosa seguida por ocho géneros diferentes de enterobacterias. Prevotella melaninogenicus entre los anaerobios obligados. La levadura más frecuentemente aislada fue Candida albicans. Pseudomonas sp presentó elevada resistencia a los antimicrobianos y solamente un hemocultivo fue positivo a Staphylococcus epidermidis. Los agentes etiológicos aislados en este estudio, en general, fueron muy diversos además de presentarse en cultivo mixto.

Relación de la otitis media con la bronconeumonía en el Instituto Nacional de Salud del Niño / The relation between middle ear infection and bronchopneumonia in the Instituto Nacional de Salud del Niño

La otitis media y la bronconeumonía son enfermedades frecuente en pediatría, que tienen como agentes etiológicos más comunes después de los virus al neumococo y al Haemophilus influenzae. El propósito del presente trabajo es investigar si existe coexistencia entre ambas entidades clínicas. Por lo tanto se realizó un estudio retrospectivo en el Servicio I-2 del Instituto Nacional de Salud del Niño, en el período de junio de 1991 a mayo de 1992. Se estudiaron 469 niños, cuyas edades fluctuaban entre 1 mes y 137 meses. El 42.8 por ciento correspondió al sexo femenino y el 57.2 por ciento restante al sexo masculino. Encontramos una prevalencia de bronconeumonía del 40.72 por ciento y una prevalencia de otitis media del 30.49 por ciento. Ambas entidades coexistieron en 56 pacientes. Un hallazgo particular fue que la proporción de bronconeumonía con componente espasmódico y/o acompañada de hiperreactividad bronquial, con un 99 por ciento de confianza, fluctuaba entre 35.75 por ciento y 54.25 por ciento. Se aplicó la prueba de Ji Cuadrado y se encontró una relación estadísticamente significativa (p<0.05) entre los pacientes con diagnóstico de otitis media y los niños con bronconeumonía. No se encontró relación estadística entre el grado de nutrición y/o el sexo y estas dos entidades clínicas. Se concluye que la bronconeumonía y la otitis media son dos enfermedades prevalentes en pediatría, y que ambas pueden coexistir en el mismo paciente.