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[Transthoracic aspiration punction with ultrafine needle in high risk community acquired pneumonia]
R Zalacaín1, J L Llorente, L Gaztelurrutia
1Servicio de Neumología, Hospital de Cruces, Vizcaya.
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.
Insights
Aspirative transthoracic puncture (ATP) is a safe and effective method for diagnosing community-acquired pneumonia in high-risk patients, improving treatment in over 23% of cases.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Diagnostic Procedures
Context:
- Diagnosing community-acquired pneumonia (CAP) in high-risk individuals presents challenges.
- Traditional diagnostic methods for CAP are often inefficient and invasive techniques are preferred.
- Aspirative transthoracic puncture (ATP) is an invasive diagnostic technique evaluated in this study.
Purpose:
- To evaluate the diagnostic utility of aspirative transthoracic puncture (ATP) in patients with suspected community-acquired pneumonia (CAP).
- To assess the sensitivity, specificity, and safety of ATP compared to conventional methods.
Summary:
- Aspirative transthoracic puncture (ATP) was performed on 94 high-risk patients with suspected CAP using an ultrafine needle without radioscopic guidance.
- ATP demonstrated a sensitivity of 36% (54.6% in untreated patients) and a specificity of 96.4%.
- Conventional methods like blood cultures (8% sensitivity) and sputum examination (13.6% sensitivity) showed lower diagnostic yield.
Impact:
- ATP was well-tolerated in 97.9% of patients with minimal complications (4.3%).
- The diagnostic results from ATP led to treatment modifications in 23.1% of cases.
- This minimally invasive technique offers a valuable bedside diagnostic tool for CAP management.