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Neumonía complicada en niños
Fernando M de Benedictis1, Eitan Kerem2, Anne B Chang3
1Salesi Children's Hospital Foundation, Ancona, Italy.
Lancet (London, England)
|September 13, 2020
Resumen
La neumonía complicada adquirida en la comunidad en niños es grave pero tratable. La sospecha temprana y los antibióticos apropiados, guiados por imágenes y cultivos, conducen a la recuperación, con el drenaje a menudo suficiente tratamiento.
Área de la Ciencia:
- Pediatría
- Enfermedades infecciosas
- Pulmonología
Sus antecedentes:
- La neumonía adquirida en la comunidad (CCAP) presenta complicaciones locales y sistémicas en los niños.
- El CCAP requiere un reconocimiento y tratamiento rápidos cuando la neumonía no responde a los antibióticos dentro de las 48-72 horas.
Objetivo del estudio:
- Describir las estrategias de diagnóstico y tratamiento de la neumonía complicada adquirida en la comunidad en niños.
- Hacer hincapié en la importancia de la identificación temprana y el tratamiento adecuado para garantizar resultados favorables.
Principales métodos:
- El diagnóstico inicial incluye radiografía de tórax y ecografía para evaluar el parénquima pulmonar y el líquido pleural.
- El tratamiento incluye antibióticos intravenosos y orales prolongados, guiados por datos microbiológicos.
- El análisis del líquido pleural y las imágenes informan las decisiones sobre los fibrinolíticos intrapleurales y los procedimientos de drenaje.
Principales resultados:
- Streptococcus pneumoniae y Staphylococcus aureus son organismos causantes comunes.
- La mayoría de los casos se manejan con antibióticos y drenaje pleural; rara vez es necesaria una cirugía extensa.
- A pesar de un curso potencialmente prolongado, especialmente con neumonía necrotizante, la recuperación completa es el resultado típico.
Conclusiones:
- La sospecha temprana y un enfoque estructurado para el diagnóstico y el tratamiento son cruciales para el manejo de la PCAP pediátrica.
- La selección de antibióticos, guiada por la microbiología, y la intervención oportuna, como el drenaje pleural, son clave para un manejo exitoso.
- CCAP, aunque grave, es generalmente una condición curable en niños con el cuidado apropiado.
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