PULMONARY ASPIRATED PUNCTURE IN THE ETIOL OGIC DIAGNOSIS OF PNEUMONIAS

In pneumonias, the short diagnostic results of non-invasive procedures lead frequently to use invasive techniques, among which we find pulmo nary puncture aspiration (PPA). In this study, the profitability of PP A in the diagnosis of pneumonias is evaluated. One hundred and thirtee n PPA were performed on 107 patients diagnosed of pneumonia. The PPA w as performed with a 22-25 G needle without radioscopic control. Hemocu ltures were gathered in 104 cases, serological tests for productive ag ents of atypical pneumonia were applied in 50 cases, sputum test in 95 cases, and bronchofibroscopy with occluded telescopic brush in 25. Th e PPA had a specificity of 98 percent and a sensibility of 54% which r ose to 73% in patients without antibiotic treatment prior to the punct ure. Only 10 patients had complications with pneumothorax (9 percent) and four (3 percent) presented hemoptoic sputum. In the 53 patients wi th a positive PPA, knowledge of an etiological agent allowed the antib iotic treatment to be switched in 32 cases (60 percent). In addition, a decrease in the number of days of hospitalization was confirmed in t he group of patients who received an etiological diagnosis while alive (p<0.03). In conclusion, the PPA is a technique with excellent specif icity, acceptable sensitivity, and a short rate of complications which allowed the treatment to be changed in 60 percent of the cases and re duced the number of days of hospitalization for patients who received a diagnosis. Thus, it constitutes a very useful technique in the etiol ogical diagnosis of severe pulmonary infections.