Efficacy of transthoracic needle aspiration in community-acquired pneumonia

Objective To evaluate the indications, efficacy, and safety of transthoraci c needle aspiration (TNA) in diagnosing community-acquired pneumonia (CAP). Methods TNA procedure was performed using an ultrathin needle with ultrason ography and/or computed tomography. The aspirate samples were Gram-stained and sent for cultures. The results were compared with those from convention al microbiological studies. Patients Sixty patients with CAP who were admitted to the hospital and were studied prospectively between July 1994 and June 1999 were included in the study. Results TNA culture was positive in 30 cases (50.0%). Streptococcus pneumon iae was the most frequently isolated pathogen, followed by the Streptococcu s milleri group, and anaerobes. The results of TNA were consistent with tho se of quantitative sputum cultures in 9 patients and with those of blood cu ltures in 4. Complications arose in 3 patients who developed small to moder ate pneumothorax. Conclusions TNA is a safe procedure with a good diagnostic yield. In partic ular, anaerobes or microaerophils such as the S. milleri group were highly detectable by TNA. The results obtained by TNA were highly consistent with those obtained by the gold standard methods. Combined with conventional met hods, TNA is considered highly useful for determining the etiology of CAP.