Absceso Pulmonar por Klebsiella Pneumoniae

Abstract

Lung abscess caused by Klebsiella pneumoniae usually due to aspiration of infected material from the upper respiratory tract, in immunosuppressed patients often complicated with abscess formation. They are usually caused by anaerobic bacteria and is often associated with periodontal diseases, sometimes multiple germs acting synergistically involved.

This case concerns a 48-year-old born and lives in Simiatug Province of Bolivar, female, married, indigenous, farmer, illiterate, Catholic, unknown blood type. With a history of pulmonary tuberculosis diagnosed BK + 9 years apparently completed treatment. Patient comes for a cough and hemoptysis. Family of patient complains that makes it about a month has dry cough of great intensity and frequency which evolves into coughing that mobilizes secretions yellowish, fetid with traces of blood very difficult elimination which produces dyspnea on moderate effort to clinical accompanied, chills, hyporexia, hike ends unquantified and asthenia. Presenting clinical picture is exacerbated dyspnea with minimal effort the same as the passage of time evolves orthopnoea whereby the patient in a bad condition decides to go to a nursing home. In reviewing devices and systems it has a weight loss of approximately 15 kg in a month because of reduced food intake.

Physical examination shows: Blood Pressure: 90/60 mmHg, heart rate: 80 beats per minute, respiratory rate 24 per minute, axillary temperature: 370C, Sat O2: 70%. conscious, oriented, hemihydrate, afebrile patients cachectic dependent oxygen by nasal cannula, dry skin, normal color hypoelastic, Glasgow 15/15, average overall. Head: normocephalic, hair normal implantation, Eyes: isochoric pupils normorreactivas light Nose: nasal septum no deviations, normal implantation Ears: normal implantation, External Auditory Canal: permeable, Mouth: no injuries, wet and pink oral mucosa, teeth in poor condition, remains sputum yellowing of fetid odor, oropharynx observed: no failure, Neck: symmetrical, thyroid OA, Thorax: domed in left hemithorax, mobility and expandability decreased, not nodal chains are palpated, decreased adipose tissue, Heart: rhythmic heart sounds no murmurs Lungs: abolished based vesicular murmur and middle third pulmonary right field, increased vocal vibration in right lung field, Abdomen: no lesions are seen, soft painless pitting on palpation, noises hydroaerial: present, Tips: symmetrical, preserved tone and strength, presence of edema ++ / +++ which leaves fovea.