Exacerbación aguda de EPOC sobreinfectada en paciente de edad avanzada con múltiples comorbilidades

Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition with high prevalence and significant mortality. It predominantly affects older adults with multiple comorbidities. Acute exacerbations, usually of infectious origin, represent a major cause of hospitalization and functional decline. Methods: We report the case of an 80-year-old male patient with a history of COPD, chronic ischemic heart disease, arterial hypertension, and former smoker, who was admitted to the Dr. Bolívar Argüello Geriatric Hospital due to progressive dyspnea, productive cough, and oxygen desaturation. A comprehensive clinical assessment was performed, including laboratory tests, arterial blood gas analysis, serial electrocardiograms, and chest radiography. Discusión: Findings revealed hypoxemia, elevated C-reactive protein levels, secondary polycythemia, mild thrombocytopenia, and urinalysis compatible with urinary tract infection. Chest radiography showed pulmonary hyperinflation and increased bronchovascular markings. Electrocardiograms demonstrated conduction abnormalities suggestive of trifascicular block. Based on these findings, a diagnosis of acute infective exacerbation of COPD was established. The patient was treated with broad-spectrum antibiotics, inhaled bronchodilators, mucolytics, oxygen therapy, and prophylactic anticoagulation, achieving a favorable clinical outcome. Conclusion: Acute exacerbations of COPD in geriatric patients with multiple comorbidities require a comprehensive and multidisciplinary approach. Timely management allowed clinical stabilization and contributed to a favorable outcome during the current acute hospitalization.