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Search Results: 1 - 10 of 1575 matches for " pneumonia "
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Corticosteroids and ICU Course of Community Acquired Pneumonia in Egyptian Settings  [PDF]
Nirmeen A. Sabry, Emad El-Din Omar
Pharmacology & Pharmacy (PP) , 2011, DOI: 10.4236/pp.2011.22009
Abstract: Background: Pneumonia is the most common cause of community-acquired infection requiring ICU admission. 60-87% of patients with severe community acquired pneumonia (CAP) admitted to the ICU develops respiratory failure and require mechanical ventilation (MV). Objectives: To assess the efficacy and safety of adjunctive low dose hydrocortisone infusion treatment in Egyptian ICU patients with CAP. Methods: Hospitalized patients, clinically and radiologically diagnosed with CAP, were randomized to receive hydrocortisone 12.5 mg/h IV infusion for 7 days or placebo, along with antibiotics. The end-points of the study were improvement in PaO2:FIO2 (PaO2:FIO2 > 300 or ≥100 increase from study entry) and SOFA score by study day 8 and the development of delayed septic shock. Results: 80 patients were recruited, 40 of them received hydrocortisone and the remaining 40 received placebo. By study day 8, hydrocortisone treated patients showed a significant improvement in PaO2:FIO2 and chest radiograph score, and a significant reduction in C-reactive protein (CRP) levels, Sepsis-related Organ Failure Assessment (SOFA) score, and delayed septic shock compared to the control group. Hydrocortisone treatment was associated with a significant reduction in the duration of MV. However, hydrocortisone infusion did not show significant difference in the ICU mortality. Conclusions: adjunctive 7-day course of low dose hydrocortisone IV in patients with CAP hastens recovery of pneumonia and prevents the development of sepsis related complications with a significant reduction in duration of the mechanical ventilation.
The Association of Pneumonia with Clinical Outcome in Patients with Inhalation Injury  [PDF]
Sharmila Dissanaike, Stephen Cox, Soleil Arrieta
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41002

Introduction: Inhalation injury is a particularly lethal form of thermal burn injury, and is associated with increased morbidity and mortality. Pneumonia is a common complication of inhalation injury, due to the increased susceptibility of lungs that have been stripped of their biologic defense mechanisms, as well as the general susceptibility of the burn population to infections. While older series suggest that pneumonia is associated with worse mortality and morbidity, recent reports suggest that this may not be the case in all populations. Methods: We attempted to clarify the impact of pneumonia in terms of mortality, length of mechanical ventilation, need for tracheostomy, and discharge disposition, in patients admitted with inhalation injury by performing a retrospective review of patients admitted to a regional burn center 2002-2009. Burn registry and electronic chart review were used to obtain demographic, clinical and outcome data. Univariate and multivariate analysis was used to compare outcomes in patients who developed pneumonia versus those who did not. Results: The study cohort comprised 166 patients, of whom 21 (13%) were diagnosed with pneumonia. Development of pneumonia was not predicted by age, surface area burned or other complications such as acute respiratory distress syndrome. Surprisingly, pneumonia was associated with reduced inpatient mortality (p = 0.006). However, patients who developed pneumonia were also more likely to have prolonged ventilator dependence (19 vs 5 days, p < 0.001), require intensive respiratory therapy (p < 0.001), receive tracheostomy (p < 0.001) and have an increased overall length of stay (33 vs. 10 days, p < 0.001). They were significantly less likely to be discharged home and more likely to be transferred to a nursing facility or rehabilitation center upon discharge (p = 0.002).

Respiratory syncytial virus and adenovirus in acute lower respiratory infections in hospitalized infants and children  [PDF]
Salvatore Barberi, Mario Barreto, Francesco La Penna, Bernardina Mazzarella, Maria-Elena Liverani, Ottavia De Luca, Maurizio Simmaco, Maria Pia Villa
Open Journal of Pediatrics (OJPed) , 2012, DOI: 10.4236/ojped.2012.21004
Abstract: Background: Lower respiratory tract infection (LRTI) is a main cause of hospitalization in infants and children. These patients’ nasopharyngeal swabs more frequently contain respiratory syncytial virus (RSV) than human adenovirus (HAdV) in cold seasons; recent data suggest that oropharyngeal swabs more frequently contain HAdV than RSV. Knowing more about virus detection with oropharyngeal swabs, seasonal fluctuations and age-related distribution of RSV and HAdV would help treat children hospitalized for LRTI more effectively. We investigated the seasonal virus-related frequency (as assessed by oropharyngeal swabs) and environmental and clinical features in infants and children hospitalized for LRTI from autumn to spring. Methods: We studied 98 subjects hospitalized for LRTI in our Pediatric Unit, from November 2006 to May 2007. RSV and HAdV in oropharyngeal swabs were assessed by real-time polymerase chain reaction (PCR) assay. Results: PCR assays more frequently detected HAdV (29.6% of patients) than RSV (25.5%). The seasonal incidence also differed (RSV, narrow peak in December and HAdV, wide peak from April to May). Most patients infected with RSV were aged 2 yrs or younger (23/25: 88%); no difference was found in age between subjects who tested HAdV-positive (13/29: 45%) or undetectable-virus (23/44: 52%). Bronchiolitis was more frequently associated with RSV than HAdV or undetectable-virus oropharyngeal swabs. No difference was found in risk factors (school attendance, atopic parents, exposure to cigarette smoking, home dampness or exposure to animals) or clinical features (vital parameters or duration of hospital stay) among the three viral groups. Conclusions: Our findings show a high frequency of HAdV-positive oropharyngeal swabs during acute LRTIs in infants and children and differences in the seasonal distribution of RSV and HAdV in Rome.
Telavancin in Experimental Murine Pneumococcal Pneumonia  [PDF]
Suzannah M. Schmidt, Melissa J. Karau, Jayawant N. Mandrekar, James M. Steckelberg, Robin Patel
Journal of Immune Based Therapies, Vaccines and Antimicrobials (JIBTVA) , 2012, DOI: 10.4236/jibtva.2012.12003
Abstract: We determined whether telavancin is as active in experimental immunocompetent murine pneumococcal pneumonia as is vancomycin or ceftriaxone. Experimental murine pneumonia was established by intratracheal administration of Streptococcus pneumoniae. Four groups of animals were studied, untreated and treated with vancomycin (110 mg/kg, bid, SQ), telavancin (40 mg/kg, bid, SQ), or ceftriaxone (50 mg/kg, bid, SQ) for 2 days. The untreated animals had a mean of 6.54 ± 0.82 log10 cfu/g lung. The vancomycin-, telavancin-, and ceftriaxone-treated animals had means of 2.01 ± 0.02, 2.00 ± 0.00, and 2.00 ± 0.01 log10 cfu/g lung, respectively (p-values < 0.0001 for each treatment group versus the untreated group). In the model studied, telavancin was as active as vancomycin and ceftriaxone in treating experimental pneumococcal pneumonia in mice.
The East Japan Great Earthquake and Three Cases of Near-Drowning with Tsunami Due to the Earthquake  [PDF]
Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Masayuki Sato, Hisaho Sato, Hironobu Noda, Masahiro Kojika, Yasushi Suzuki, Shigeatu Endo
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.43023

We encountered the Great East Japan Earthquake on March 11, 2011. The magnitude of the earthquake is 9.0 and it is one of the greatest from A.D. 1900 to now. The earthquake developed large tsunami and many people living on the pacific coast of east Japan died from lung disorder caused by near drowning with tsunami. We also encountered three cases of lung disorders caused by near drowning. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within three weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Many bacteria were detected from the phlegm of two cases.

Should Empyema with or without Necrotizing Pneumonia in Children Be Managed Differently?  [PDF]
Karine Anastaze Stelle, Anne Mornand, Nadia Bajwa, Isabelle Vidal, Mehrak Anooshiravani, Aikaterini Kanavaki, Constance Barazzone Argiroffo, Sylvain Blanchon
Health (Health) , 2017, DOI: 10.4236/health.2017.92014
Abstract: Background: Necrotizing pneumonia (NP) is an increasing lung infection mostly associated with pleural empyema. Objectives: We aimed to compare children with empyema with and without concomitant NP, in terms of risk factors, management and outcome. Methods: We retrospectively included children hospitalized between 2005-2014 with empyema to whom a computed tomography was performed. We recorded patient characteristics, clinical, biological (blood and pleural fluid) and radiological findings, medical and surgical treatments, and clinical, radiological and functional follow-up. Results: 35 children with empyema were included, including 25 with a concomitant NP. Patients with or without NP were undistinguishable, in terms of characteristics, symptoms at admission or detected pathogens. Pleural leucocytes were significantly higher in the empyema group (p = 0.0002) as pleural LDH (p = 0.002), and pleural/blood LDH ratio (p = 0.0005). Medical and surgical managements were similar between both groups. Complications occurred in 1/10 children with empyema alone (pneumatocele) and 5/25 with concomitant NP (bronchopleural fistula (n = 3), lobectomy, pneumothorax). The hospital length of stay and delay for chest X-ray normalization were similar in both groups. Conclusion: Except for minor biological parameters, the presence of concomitant NP in case of empyema does not change the presentation, clinical features, management and outcome, suggesting that the presence of additional NP to empyema should not be managed differently. Therefore, in case of empyema with suspected concomitant NP, chest CT should probably be restricted to abnormal worsening or when mandatory for surgical treatment.
Recurrent Pneumonia in Children
Solmaz ?elebi,Mustafa Hac?mustafao?lu,Yücehan Albayrak,Nurcan Bulur
Cocuk Enfeksiyon Dergisi , 2010,
Abstract: Objective: The aim of this study was to determine the relative frequency and describe the predisposing causes of recurrent pneumonia in children. Material and methods: We retrospectively reviewed the medical records of patients with pneumonia at Uludag University Medical Faculty, Department of Pediatrics, between January 1998 and December 2007. Recurrent pneumonia was defined as at least two episodes in a 1 year period or at least three episodes over a lifetime. Patients with recurrent pneumonia were included in this study.Results: During the study period, 1617 children were admitted to hospital with a diagnosis of pneumonia, 185 (11.4%) met the criteria for recurrent pneumonia. The mean age of patients was 16±32 months (3 months-14 years) and 61% were male. An underlying cause was identified in 143 patients (77%). Of these, the underlying cause was diagnosed prior the pneumonia in 25 patients (17%), during the first episode in 30 (21%), and during recurrence in 88 (62%). Underlying causes included congenital cardiac defects in 32 patients (17.2%), gastroesophageal reflux in 31 patients (16.7%), aspiration syndrome in 27 patients (14.5%), asthma in 16 patients (8.6%), cystic fibrosis in 12 patients (6.4%) immune disorders in 10 patients (5.4%), tuberculosis in 9 patients (4.8%) and anomalies of the chest and lung in 6 patients (3.2%). No predisposing illness could be demonstrated in 42 patients (33%). Conclusion: Recurrent pneumonia occurred in 11.4% of all children hospitalized for pneumonia. The underlying cause was identified in 77% of the children. The most common causes were congenital cardiac defects, gastroesophageal reflux and aspiration syndrome.
Clinical Utility of Procalcitonin for Differentiating between Cryptogenic Organizing Pneumonia and Community-Acquired Pneumonia  [PDF]
Satoshi Takeda, Nobuhiko Nagata, Hiroyuki Miyazaki, Takanori Akagi, Taishi Harada, Masaru Kodama, Shinichiro Ushijima, Takashi Aoyama, Kentaro Wakamatsu, Masaki Fujita, Kentaro Watanabe
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.66048
Background: Differentiating cryptogenic organizing pneumonia (COP) from community-acquired pneumonia (CAP) can be difficult in some cases. Objective: To clarify the clinical utility of procalcitonin (PCT) levels for differentiating between COP and CAP. Methods: Blood PCT levels, leukocyte count, C-reactive protein concentration, number of segments involved on computed tomography (CT) images, and pneumonia severity assessment scale were retrospectively investigated from clinical charts and chest CT images of COP and CAP patients who were admitted to our hospital from 2012 to 2014. The clinical characteristics of COP patients were compared to those of CAP patients for whom causative organisms were not detected. Results: There were 16 COP and 94 CAP patients for whom causative organisms were not detected. Blood PCT levels of all COP patients were less than 0.16 ng/dL, and significantly lower than those of CAP patients (p = 0.0004), while the number of involved segments was significantly higher than that of CAP patients (p = 0.0001). Blood PCT levels and the number of involved segments remained independently significant for differentiating between COP and CAP by multivariate analysis. Receiver operating characteristics curve analysis revealed that 7 was the best cut-off number for involved segments to differentiate between COP and CAP patients with low PCT levels (sensitivity 85.7%, specificity 94.7%). Conclusion: A combination of PCT levels and number of involved segments on CT images is useful for differentiation between COP and CAP.
Cidofovir Therapy for Adenovirus Pneumonia in an AIDS Patient on HAART: A Case Report  [PDF]
Trong Tony Trinh, Quy Ton, Robert Y. Choi
World Journal of AIDS (WJA) , 2012, DOI: 10.4236/wja.2012.24046
Abstract: Introduction: Adenovirus infections are associated with significant morbidity and mortality among immunocompromised hosts. Adenovirus pneumonia is a rare and often fatal disease in patients with AIDS. Case Report: We report a case of a 28-year-old woman with advanced HIV/AIDS, who developed pneumonia four weeks after initiation of highly active antiretroviral therapy (HAART). Despite empiric antibiotics, the patient developed worsening hypoxemia and progressive pneumonia on chest x-ray. Culture data from a bronchoalveolar lavage (BAL) was negative for bacteria, fungi, pneumocystis jirovecii, but was positive for adenovirus detected by PCR. After transfer to a tertiary care hospital intensive care unit, a repeat BAL confirmed the presence of adenovirus by immunohistochemical staining. Tissue samples sent for histopathology revealed \"smudge cells\". Serum adenovirus viral load was 1.6 × 105 copies/mL. Intravenous cidofovir, 1 mg/kg/day, was initiated and scheduled three times a week. The patient exhibited remarkable improvement and was discharged to home in stable condition after four doses of cidofovir treatment. Discussion: Prior to our case, the few published accounts of HIV patients with adenovirus pneumonia treated with cidofovir have all resulted in death. Our case is distinct from these cases by the lack of concomitant pulmonary infection and the initiation of HAART prior to presentation. Conclusion: To our knowledge, we present the first case of adenovirus pneumonia in a patient with AIDS successfully treated with cidofovir. Our case suggests that limited and low dose cidofovir may be an efficacious approach to treat adenovirus pneumonia among HIV patients, especially those established on HAART.
Comparative efficacy of levofloxacin and ceftriaxone in the treatment of community acquired pneumonia in children  [PDF]
Mujibul Hoque, Mohammad Nuruzzaman, Md. Abdul Malik
Open Journal of Pediatrics (OJPed) , 2013, DOI: 10.4236/ojped.2013.33046

Pneumonia is a common cause of mortality and morbidity in under-5 children throughout the world. Globally an estimated 156 million new episodes of pneumonia occur each year in children and 2 million children die from pneumonia each year which is 20 percent of all deaths of children under five years old. Ceftriaxone is a commonly used drug for empiric treatment of community acquired pneumonia (CAP) in children. Levofloxacin may be an adequate option for empiric therapy in treatment of CAP in children because it gives the broad spectrum activity against both bacterial and atypical pathogens causing CAP and studies suggest that it can be safely used in children. This open labeled, randomized, comparative clinical trial was carried out in the Department of Pediatrics, Sylhet MAG Osmani Medical College Hospital, Bangladesh during January, 2011 & December, 2012 to compare the efficacy of levofloxacin and ceftriaxone in the treatment CAP in children. A total 70 cases of CAP were enrolled. 35 cases were allocated to levofloxacin group and another 35 cases to ceftriaxone group. At first the study cases were selected by systematic random sampling. Group allocation to either levofloxacin or ceftriaxone group was done by lottery method. Total duration for receiving study drugs was seven days. Dose of levofloxacin was 10 mg/kg/day children ≥5 years, where as it was 10 mg/kg 12 hourly in 6 months to <5 years age groups. Dose of ceftriaxone was 75 mg/kg/day. Response to treatment was assessed initially after 3 days and also after 7 days by clinical symptoms and signs. Clinical cure rate was determined by disappearance of the clinical signs and symptoms of pneumonia and resolution of radiological findings reported at admission. Clinical responses were categorized as cured and treatment failure. 91.43% cases were cured in levofloxacin group, whereas cure rate of ceftriaxone group was 68.57% which was statistically significant (p = 0.0168). Adverse effects of levofloxacin were found as skin rash in 1 case and vomiting in 2 cases whereas skin rash was found in 1 case in ceftriaxone group. So it can be concluded that levofloxacin is more effective than ceftriaxone in the treatment of CAP in children.

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