# ent

id: cord-261118-rzdxdzp5
type: CHEMICAL
entity:
  ibuprofen naproxen indomethacin diclofenac piroxicam antidepressants amitriptyline trazodone venlafaxine


id: cord-000757-bz66g9a0
type: ORG
entity:
  World Health Organization International Statistical Classification of Disease and Related Health Problems Tenth Revision Version for


id: cord-000757-bz66g9a0
type: ORG
entity:
  the Steering Committee to Reengineer the Death Registration Process National Association for Public Health Statistics and Information Systems


id: cord-029183-3aotgq6m
type: GGP
entity:
  aminoglycosides n 15 9 Table 3 Based on the results of the rm PCR the multidisciplinary committee proposed a modification of the routine empirical therapy in 123 77 pneumonia episodes deescalation in 63 40 and escalation in 35 22 Table 4 The proportion of antibiotic modifications


id: cord-029183-3aotgq6m
type: CL
entity:
  Proteus spp Moraxella catarrhalis 1 5 Klebsiella oxytoca 1 5 Gram positive cocci Streptococcus pneumoniae 8 1 6 Streptococcus pyogenes 0 0 Streptococcus agalactiae 0 0 Legionella pneumophila 1 1 Mycoplasma


id: cord-029183-3aotgq6m
type: GGP
entity:
  Staphylococcus n 4 Enterococcus faecium n 1 Enterococcus faecalis n 6 Lactobacillus reuteri n 1 Streptococcus alpha n 1 Streptococcus pseudopneumoniae n 1


id: cord-029183-3aotgq6m
type: GGP
entity:
  bacilli 4 Escherichia coli 3 Pseudomonas aeruginosa 2 Klebsiella pneumoniae 2 Enterobacter sp 1 Raoultella The number of Gram negative


id: cord-009667-8r8j0h08
type: ORG
entity:
  the European Organization for Research and Treatment of Cancer Invasive Fungal Infections Cooperative Group


id: cord-009667-8r8j0h08
type: CHEMICAL
entity:
  ceftazidime cefepime aztreonam piperacillin piperacillin tazobactam ticarcillin ticarcillin clavulanic acid cefoperazone cefoperazone sulbactam imipenem cilastatin meropenem panipenem


id: cord-009667-8r8j0h08
type: CHEMICAL
entity:
  Piperacillin amoxicillin clavulanic acid ampicillin sulbactam piperacillin tazobactam doxycycline minocycline ceftriaxone clindamycin chloramphenicol azithromycin erythromycin moxifloxacin imipenem ertapenem Penicillin G


id: cord-009667-8r8j0h08
type: DISEASE
entity:
  influenza A H1N1 pdm09 and A H3N2 in the post pandemic period Clinical and epidemiologic characteristics of 3 early


id: cord-028328-5lews3uw
type: DISEASE
entity:
  chronic obstructive pulmonary disease COPD asthma diabetes mellitus renal insuffi ciency congestive heart failure CHF coronary artery disease malignancy alcoholism


id: cord-261410-kb91eagd
type: TAXON
entity:
  respiratory bacterial pathogens Mycoplasma pneumoniae Chlamydophila pneumoniae Legionella pneumophila


id: cord-261410-kb91eagd
type: WORK_OF_ART
entity:
  Exploration of the Effectiveness of Social Distancing on Respiratory Pathogen Transmission Implicates Environmental Contributions Psychological Stress and Susceptibility


id: cord-261410-kb91eagd
type: DISEASE
entity:
  coronaviruses 229E NL63 OC43 respiratory syncytial viruses A B parainfluenza viruses 1 2 3 and metapneumovirus


id: cord-015763-5lx179pa
type: ORG
entity:
  de l adulte immunocompétent Infectious Diseases Society of America American Thoracic Society Consensus Guidelines


id: cord-303079-tglvxelu
type: GGP
entity:
  penicillinresistant S pneumoniae 19 20 Each patient group is assigned a list of likely pathogens and suggested antimicrobial therapy that provide coverage of both the likely pathogens and resistant strains Severity


id: cord-297494-6yxmaihl
type: GGP
entity:
  Sugihiro Hamaguchi 1 9 Shungo Katoh 1 9 Satoshi Kakiuchi 9 Emi Kitashoji 9 Takaharu Shimazaki 9 Masahiro Takaki 9 Additional file 1 Table S1 Proportion of


id: cord-297494-6yxmaihl
type: ORG
entity:
  the Institute of Tropical Medicine Nagasaki University Ebetsu City Hospital Kameda Medical Center Chikamori Hospital


id: cord-297494-6yxmaihl
type: DISEASE
entity:
  diabetes mellitus cerebrovascular disease dementia neuromuscular disease cardiac failure ischaemic heart disease


id: cord-008695-y7il3hyb
type: DISEASE
entity:
  ischaemic heart disease Chronic renal disease Nephrotic syndrome chronic renal failure renal transplantation Chronic liver disease Cirrhosis inflammatory bowel disease Diabetes


id: cord-256424-t3dtabi4
type: DISEASE
entity:
  Pseudomonas aeruginosa Streptococcus mitis Prevotella melaninogenica Peptostreptococcus stomatis Candida albicans


id: cord-256424-t3dtabi4
type: DISEASE
entity:
  Cytomegalovirus herpes simplex virus parainfluenza viruses types 1 and 3 respiratory syncytial virus varicella zoster


id: cord-266516-0ure8256
type: ORG
entity:
  American Thoracic Society Infectious Diseases Society of America Centers for Disease Control and Prevention Clinical Practice Guidelines


id: cord-017016-twwa9djm
type: DISEASE
entity:
  intermittent obstruction of the precariously situated bronchi in the setting of reduced collateral ventilation of the middle lobe 208


id: cord-300356-oorac5he
type: TAXON
entity:
  bacteria Pseudomonas aeruginosa Klebsiella pneumoniae Escherichia coli Enterobacter spp Serratia spp


id: cord-300356-oorac5he
type: WORK_OF_ART
entity:
  Procalcitonin Guided Antibiotic Therapy and Hospitalisation in Patients with Lower Respiratory Tract Infections ProHOSP Study Group Prognostic


id: cord-300356-oorac5he
type: DISEASE
entity:
  chronic obstructive pulmonary disease COPD congestive heart failure chronic kidney disease liver disease


id: cord-300356-oorac5he
type: DISEASE
entity:
  Parainfluenza virus respiratory syncytial virus RSV human metapneumovirus severe acute respiratory syndrome virus varicella Hantavirus


id: cord-300356-oorac5he
type: DISEASE
entity:
  chronic heart lung metabolic hematologic or immune compromising illnesses Pneumococcal polysaccharide vaccine


id: cord-302111-kg0dmgq0
type: PROTEIN
entity:
  influenza M2 protein M2e or hemagglutinin stalk domains Hemagglutinin globular head specific antibodies


id: cord-302111-kg0dmgq0
type: WORK_OF_ART
entity:
  The Clinical Presentation and Immunology of Viral Pneumonia and Implications for Management of Coronavirus Disease


id: cord-001894-ptuelrqj
type: CELL_TYPE
entity:
  TBAS tracheobronchial aspirates TNF tumor necrosis factor VAP ventilator associated pneumonia XDR extensive drug resistant Infectious Diseases Society Of America Guidelines


id: cord-009278-98ebmd33
type: DISEASE
entity:
  chronic obstructive pulmonary disease diabetes mellitus renal failure congestive heart failure coronary artery disease


id: cord-304356-jyp9gjh9
type: PROTEIN
entity:
  creatine phosphokinase CPK C reactive protein CRP Ddimer ferritin lactate dehydrogenase LDH procalcitonin q 4 6x10 2


id: cord-304356-jyp9gjh9
type: ORG
entity:
  the Acute Respiratory Distress Syndrome Multidimensional Assessment of the Host Response in Mechanically Ventilated Patients with Suspected Pneumonia Elevated


id: cord-304356-jyp9gjh9
type: ORG
entity:
  the Feinberg School of Medicine the Center for Genetic Medicine and Feinberg s Department of Biochemistry


id: cord-254874-ug0ler5e
type: ORG
entity:
  the American Journal of Respiratory and Critical Care Critical Care Medicine and Intensive Care Medicine


id: cord-007575-5ekgabx5
type: DISEASE
entity:
  influenza B virus parainfluenza 3 virus respiratory syncytial virus and adenovirus in 2 each MUltiple infections


id: cord-295201-u2dola34
type: GGP
entity:
  Ariyoshi 9 Bhim G Dhoubhadel 9 Akitsugu Furumoto 9 Sugihiro Hamaguchi 1 9 Tomoko Ishifuji 9 Shungo Katoh 1 9 Satoshi Kakiuchi 9


id: cord-312266-hnbgaxft
type: ORG
entity:
  Recommendations for Management of Common Childhood Conditions Evidence for Technical Update of Pocket Book Recommendations Newborn Conditions Dysentery Pneumonia Oxygen Use and Delivery


id: cord-312266-hnbgaxft
type: DISEASE
entity:
  impaired immunity and lung function dysfunctional nasal mucociliary clearance lung and heart diseases


id: cord-021951-xxvol17t
type: DISEASE
entity:
  meningitis transverse myelitis peripheral neuropathy erythema multiforme myocarditis pericarditis hemolytic anemia


id: cord-021951-xxvol17t
type: DISEASE
entity:
  Bronchiectasis Ciliary dyskinesia Interstitial lung disease Heart failure pulmonary edema Pulmonary hemosiderosis


id: cord-018134-k4vdqlgs
type: DISEASE
entity:
  Differential Diagnosis Lower lobe predominant diseases of the lung Mosaic attenuation Multiple cystlike lung lesions


id: cord-287145-w518a0wa
type: DISEASE
entity:
  tuberculosis breast cancer colon cancer prostate cancer coronary artery disease congenital heart defects


id: cord-018408-ttae193b
type: ORG
entity:
  US Children s Hospitals Fourth Decennial International Conference on Nosocomial and Healthcare Associated Infections Clinical


id: cord-260679-tm1s6wvj
type: DISEASE
entity:
  COPD cancer diabetes chronic liver disease renal impairment Immunosuppressive disorders HIV Solid organ


id: cord-315834-ashjw2xs
type: DISEASE
entity:
  influenza A FluA adenovirus AdV bocavirus human rhinovirus HRV influenza B FluB parainfluenza PIV coronavirus CoV respiratory syncytial virus A RSVA respiratory syncytial virus B RSVB enterovirus EV


id: cord-305547-e66o5j85
type: GGP
entity:
  bacilli n 2 Acinetobacter baumannii n 1 Aerococcus viridans n 1 Enterococcus faecium n 1 Granulicatella elegans n 1


id: cord-017252-88b3preq
type: ORG
entity:
  the Infectious Diseases Society of America Infectious Diseases Society of America American Thoracic Society


id: cord-017252-88b3preq
type: DISEASE
entity:
  rhinovirus human bocavirus human metapneumovirus hMPV and respiratory syncytial virus RSV Human metapneumovirus


id: cord-294546-0otd1heg
type: PROTEIN
entity:
  Prendki V Huttner B Marti C Mamin A Fubini P E Meynet M P Scheffler M Montet X Janssens J P Reny J L Kaiser L Garin N Stirnemann J title Accuracy


id: cord-026005-f2khcjdy
type: CELL_TYPE
entity:
  thymus thymic branchial cysts bronchi bronchogenic cysts ectopic thyroid tissue thyroglossal duct cysts


id: cord-026005-f2khcjdy
type: CL
entity:
  Mannheimia haemolytica Pasteurella multocida parainfluenza virus 3 PI 3 adenovirus reovirus respiratory syncytial virus RSV chlamydiae


id: cord-026005-f2khcjdy
type: CL
entity:
  bronchiolar and alveolar epithelium edema and a few days later proliferation of type II pneumonocytes


id: cord-026005-f2khcjdy
type: WORK_OF_ART
entity:
  Disorders of the Conducting System Species Specific Diseases of the Nasal Cavity and Paranasal Sinuses Disorders of Dogs Mycotic Infections Neoplasms


id: cord-026005-f2khcjdy
type: DISEASE
entity:
  rhinoviruses infectious bovine rhinotracheitis bovine herpesvirus 1 feline rhinotracheitis felid herpesvirus 1 and viruses of the canine infectious respiratory disease


id: cord-026005-f2khcjdy
type: DISEASE
entity:
  infectious canine hepatitis virus reovirus type 1 canid herpesvirus 1 CaHV 1 canine respiratory coronavirus CRCoV


id: cord-026005-f2khcjdy
type: DISEASE
entity:
  respiratory syndrome virus PRRSV swine influenza virus SIV porcine circovirus 2 PCV2 porcine respiratory coronavirus PRCoV Mycoplasma hyopneumoniae


id: cord-292094-vmsdhccp
type: ORG
entity:
  American Thoracic Society Centers for Disease Control and Prevention Infectious Diseases Society of America


id: cord-292094-vmsdhccp
type: DISEASE
entity:
  influenza A H5N1 World Health Organization Production of pilot lots of inactivated influenza vaccines from reassortants derived from avian influenza viruses interim biosafety assessment Avian influenza A H5N1 infection


id: cord-005692-n4vxazst
type: ORG
entity:
  the European Respiratory Society European Society of Intensive Care Medicine European Society of Clinical Microbiology and Infectious Diseases


id: cord-275828-c6d6nk7x
type: TAXON
entity:
  viruses Cytomegalovirus herpes simplex virus bacteria Streptococcus agalactiae GBS E coli Listeria monocytogenes Chlamydia


id: cord-275828-c6d6nk7x
type: TAXON
entity:
  Paragonimus spp Ascaris lumbricoides Ancylostoma duodenale Necator americanus Strongyloides stercoralis Toxocara canis Toxocara cati Wuchereria bancrofti Brugia malayi


id: cord-275828-c6d6nk7x
type: ORG
entity:
  the Surveillance Committee of Japanese Society of Chemotherapy Japanese Association for Infectious Diseases


id: cord-275828-c6d6nk7x
type: ORG
entity:
  Committee to Prepare the Guidelines for the Management of Respiratory Infectious Diseases in Children Pneumonia


id: cord-275828-c6d6nk7x
type: ORG
entity:
  the Tuberculosis and Infectious Diseases Control Division Health Service Bureau Ministry of Health Labour and Welfare Statistics


id: cord-275828-c6d6nk7x
type: ORG
entity:
  the Japanese Association for Infectious Diseases Proposal by the Japanese Association for Infectious Diseases Effect of


id: cord-275828-c6d6nk7x
type: CHEMICAL
entity:
  pimozide quinidine bepridil simvastatin triazolam azelnidipine ergotamine nisoldipine dihydroergotamine vardenafil eplerenone blonanserin sildenafil tadalafil


id: cord-275828-c6d6nk7x
type: DISEASE
entity:
  bacterial tracheitis Croup laryngitis laryngotracheitis spasmodic croup laryngotracheobronchitis bacterial tracheitis


id: cord-023942-vrs3je1x
type: ORG
entity:
  American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis Diagnosis and Management of Bronchiolitis


id: cord-322104-f1dukpso
type: TAXON
entity:
  organisms Chlamydophila pneumoniae Legionella pneumophila Mycoplasma pneumoniae Hemophilus influenzae


id: cord-322104-f1dukpso
type: ORG
entity:
  Blastomycosis Coccidioidomycocis Histoplasmosis Paracoccidioidomycosis Aspergillosis Candidosis Cryptococcosis and Mucormycosis Fungi


id: cord-322104-f1dukpso
type: DISEASE
entity:
  comorbid illness congestive heart failure diabetes renal failure chronic obstructive lung disease malnutrition


id: cord-322104-f1dukpso
type: DISEASE
entity:
  myocarditis pericarditis hepatitis gastroenteritis erythema multiforme arthralgias pancreatitis generalized lymphadenopathy


id: cord-322104-f1dukpso
type: DISEASE
entity:
  sickle cell disease chronic renal failure immunoglobulin deficiency Hodgkin s disease lymphoma leukemia


id: cord-317024-1rhzhpij
type: GGP
entity:
  VSR e HPIV sendo geralmente adquirido na primeira infância e responsável por bronquiolite crupe e pneumonia Reinfecção pode ocorrer em idade adulta com os casos mais graves atingindo idosos portadores


id: cord-007564-ljqrxjvv
type: FAC
entity:
  Ensuite il n est pas simple microbiologiquement de différencier une colonisation des voies aériennes inférieures d une infection


id: cord-007564-ljqrxjvv
type: FAC
entity:
  les fréquences de positivité de l examen direct et de la culture de l expectoration selon que cet examen


id: cord-007564-ljqrxjvv
type: CHEMICAL
entity:
  des échantillons avec examen direct négatif Dans la plupart des cas le pathogène retrouvé par l examen direct et ou la culture est le pneumocoque Au


id: cord-007564-ljqrxjvv
type: CHEMICAL
entity:
  des résultats rapides elle ne peut être réalisée que par des laboratoires très spécialisés Les méthodes sérologiques


id: cord-007564-ljqrxjvv
type: CHEMICAL
entity:
  Murdoch 137 permet de souligner les points suivants Pendant les deux premières semaines de la maladie la mise


id: cord-007564-ljqrxjvv
type: CHEMICAL
entity:
  Le virus peut être détecté au niveau d échantillons respiratoires supérieurs Tableau 20 Comparaison des tests de diagnostic rapide de la grippe avec la culture virale et ou l immunofluorescence


id: cord-294270-do6i6ymq
type: GPE
entity:
  the United States Advisory Committee on Immunization Practices ACIP ACIP Adult Immunization Work Group Advisory Committee on Immunization Practices


id: cord-294270-do6i6ymq
type: DISEASE
entity:
  diseases chronic cardiovascular pulmonary renal or liver disease diabetes mellitus alcoholism asplenia


id: cord-314359-fw14b5cv
type: DISEASE
entity:
  rhinoviruses coronaviruses influenza virus respiratory syncytial virus RSV adenovirus and parainfluenza virus ICPs


id: cord-321514-knyw023l
type: DNA
entity:
  GABRIEL Global Approach to Biological Research Infectious Diseases and Epidemics in Low Income Countries


id: cord-321514-knyw023l
type: ORG
entity:
  the Department of Microbiology Bangladesh Institute of Child Health Dhaka Shishu Hospital Bangladesh


id: cord-321514-knyw023l
type: CHEMICAL
entity:
  ceftriaxone N 135 26 0 amoxicillin N 120 23 1 ampicillin N 51 9 8 amoxicillin sulbactam N 36 6 9 amoxicillin clavulanic acid N 35 6 7 oxacillin N 35 6 7


id: cord-273096-pgda7i3u
type: DISEASE
entity:
  herpes simplex virus type 1 HSV1 of lymphocytes using bronchial washing fluid was positive Fig 2C Diagnosis Viral Pneumonia


id: cord-340766-aic570x8
type: ORG
entity:
  Outcomes of Early Administration of Cidofovir in Non Immunocompromised Patients with Severe Adenovirus Pneumonia


id: cord-310840-h49dx92d
type: DISEASE
entity:
  enteric respiratory tract fistula airway abnormalities foreign body stenosis bronchiectasis cystic fibrosis


id: cord-304277-aek6mvdw
type: TAXON
entity:
  human metapneumovirus A B rhinovirus respiratory syncytial virus A B adenovirus enterovirus human parechovirus bocavirus


id: cord-016990-ot1wi3xi
type: CELL_TYPE
entity:
  periarteriolar white pulp lymph nodal paracortical zones hepatic portal triads and peripheral blood Fig 11 3D E


id: cord-323742-rt0g0ufe
type: GGP
entity:
  PhtD 0 59 95 CI 0 42 0 76 for Ply and 0 66 95 CI 0 50 0 81 for StkpC Acute IgG ALS was higher in children with pneumococcal pneumonia than with non pneumococcal pneumonia for all five pneumococcal proteins Figure 4 Acute IgG ALS to pneumococcal proteins discriminated


id: cord-323742-rt0g0ufe
type: DISEASE
entity:
  influenza B RSV A RSV B parainfluenza 1 4 coronaviruses 229E NL63 OC43 HKU1 human metapneumovirus rhinovirus enterovirus adenovirus human bocavirus Chlamydophila


# bib

id: cord-000237-mticfoic
author: Guan, Xuhua
date: 2010-07-23
txt: ./txt/cord-000237-mticfoic.txt
cache: ./cache/cord-000237-mticfoic.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909231/
doi: 10.1371/journal.pone.0011721
summary:
  We conducted a systematic review of the Chinese-and Englishlanguage literature in order to describe pneumonia incidence and mortality in China, evaluate the quality of published studies, and identify gaps in the literature that can be addressed through surveillance and epidemiologic research projects in the future. Based on published recommendations for measuring quality of epidemiologic studies of pneumonia [15] , we assessed quality using the following six criteria: (1) geographic location was reported, (2) study was conducted for a period of at least one year or multiples of one year to account for seasonal factors, (3) site of case detection or surveillance location was reported, (4) age and population size of cohort of at least 50 cases were reported, (5) quality assurance and monitoring methods were employed to assure that data was complete and high quality, and (6) a clearly defined case definition (e.g., not based solely on clinical diagnosis) was used and reported. In children aged ,5 years, the highest mortality rates were reported by four studies that were each conducted in multiple regions throughout mainland China (9.55±14.40 deaths from pneumonia per 1,000 live births; Table S3 ) [21, 23, 38, 48] .

title:
  Pneumonia Incidence and Mortality in Mainland China: Systematic Review of Chinese and English Literature, 1985–2008

abstract:
  BACKGROUND: Pneumonia is a leading infectious disease killer worldwide, yet the burden in China is not well understood as much of the data is published in the non-English literature. METHODOLOGY/PRINCIPAL FINDINGS: We systematically reviewed the Chinese- and English-language literature for studies with primary data on pneumonia incidence and mortality in mainland China. Between 1985 and 2008, 37 studies met the inclusion criteria. The quality of the studies was highly variable. For children <5 years, incidence ranged from 0.06–0.27 episodes per person-year and mortality ranged from 184–1,223 deaths per 100,000 population. Overall incidence and mortality were stable or decreased over the study period and were higher in rural compared to urban areas. CONCLUSIONS/SIGNIFICANCE: Pneumonia continues to be a major public health challenge in young children in China, and estimates of pneumonia incidence and mortality vary widely. Reliable surveillance data and new prevention efforts may be needed to achieve and document additional declines, especially in areas with higher incidence and mortality such as rural settings.


id: cord-000286-3njrml7x
author: Facciolongo, Nicola
date: 2010-11-11
txt: ./txt/cord-000286-3njrml7x.txt
cache: ./cache/cord-000286-3njrml7x.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993722/
doi: 10.1186/1752-1947-4-360
summary:
  title: Eosinophilic infiltrate in a patient with severe Legionella pneumonia as a levofloxacin-related complication: a case report This report concerns the case of a man with Legionella pneumonia that evolved into ARDS and then became complicated with eosinophilic infiltration as an effect of treatment with levofloxacin. There are some reports in the literature regarding the possibility of development of eosinophilic pneumonia during the course of levofloxacin therapy [4] ; moreover, it was the drug administered to our patient for the greatest number of days (21 in total). (2) The BAL on the 22nd day, as some other authors have reported, still showed compatibility with ARDS Legionella, [10] while the following BAL showed eosinophilia (28%) compatible with an acute eosinophilic pneumonia [6] , which histological exams confirmed ( Figure 3) . Severe sepsis and acute respiratory distress syndrome from community-acquired Legionella pneumonia: case report

title:
  Eosinophilic infiltrate in a patient with severe Legionella pneumonia as a levofloxacin-related complication: a case report

abstract:
  INTRODUCTION: Legionella pneumonia can appear with different levels of severity and it can often present with complications such as acute respiratory distress syndrome. CASE PRESENTATION: We report the case of a 44-year-old Caucasian man with Legionella pneumonia with successive development of severe acute respiratory distress syndrome. During his stay in intensive care the clinical and radiological situation of the previously observed acute respiratory distress syndrome unexpectedly worsened due to acute pulmonary eosinophilic infiltrate of iatrogenic origin. CONCLUSION: Levofloxacin treatment caused the occurrence of acute eosinophilic infiltrate. Diagnosis was possible following bronchoscopic examination using bronchoaspirate and transbronchial biopsy.


id: cord-000757-bz66g9a0
title: Identification of pneumonia and influenza deaths using the death certificate pipeline
author: Davis, Kailah
date: 2012-05-08
txt: ./txt/cord-000757-bz66g9a0.txt
cache: ./cache/cord-000757-bz66g9a0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444937/
doi: 10.1186/1472-6947-12-37
summary:
  Therefore, the purpose of this study was to demonstrate the feasibility of using a pipeline, composed of a detection rule and a natural language processor, for the real time encoding of death certificates using the identification of pneumonia and influenza cases as an example and demonstrating that its accuracy is comparable to existing methods. Other research groups [18, 19] have demonstrated the feasibility of using mortality data for real time surveillance but all used "free text" search for the string "pneumonia", "flu" or "influenza." As noted earlier, although this method can provide the semi quantitative measurements for disease surveillance purposes, keyword searches can also result in an array of problems that result from complexities of human language such as causal relationships and synonyms [20] . Although, the focus of this study was to use NLP techniques to process death certificates, the description of this system reported in the literature did not show how well coded data from an NLP tool along with predefined rules can detect countable cases for a specific disease or condition.

abstract:
  BACKGROUND: Death records are a rich source of data, which can be used to assist with public surveillance and/or decision support. However, to use this type of data for such purposes it has to be transformed into a coded format to make it computable. Because the cause of death in the certificates is reported as free text, encoding the data is currently the single largest barrier of using death certificates for surveillance. Therefore, the purpose of this study was to demonstrate the feasibility of using a pipeline, composed of a detection rule and a natural language processor, for the real time encoding of death certificates using the identification of pneumonia and influenza cases as an example and demonstrating that its accuracy is comparable to existing methods. RESULTS: A Death Certificates Pipeline (DCP) was developed to automatically code death certificates and identify pneumonia and influenza cases. The pipeline used MetaMap to code death certificates from the Utah Department of Health for the year 2008. The output of MetaMap was then accessed by detection rules which flagged pneumonia and influenza cases based on the Centers of Disease and Control and Prevention (CDC) case definition. The output from the DCP was compared with the current method used by the CDC and with a keyword search. Recall, precision, positive predictive value and F-measure with respect to the CDC method were calculated for the two other methods considered here. The two different techniques compared here with the CDC method showed the following recall/ precision results: DCP: 0.998/0.98 and keyword searching: 0.96/0.96. The F-measure were 0.99 and 0.96 respectively (DCP and keyword searching). Both the keyword and the DCP can run in interactive form with modest computer resources, but DCP showed superior performance. CONCLUSION: The pipeline proposed here for coding death certificates and the detection of cases is feasible and can be extended to other conditions. This method provides an alternative that allows for coding free-text death certificates in real time that may increase its utilization not only in the public health domain but also for biomedical researchers and developers. TRIAL REGISTRATION: This study did not involved any clinical trials.


id: cord-001280-skavefji
author: Choi, Sang-Ho
date: 2014-05-13
txt: ./txt/cord-001280-skavefji.txt
cache: ./cache/cord-001280-skavefji.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019586/
doi: 10.1371/journal.pone.0097346
summary:
  This study investigated the ability of cellular analysis of BAL fluid to differentially diagnose bacterial pneumonia from viral pneumonia in adult patients who are admitted to intensive care unit. Exclusion criteria were as follows: (1) patients in whom the pathogen was not identified, (2) patients in whom BAL fluid analysis was impossible (due to severe neutropenia or clotting of specimen) or not performed, (3) patients with a mixed infection (identification of bacteria and virus), (4) patients who were treated with antimicrobial agents for more than 24 hours before bronchoscopic BAL, (5) patients with invasive pulmonary aspergillosis, (6) patients with mycobacterial infection, and (7) patients with Pneumocystis jirovecii pneumonia. Several authors of the current study previously investigated the diagnostic utility of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in BAL fluid of various patient populations with bilateral lung infiltrates.

title:
  Usefulness of Cellular Analysis of Bronchoalveolar Lavage Fluid for Predicting the Etiology of Pneumonia in Critically Ill Patients

abstract:
  BACKGROUND: The usefulness of bronchoalveolar lavage (BAL) fluid cellular analysis in pneumonia has not been adequately evaluated. This study investigated the ability of cellular analysis of BAL fluid to differentially diagnose bacterial pneumonia from viral pneumonia in adult patients who are admitted to intensive care unit. METHODS: BAL fluid cellular analysis was evaluated in 47 adult patients who underwent bronchoscopic BAL following less than 24 hours of antimicrobial agent exposure. The abilities of BAL fluid total white blood cell (WBC) counts and differential cell counts to differentiate between bacterial and viral pneumonia were evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: Bacterial pneumonia (n = 24) and viral pneumonia (n = 23) were frequently associated with neutrophilic pleocytosis in BAL fluid. BAL fluid median total WBC count (2,815/µL vs. 300/µL, P<0.001) and percentage of neutrophils (80.5% vs. 54.0%, P = 0.02) were significantly higher in the bacterial pneumonia group than in the viral pneumonia group. In ROC curve analysis, BAL fluid total WBC count showed the best discrimination, with an area under the curve of 0.855 (95% CI, 0.750–0.960). BAL fluid total WBC count ≥510/µL had a sensitivity of 83.3%, specificity of 78.3%, positive likelihood ratio (PLR) of 3.83, and negative likelihood ratio (NLR) of 0.21. When analyzed in combination with serum procalcitonin or C-reactive protein, sensitivity was 95.8%, specificity was 95.7%, PLR was 8.63, and NLR was 0.07. BAL fluid total WBC count ≥510/µL was an independent predictor of bacterial pneumonia with an adjusted odds ratio of 13.5 in multiple logistic regression analysis. CONCLUSIONS: Cellular analysis of BAL fluid can aid early differential diagnosis of bacterial pneumonia from viral pneumonia in critically ill patients.


id: cord-001746-pbahviaz
author: Garg, Shikha
date: 2015-08-26
txt: ./txt/cord-001746-pbahviaz.txt
cache: ./cache/cord-001746-pbahviaz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550040/
doi: 10.1186/s12879-015-1004-y
summary:
  Although there is evidence that adult patients with underlying cardiac or pulmonary disease are more likely to develop influenza-associated pneumonia than those without underlying medical conditions [6, 7] , much of the data describing factors associated with influenzaassociated pneumonia among adults comes from case series conducted at single sites and during a limited number of seasons. The following data were collected on patients: demographics, results of laboratory tests for influenza, influenza vaccination status for the current season, underlying medical conditions, bacterial coinfections, CXR data, antiviral treatment, clinical outcomes, and discharge diagnoses. Patients with pneumonia were significantly more likely than patients without pneumonia to reside in a nursing home prior to hospital admission, to have received influenza vaccine, and to have the following underlying medical conditions: chronic lung disease, cardiovascular disease, and immunosuppression.

title:
  Pneumonia among adults hospitalized with laboratory-confirmed seasonal influenza virus infection—United States, 2005–2008

abstract:
  BACKGROUND: Influenza and pneumonia combined are the leading causes of death due to infectious diseases in the United States. We describe factors associated with pneumonia among adults hospitalized with influenza. METHODS: Through the Emerging Infections Program, we identified adults ≥ 18 years, who were hospitalized with laboratory-confirmed influenza during October 2005 through April 2008, and had a chest radiograph (CXR) performed. Pneumonia was defined as the presence of a CXR infiltrate and either an ICD-9-CM code or discharge summary diagnosis of pneumonia. RESULTS: Among 4,765 adults hospitalized with influenza, 1392 (29 %) had pneumonia. In multivariable analysis, factors associated with pneumonia included: age ≥ 75 years, adjusted odds ratio (AOR) 1.27 (95 % confidence interval 1.10–1.46), white race AOR 1.24 (1.03–1.49), nursing home residence AOR 1.37 (1.14–1.66), chronic lung disease AOR 1.37 (1.18–1.59), immunosuppression AOR 1.45 (1.19–1.78), and asthma AOR 0.76 (0.62–0.92). Patients with pneumonia were significantly more likely to require intensive care unit (ICU) admission (27 % vs. 10 %), mechanical ventilation (18 % vs. 5 %), and to die (9 % vs. 2 %). CONCLUSIONS: Pneumonia was present in nearly one-third of adults hospitalized with influenza and was associated with ICU admission and death. Among patients hospitalized with influenza, older patients and those with certain underlying conditions are more likely to have pneumonia. Pneumonia is common among adults hospitalized with influenza and should be evaluated and treated promptly. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-015-1004-y) contains supplementary material, which is available to authorized users.


id: cord-001894-ptuelrqj
title: Polymicrobial intensive care unit-acquired pneumonia: prevalence, microbiology and outcome
author: Ferrer, Miquel
date: 2015-12-23
txt: ./txt/cord-001894-ptuelrqj.txt
cache: ./cache/cord-001894-ptuelrqj.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699341/
doi: 10.1186/s13054-015-1165-5
summary:
  Intensive care unit (ICU)-acquired pneumonia (ICUAP) is the leading infection in critically-ill patients, accounting for prolonged mechanical ventilation and length of stay, and poor outcome [1] [2] [3] [4] . Recent investigations have shown that multi-drug-resistant (MDR) or high-risk pathogens have been isolated in around half of patients with an episode of ventilator-associated pneumonia (VAP) or ICUAP confirmed microbiologically [9, 10] . The association between polymicrobial or monomicrobial etiology and patients'' outcomes was adjusted for variables potentially related to mortality, such as age, APACHE-II and SAPS scores at ICU admission, SOFA score, CPIS and arterial partial pressure of oxygen/inspired oxygen fraction (PaO 2 /FiO 2 ) ratio at onset of pneumonia, VAP or NV-ICUAP, and unilateral or bilateral chest x-ray infiltrates.

abstract:
  BACKGROUND: Microbial aetiology of intensive care unit (ICU)-acquired pneumonia (ICUAP) determines antibiotic treatment and outcomes. The impact of polymicrobial ICUAP is not extensively known. We therefore investigated the characteristics and outcomes of polymicrobial aetiology of ICUAP. METHOD: Patients with ICUAP confirmed microbiologically were prospectively compared according to identification of 1 (monomicrobial) or more (polymicrobial) potentially-pathogenic microorganisms. Microbes usually considered as non-pathogenic were not considered for the etiologic diagnosis. We assessed clinical characteristics, microbiology, inflammatory biomarkers and outcome variables. RESULTS: Among 441 consecutive patients with ICUAP, 256 (58 %) had microbiologic confirmation, and 41 (16 %) of them polymicrobial pneumonia. Methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, and several Enterobacteriaceae were more frequent in polymicrobial pneumonia. Multi-drug and extensive-drug resistance was similarly frequent in both groups. Compared with monomicrobial, patients with polymicrobial pneumonia had less frequently chronic heart disease (6, 15 % vs. 71, 33 %, p = 0.019), and more frequently pleural effusion (18, 50 %, vs. 54, 25 %, p = 0.008), without any other significant difference. Appropriate empiric antimicrobial treatment was similarly frequent in the monomicrobial (185, 86 %) and the polymicrobial group (39, 95 %), as were the initial response to the empiric treatment, length of stay and mortality. Systemic inflammatory response was similar comparing monomicrobial with polymicrobial ICUAP. CONCLUSION: The aetiology of ICUAP confirmed microbiologically was polymicrobial in 16 % cases. Pleural effusion and absence of chronic heart disease are associated with polymicrobial pneumonia. When empiric treatment is frequently appropriate, polymicrobial aetiology does not influence the outcome of ICUAP.


id: cord-002227-x1ddi8wg
author: Li, Wanli
date: 2016-07-29
txt: ./txt/cord-002227-x1ddi8wg.txt
cache: ./cache/cord-002227-x1ddi8wg.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038202/
doi: 10.3892/etm.2016.3558
summary:
  In the process of nursing children with severe pneumonia, intensive care was provided, including condition assessment and diagnosis, close observation of disease, keeping the airway unblocked, rational oxygen therapy, prevention and treatment of respiratory and circulatory failure, support of vital organs, complications, and health education. As a result, severe pneumonia produces corresponding clinical symptoms, such as respiratory failure, heart failure, toxic encephalopathy and intestinal paralysis, which endanger the lives of children in the short term, and is the first cause of death of pediatric inpatients (6, 7) . Type I respiratory failure also refers to the coexistence of hypoxemia and hypercapnia, impairment of ventilatory function and gas exchange functions, severe lung lesion, obstruction of trachea and bronchia caused by sticky secretions, blood change of PaO 2 <60 mmHg, and PaCO 2 >50 mmHg. Main clinical manifestations of children patients with type I pneumonia with respiratory failure include, poor mental state or dysphoria, polypnea, cyanosis of lips, dyspnea, nasal flaring and three depression signs.

title:
  Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports

abstract:
  Pneumonia refers to lung inflammation caused by different pathogens or other factors, and is a common pediatric disease occurring in infants and young children. It is closely related to the anatomical and physiological characteristics of infants and young children and is more frequent during winter and spring, or sudden changes in temperature. Pneumonia is a serious disease that poses a threat to children's health and its morbidity and mortality rank first, accounting for 24.5–65.2% of pediatric inpatients. Due to juvenile age, severe illness and rapid changes, children often suffer acute heart failure, respiratory failure and even toxic encephalopathy at the same time. The concurrence in different stages of the process of emergency treatment tends to relapse, which directly places the lives of these children at risk. Severe pneumonia constitutes one of the main causes of infant mortality. In the process of nursing children with severe pneumonia, intensive care was provided, including condition assessment and diagnosis, close observation of disease, keeping the airway unblocked, rational oxygen therapy, prevention and treatment of respiratory and circulatory failure, support of vital organs, complications, and health education. The inflammatory response was proactively controlled, to prevent suffocation and reduce mortality. In summary, positive and effective nursing can promote the rehabilitation of children patients, which can be reinforced with adequate communication with the parents and/or caretakers.


id: cord-003291-zuqx6ksy
author: Tang, Pingping
date: 2018-11-03
txt: ./txt/cord-003291-zuqx6ksy.txt
cache: ./cache/cord-003291-zuqx6ksy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215647/
doi: 10.1186/s12884-018-2070-0
summary:
  title: Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review METHODS: A retrospective cohort study was conducted with 12 patients who were diagnosed with severe pneumonia complicating pregnancy at Peking Union Medical College Hospital between January 2010 and June 2017. High incidences of adverse fetal outcomes were observed; thus, termination of the pregnancy is recommended for patients in their third trimester when respiratory function deteriorates progressively. Several physiological and immunological changes that are experienced during pregnancy, such as altered T lymphocyte immunity, increased oxygen consumption, decreased functional residual capacity, decreased chest compliance, and increased risk of aspiration, may predispose pregnant women to a more severe course of pneumonia, which may result in greater maternal and fetal morbidity and mortality [1, 4] . The patients'' clinical data including symptoms at presentation, laboratory tests, and treatment strategies were reviewed carefully to screen for severe pneumonia.

title:
  Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review

abstract:
  BACKGROUND: Pneumonia during pregnancy has been proven to be associated with increased maternal and fetal morbidity and mortality. The management of severe pneumonia in gravid patients is even more challenging. Thus, we summarized the characteristics and pregnancy outcomes of these patients and explored the probable risk factors and predictive factors for pneumonia during pregnancy and the appropriate timing of delivery in severe pneumonia patients. METHODS: A retrospective cohort study was conducted with 12 patients who were diagnosed with severe pneumonia complicating pregnancy at Peking Union Medical College Hospital between January 2010 and June 2017. The clinical features, treatment strategies, and pregnancy outcomes were collected from medical records and telephone calls. RESULTS: All 12 patients were in their late second or third trimester. The patients had a higher prevalence of anemia (50%) and preeclampsia (25%) than ordinary pregnant women. Delayed diagnoses were not uncommon. Two mothers died in our series, resulting in a mortality rate of 17%. Two intrauterine deaths were observed. Elective delivery was not performed in any of the four patients in their second trimester. Six of the seven patients who presented after 28 weeks of gestation and had live fetuses underwent emergency deliveries. Preterm births (6/7) and cesarean sections (5/7) were the two leading adverse outcomes in newborns. CONCLUSIONS: Anemia, advanced gestational age, and preeclampsia might be associated with the severity of pneumonia. Chest radiographs should be taken as soon as pneumonia is highly suspected to facilitate an early diagnosis. High incidences of adverse fetal outcomes were observed; thus, termination of the pregnancy is recommended for patients in their third trimester when respiratory function deteriorates progressively. However, it might be reasonable to continue pregnancy for those in their first or second trimester.


id: cord-004464-nml9kqiu
author: Lhommet, Claire
date: 2020-03-06
txt: ./txt/cord-004464-nml9kqiu.txt
cache: ./cache/cord-004464-nml9kqiu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060632/
doi: 10.1186/s12890-020-1089-y
summary:
  title: Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation? Whether the etiology of CAP is viral or bacterial should be determined based on the patient interview, clinical symptoms and signs, biological findings and radiological data from the very first hours of the patient''s presentation (a time when microbiological findings are typically not yet available). The aim of our study was to evaluate and compare the abilities of experienced physicians and a data-driven approach to answer this simple question within the first hours of a patient''s admission to the ICU for CAP: is it a viral or a bacterial pneumonia? Step 2: clinician and data-driven predictions of microbial etiology Clinicians and a mathematical algorithm were tasked with predicting the microbial etiology of pneumonia cases based on all clinical (43 items), and biological or radiological (17 items) information available in the first 3-h period after admission except for any microbiological findings (Supplementary Table 1 ).

title:
  Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation?

abstract:
  BACKGROUND: Community-acquired pneumonia (CAP) requires urgent and specific antimicrobial therapy. However, the causal pathogen is typically unknown at the point when anti-infective therapeutics must be initiated. Physicians synthesize information from diverse data streams to make appropriate decisions. Artificial intelligence (AI) excels at finding complex relationships in large volumes of data. We aimed to evaluate the abilities of experienced physicians and AI to answer this question at patient admission: is it a viral or a bacterial pneumonia? METHODS: We included patients hospitalized for CAP and recorded all data available in the first 3-h period of care (clinical, biological and radiological information). For this proof-of-concept investigation, we decided to study only CAP caused by a singular and identified pathogen. We built a machine learning model prediction using all collected data. Finally, an independent validation set of samples was used to test the pathogen prediction performance of: (i) a panel of three experts and (ii) the AI algorithm. Both were blinded regarding the final microbial diagnosis. Positive likelihood ratio (LR) values > 10 and negative LR values < 0.1 were considered clinically relevant. RESULTS: We included 153 patients with CAP (70.6% men; 62 [51–73] years old; mean SAPSII, 37 [27–47]), 37% had viral pneumonia, 24% had bacterial pneumonia, 20% had a co-infection and 19% had no identified respiratory pathogen. We performed the analysis on 93 patients as co-pathogen and no-pathogen cases were excluded. The discriminant abilities of the AI approach were low to moderate (LR+ = 2.12 for viral and 6.29 for bacterial pneumonia), and the discriminant abilities of the experts were very low to low (LR+ = 3.81 for viral and 1.89 for bacterial pneumonia). CONCLUSION: Neither experts nor an AI algorithm can predict the microbial etiology of CAP within the first hours of hospitalization when there is an urgent need to define the anti-infective therapeutic strategy.


id: cord-005692-n4vxazst
title: Ventilator-associated pneumonia in adults: a narrative review
author: Papazian, Laurent
date: 2020-03-10
txt: ./txt/cord-005692-n4vxazst.txt
cache: ./cache/cord-005692-n4vxazst.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095206/
doi: 10.1007/s00134-020-05980-0
summary:
  Empirical treatment takes into account the underlying disease and its severity, the presence of risk factors for multiple-drug-resistant pathogens (antibiotic therapy in the previous 90 days, hospital stay > 5 days, septic shock at VAP onset, ARDS prior to VAP onset, acute renal replacement therapy prior to VAP onset, previous colonization with MDR pathogen) and local pattern of antimicrobial susceptibility. While lower respiratory tract surveillance cultures may help to predict the involvement of MDR microorganisms in patients that develop VAP and thus decrease unnecessary broad-spectrum antibiotics use, there are no clear data that this strategy improves clinical outcomes or lowers costs [89, 90] . Subglottic secretion drainage has repeatedly been associated with lower VAP rates in both individual randomized trials and meta-analyses but does not appear to shorten the time to extubation, ICU length-of-stay, prevent ventilator-associated events, or lower mortality rates [94] . Effect of oropharyngeal povidone-iodine preventive oral care on ventilator-associated pneumonia in severely brain-injured or cerebral hemorrhage patients: a multicenter, randomized controlled trial

abstract:
  Ventilator-associated pneumonia (VAP) is one of the most frequent ICU-acquired infections. Reported incidences vary widely from 5 to 40% depending on the setting and diagnostic criteria. VAP is associated with prolonged duration of mechanical ventilation and ICU stay. The estimated attributable mortality of VAP is around 10%, with higher mortality rates in surgical ICU patients and in patients with mid-range severity scores at admission. Microbiological confirmation of infection is strongly encouraged. Which sampling method to use is still a matter of controversy. Emerging microbiological tools will likely modify our routine approach to diagnosing and treating VAP in the next future. Prevention of VAP is based on minimizing the exposure to mechanical ventilation and encouraging early liberation. Bundles that combine multiple prevention strategies may improve outcomes, but large randomized trials are needed to confirm this. Treatment should be limited to 7 days in the vast majority of the cases. Patients should be reassessed daily to confirm ongoing suspicion of disease, antibiotics should be narrowed as soon as antibiotic susceptibility results are available, and clinicians should consider stopping antibiotics if cultures are negative.


id: cord-007564-ljqrxjvv
author: Leroy, O.
date: 2006-11-13
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119138/
doi: 10.1016/j.medmal.2006.07.008
title:
  04 – Apport des explorations microbiologiques au diagnostic des infections des voies respiratoires basses

abstract:
  The diagnosis of community-acquired pneumonia is usually based on clinical and radiological criteria. The identification of a causative organism is not required for the diagnosis. Although numerous microbiological techniques are available, their sensitivity and specificity are not high enough to guide first-line antimicrobial therapy. Consequently, this treatment remains most often empiric. If the causative organism is identified, the antimicrobial treatment is adapted. Sputum analysis may be proposed as a diagnostic tool for patients with an acute exacerbation of chronic obstructive pulmonary disease, in specific cases (prior antibiotherapy, hospitalization, failure of the empiric antimicrobial treatment).


id: cord-007575-5ekgabx5
author: Luby, James P.
date: 2016-01-14
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119385/
doi: 10.1097/00000441-198707000-00007
title:
  Southwestern Internal Medicine Conference: Pneumonias in Adults Due to Mycoplasma, Chlamydiae, and Viruses

abstract:
  Pneumonias in adults due to mycoplasma, chlamydiae, and viruses are a common clinical problem. These microorganisms contribute to the etiologies in 6–35% of all cases of pneumonia and are the sole pathogens in 1–17% of hospitalized cases. Important trends and developments in the field include (1) the emergence of a Chlamydia psittaci strain (TWAR) that is passaged from human to human, causes a mycoplasma-like illness, and that is relatively resistant to erythromycin, (2) the recognition of respiratory syncytial virus as a pathogen in nursing home outbreaks and in immunosuppressed adults, the continuing high lethality of fully developed influenza pneumonia, (4) the efficacy of acyclovir and adenine arabinoside in limiting the complications of varicella-zoster virus infections, and (5) the increasing frequency of pneumonia caused by cytomegalovirus and the severity of this disorder in highly immunosuppressed patients. Developments in the rapid diagnosis and therapy of respiratory syncytial virus infections with an aerosolized antiviral drug in children may pave the way for comparable advances in difficult pneumonias in adult patients.


id: cord-007797-toam6r5y
title: Imaging of Pulmonary Infection
author: Franquet, Tomás
date: 2019-02-20
txt: ./txt/cord-007797-toam6r5y.txt
cache: ./cache/cord-007797-toam6r5y.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123565/
doi: 10.1007/978-3-030-11149-6_7
summary:
  Community acquired pneumonia refers to an acute infection of the lung in patients who did not meet any of the criteria for HCAP, presenting select clinical features (e.g., cough, fever, sputum production, and pleuritic chest pain) and accompanied by an acute infiltrate on a chest radiograph. Chest radiographs are of limited value in predicting the causative pathogen but are of good use to determine the extent of pneumonia and to detect complications (i.e., cavitation, abscess formation, pneumothorax, pleural effusion), to detect additional or alternative diagnoses, and, in some cases, to guide invasive diagnostic procedures. Risk factors for the development of staphylococcal pneumonia include underlying pulmonary disease (e.g., COPD, carcinoma), chronic illnesses (e.g., diabetes mellitus, renal failure), or viral infection. The lower lobes contrast-enhanced CT image shows a mixed opacity of consolidation (arrow) and ground-glass opacity (small arrows) consistent with lobar pneumonia tend to be affected, and the radiographic pattern is similar to that seen with S.

abstract:
  The spectrum of organisms known to cause respiratory infections is broad and constantly increasing as new pathogens are identified, and an increasing number of patients have impaired immunity due to disease or medications. The radiographic manifestations of a given organism may be variable depending on the immunologic status of the patient and the presence of pre- or coexisting lung disease. Moreover, the clinical data and radiographic findings often fail to lead to a definitive diagnosis of pneumonia because there are an extensive number of noninfectious processes associated with febrile pneumonitis. This chapter describes and illustrates the characteristic imaging manifestations of the most common community- acquired pneumonias, nosocomial pneumonias, and the various infections seen in both immunocompetent and immunocompromised patients.


id: cord-008695-y7il3hyb
author: nan
date: 2007-01-25
txt: ./txt/cord-008695-y7il3hyb.txt
cache: ./cache/cord-008695-y7il3hyb.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133687/
doi: 10.1016/s0163-4453(07)60001-2
abstract: nan
summary:
  Children may be considered at increased risk of complications if they have cough and fever (or influenza-like illness) and temperature >38.5ºC, plus either chronic co-morbid disease or one of following features: breathing difficulties severe earache vomiting >24 hours drowsiness These patients should be offered an antibiotic as well as oseltamivir (in those >1 year of age) and advice on antipyretics and fluids. Children may be considered at increased risk of complications if they have: Cough and fever (or influenza-like illness) and temperature >38.5ºC and either (i) chronic co-morbid disease (see Appendix 2) or (ii) one of the following features • Breathing difficulties • Severe earache • Vomiting > 24 hours • Drowsiness These patients should be offered an antibiotic as well as oseltamivir (in those over one year of age) and advice on antipyretics and fluids.

title:
  Pandemic Flu: Clinical management of patients with an influenza-like illness during an influenza pandemic


id: cord-009278-98ebmd33
title: Burden of Community-Acquired Pneumonia and Unmet Clinical Needs
author: Ferreira-Coimbra, João
date: 2020-02-18
txt: ./txt/cord-009278-98ebmd33.txt
cache: ./cache/cord-009278-98ebmd33.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140754/
doi: 10.1007/s12325-020-01248-7
summary:
  Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Recently, Nature Medicine published the first use of phages to treat a multidrug-resistant (MDR) microorganism [3] and Lancet Infectious Diseases reported the first use of pneumolysin in severe CAP treatment added to standard of care in a phase II trial [4] . Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America Disease burden and etiologic distribution of community-acquired pneumonia in adults: evolving epidemiology in the era of pneumococcal conjugate vaccines Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial

abstract:
  Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is also high in the elderly. Even after a CAP episode, higher risk of death remains during a long period, a risk mainly driven by inflammation and patient-related co-morbidities. CAP microbiology has been altered by new molecular diagnostic tests that have turned viruses into the most identified pathogens, notwithstanding uncertainties about the specific role of each virus in CAP pathogenesis. Pneumococcal vaccines also impacted CAP etiology and thus had changed Streptococcus pneumoniae circulating serotypes. Pathogens from specific regions should also be kept in mind when treating CAP. New antibiotics for CAP treatment were not tested in severely ill patients and focused on multidrug-resistant pathogens that are unrelated to CAP, limiting their general use and indications for intensive care unit (ICU) patients. Similarly, CAP management could be personalized through the use of adjunctive therapies that showed outcome improvements in particular patient groups. Although pneumococcal vaccination was only convincingly shown to reduce invasive pneumococcal disease, with a less significant effect in pneumococcal CAP, it remains the best therapeutic intervention to prevent bacterial CAP. Further research in CAP is needed to reduce its population impact and improve individual outcomes.


id: cord-009667-8r8j0h08
author: Cao, Bin
date: 2017-09-26
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162259/
doi: 10.1111/crj.12674
title:
  Diagnosis and treatment of community‐acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association

abstract:
  Community‐acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence. Corresponding recommendations are provided appropriately based on the level of evidence. This updated guideline covers comprehensive topics on CAP, including aetiology, antimicrobial resistance profile, diagnosis, empirical and targeted treatments, adjunctive and supportive therapies, as well as prophylaxis. The recommendations may help clinicians manage CAP patients more effectively and efficiently. CAP in pediatric patients and immunocompromised adults is beyond the scope of this guideline. This guideline is only applicable for the immunocompetent CAP patients aged 18 years and older. The recommendations on selection of antimicrobial agents and the dosing regimens are not mandatory. The clinicians are recommended to prescribe and adjust antimicrobial therapies primarily based on their local etiological profile and results of susceptibility testing, with reference to this guideline.


id: cord-010018-gl8uuqej
author: Del Borrello, Giovanni
date: 2019-12-10
txt: ./txt/cord-010018-gl8uuqej.txt
cache: ./cache/cord-010018-gl8uuqej.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168041/
doi: 10.1002/ppul.24602
summary:
  3, 4 Although epidemiological research has repeatedly pointed out that the large majority of lower respiratory infection in pediatric patients are caused by viruses, 2 physicians often lack the tools to reliably discriminate between bacterial and viral etiology [5] [6] [7] and a large percentage of children presenting with respiratory symptoms and fever are ultimately administered antibiotics. To increase the specificity of our findings and reduce the role of confounding variables, three exclusion criteria were strictly applied, concerning: infants (ie, children under 1 year of age), to avoid any diagnostic overlap between pneumonia and bronchiolitis; children with a previous diagnosis of chronic disease (HIV, asthma, immunodeficiency, CHD), to reduce the pathophysiological heterogeneity between CAP cases; and children given any oral or injected antibiotic therapy in the 48 hours preceding enrollment, to avoid cases of partially treated pneumonia, as the related pathophysiological profile differs from that of a lung infection devoid of any treatment.

title:
  New insights into pediatric community‐acquired pneumonia gained from untargeted metabolomics: A preliminary study

abstract:
  BACKGROUND: Available diagnostics often fail to distinguish viral from bacterial causes of pediatric community‐acquired pneumonia (pCAP). Metabolomics, which aims at characterizing diseases based on their metabolic signatures, has been applied to expand pathophysiological understanding of many diseases. In this exploratory study, we used the untargeted metabolomic analysis to shed new light on the etiology of pCAP. METHODS: Liquid chromatography coupled with mass spectrometry was used to quantify the metabolite content of urine samples collected from children hospitalized for CAP of pneumococcal or viral etiology, ascertained using a conservative algorithm combining microbiological and biochemical data. RESULTS: Fifty‐nine children with CAP were enrolled over 16 months. Pneumococcal and viral cases were distinguished by means of a multivariate model based on 93 metabolites, 20 of which were identified and considered as putative biomarkers. Among these, six metabolites belonged to the adrenal steroid synthesis and degradation pathway. CONCLUSIONS: This preliminary study suggests that viral and pneumococcal pneumonia differently affect the systemic metabolome, with a stronger disruption of the adrenal steroid pathway in pneumococcal pneumonia. This finding may lead to the discovery of novel diagnostic biomarkers and bring us closer to personalized therapy for pCAP.


id: cord-015763-5lx179pa
author: Thellier, D.
date: 2014-09-23
txt: ./txt/cord-015763-5lx179pa.txt
cache: ./cache/cord-015763-5lx179pa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117809/
doi: 10.1007/s13546-014-0923-8
summary:
  Keywords Severe community acquired pneumonia · Microbial diagnosis La pneumonie communautaire grave (PCG) est la première cause de sepsis sévère et de choc septique rencontrée aux urgences [1] . Ainsi, puisque les pathogènes responsables et l''antibiothérapie à instaurer sont connus, l''utilité de réaliser des prélèvements microbiologiques systématiques chez tous les patients admis aux urgences pour une pneumonie communautaire peut se discuter. Toutefois, cette relation entre la gravité de l''infection et la fréquence de positivité de l''hémoculture lorsqu''elle est appréciée non plus par le lieu d''admission du patient mais par un élément objectif tel que le Pneumonia Severity Index (PSI, score de Fine) ou le CURB-65 apparaît plus difficile à établir, tant les études sur le sujet rapportent des résultats discordants. Ces données ne doivent pas toutefois faire perdre de vue que les pneumonies ayant une étiologie pluri microbienne dans plus de 10 % des cas il n''est peutêtre pas raisonnable de focaliser l''antibiothérapie uniquement sur le pneumocoque en cas de test positif.

title:
  Quels prélèvements aux urgences pour le diagnostic microbiologique d’une infection pulmonaire communautaire grave du sujet immunocompétent ?

abstract:
  Current diagnostic methods allow microbial identification in 50% of patients admitted with severe community-acquired pneumonia (CAP). Guidelines derived from epidemiological data help physicians to start empirical antimicrobial therapy. Definitive microbial diagnosis is useful to guide further pathogen-directed therapy. Blood cultures, cultures of respiratory specimens and urine antigen tests are recommended to determine the causative bacterial pathogen. Positive blood cultures range from 15 to 25% of CAP patients according to severity. Whether sputum specimens represent or not lower respiratory secretions determines its accuracy in CAP microbial diagnosis. In intubated patients, endotracheal aspirates are often of interest. Detection of positive pneumococcal or legionella urinary antigen is often associated with CAP severity. The sensitivity of this test is not decreased in patients who have received antibiotics prior to sampling. Viral pneumonia account for 10 to 40% of severe CAP. Nasal swabs are recommended for influenza identification using polymerase chain reaction (PCR) in order to deliver oseltamivir treatment. In the emergency department, atypical pneumonia serology is less useful than respiratory specimens obtained using fiberoptic bronchoscopy. Serum PCR to diagnose bacterial CAP is not superior to the other usual methods.


id: cord-016498-j72vrvqf
title: Issues in Community-Acquired Pneumonia
author: Fong, I. W.
date: 2020-03-07
txt: ./txt/cord-016498-j72vrvqf.txt
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extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120789/
doi: 10.1007/978-3-030-36966-8_3
summary:
  In a recent study of 70 children <5 years of age hospitalized for CAP without an identifiable etiology and 90 asymptomatic controls, metagenomics [next-generation sequencing] and pan-viral PCR were able to identify a putative pathogen in 34% of unidentifiable cases from nasopharyngeal and oropharyngeal swabs [18] . More recently in Britain, 325 adult patients with confirmed pneumonia admitted to two tertiary-care hospitals had cultures and comprehensive molecular testing [multiplex real-time PCR for 26 respiratory viruses and bacteria] from sputum [96%] and endotracheal aspirate [4% or 13 cases] [32] . Incidence of respiratory viral infections detected by PCR and real-time PCR in adult patients with community-acquired pneumonia: a meta-analysis Severe thinness is associated with mortality in patients with community-acquired pneumonia: a prospective observational study Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial

abstract:
  Pneumonia is one of the most commonly diagnosed infectious diseases and is the third most frequent cause of death worldwide. Accurate statistics of community-acquired pneumonia incidence globally or in countries of various regions are lacking. Although the clinical diagnosis of pneumonia is not difficult, the etiology diagnosis to guide targeted specific antimicrobial therapy still poses a challenge even with novel molecular methods. This has led to different approaches and guidelines for the empiric treatment of community-acquired pneumonia, often with broad-spectrum antimicrobial agents which may play a role in fostering the worldwide development of antibiotic resistant bacteria. Severe community-acquired pneumonia, seen mainly at the extremes of age and in persons with chronic underlying diseases, is associated with high mortality of 20–40%. Pneumonia severity tools, such as CURB-65, have been developed over the past decade to assist emergency department physicians to recognize, admit, and implement rapid antimicrobial therapy in severely ill patients. The evidence for the beneficial effects of these tools will be reviewed in this chapter. Issues in the management of severe community-acquired pneumonia that are discussed include: combination with newer macrolides [irrespective of microbial etiology], value of adjunctive therapy such as corticosteroids and statins.


id: cord-016521-ouwwkxox
title: Ventilator-Associated Pneumonia and Other Complications
author: Stevens, Jennifer P.
date: 2016-07-21
txt: ./txt/cord-016521-ouwwkxox.txt
cache: ./cache/cord-016521-ouwwkxox.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120823/
doi: 10.1007/978-3-319-43341-7_29
summary:
  Ventilator-associated pneumonia occurs in patients who have been intubated for two to three days with significant exposure to hospital-acquired organisms. Patients with ventilator-associated pneumonia should have the duration of antimicrobial therapy guided by type of organism. Other studies have employed the Clinical Pulmonary Infection Score (CPIS) with a cut-off of 6 as a noninvasive method of identifying patients with VAP, using autopsy findings of pneumonia as the gold standard (Table 29 .1) [18] . While clinical suspicion and identification of ventilator-associated pneumonia should remain high, significant controversy has revolved around establishing a reliable epidemiological surveillance definition. Comparison of 8 vs 15 days of antibiotic therapy for ventilatorassociated pneumonia in adults: a randomized trial Randomized trial of combination versus monotherapy for the empiric treatment of suspected ventilator-associated pneumonia Alternative case definitions of ventilator-associated pneumonia identify different patients in a surgical intensive care unit Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial

abstract:
  Ventilator-associated pneumonia occurs in patients who have been intubated for two to three days with significant exposure to hospital-acquired organisms. Treatment should be initiated rapidly and cover P. aeruginosa, Escheriochia coli, Klebsiella pneumonia, and Acinetobacter species as well as methicillin-resistant S. aureus. Within 72 h or with the availability of culture results, antibiotics should be narrowed. Active research is on-going to identify patients at risk for ventilator-associated complications and to minimize the likelihood of infection in these patients.


id: cord-016659-26zz8kaw
title: Influenza
author: Chen, Feng
date: 2016-06-23
txt: ./txt/cord-016659-26zz8kaw.txt
cache: ./cache/cord-016659-26zz8kaw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121016/
doi: 10.1007/978-94-024-0908-6_8
summary:
  Chest X-ray demonstrates mainly interstitial pneumonia and bronchial pneumonia, initially with poorly defined thickening of the lung markings, predominantly both lower lung field significantly; increased density of the lung markings resembling to GGO. Chest X-ray demonstrates primary influenza virus pneumonia mainly as interstitial pneumonia and bronchial pneumonia, early with poorly defined but enhanced lung markings, predominantly in bilateral lower lung fields. Chest X-ray demonstrates primary influenza virus pneumonia as interstitial pneumonia and bronchial pneumonia, with initial radiological signs of enhanced but poorly defined lung markings, predominantly in bilateral lower lungs. CT scan demonstrates uniform shaped consolidations with lobar distribution, with air bronchogram inside, and poorly defined nodular and patches of opacity in different sizes along bronchical bundle as well as lobular atelectasis or focal emphysema. CT scan demonstrates consolidations with uniform shape and lobar distribution, with air bronchogram inside, and poorly defined nodular or patches of opacities of different sizes along bronchial bundles as well as lobular atelectasis and focal emphysema.

abstract:
  Influenza, abbreviated as flu, is an acute respiratory infectious disease caused by influenza virus, which is mainly spread along with droplets with strong infectivity. The influenza virus may cause epidemics or pandemics of influenza and its incidence ranks the first among legally listed infectious diseases. The prevalence of influenza peaks in autumns and winters, with short illness course and self limitation. However, influenza can be complicated by pneumonia or other serious complications that may cause death in populations of infants, young children, the elderly, those with underlying heart and lung disease and those with compromised immunity.


id: cord-016990-ot1wi3xi
title: Viral Infections of the Lung
author: Zaki, Sherif R.
date: 2008
txt: ./txt/cord-016990-ot1wi3xi.txt
cache: ./cache/cord-016990-ot1wi3xi.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121437/
doi: 10.1007/978-0-387-68792-6_11
summary:
  105, [181] [182] [183] [184] [185] [186] [187] [188] [189] [190] [191] The pathology is more prominent in larger bronchi, and inflammation may vary in intensity in individual patients, Viral inclusions cannot be identified by light microscopy (Fig, 11 .8D), Secondary bacterial infections with organisms such as Streptococcus pneumoniae (group A streptococcus [GAS]), Staphylococcus aureus, and Haemophilus influenzae may occur as a complication in about 50% to 75% of fatal cases and make it difficult to recognize the pathologic changes associated with the primary viral infec-445 tion ,190,192,193 The histopathologic features in other organs may include myocarditis, cerebral edema, rhabdomyolysis, and hemophagocytosis (Figs, 11.8H and 11.9E,F), Immunohistochemistry and ISH assays demonstrate that viral antigens and nucleic acids are usually sparse and are primarily seen in the bronchioepithelial cells of larger bronchioles (Figs.

abstract:
  The lungs are among the most vulnerable to microbial assault of all organs in the body. From a contemporary vantage, lower respiratory tract infections are the greatest cause of infection-related mortality in the United States, and rank seventh among all causes of deaths in the United States.2,3 From a global and historic perspective, the scope and scale of lower respiratory tract infection is greater than any other infectious syndrome, and viral pneumonias have proven to be some of the most lethal and dramatic of human diseases. The 1918–1919 influenza pandemic, perhaps the most devastating infectious disease pandemic in recorded history, resulted in an estimated 40 million deaths worldwide, including 700,000 deaths in the U.S.4 The global outbreak of severe acute respiratory syndrome (SARS) during 2003, although considerably smaller in scale, resulted in 8098 cases and 774 deaths5 and is a dramatic contemporary example of the ability of viral pneumonias to rapidly disseminate and cause severe disease in human populations.


id: cord-017016-twwa9djm
title: Aspiration, Bronchial Obstruction, Bronchiectasis, and Related Disorders
author: Tomashefski, Joseph F.
date: 2008
txt: ./txt/cord-017016-twwa9djm.txt
cache: ./cache/cord-017016-twwa9djm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121473/
doi: 10.1007/978-0-387-68792-6_5
summary:
  These occult aspirations may lead to interstitial fibrosis, and perhaps account for the 20% to 54 % incidence of associated and unexplained pulmonary fibrosis in patients with esophageal abnormalities, most commonly hiatal hernia or simple reflux,39,40 The role of reflux in asthma, chronic bronchitis, chronic cough, recurrent pneumonia, cystic fibrosis, and sudden infant death syndrome has been reviewed by Allen et al. 130 In their reviews, Phillips and Rao l3l and Penner and colleagues130 note that similar predisposing factors as those with community-acquired pneumonia, such as aspiration and abscess formation, pertain to this entity, but the location helps distinguish it from the other typical sites of aspiration, When in the upper lobes, it appears to progress through necrotizing pneumonia with thrombosis of arteries (pulmonary and bronchial) and veins, [129] [130] [131] Although not strictly abiding by the foregoing definition (of localization in upper lobe), in one case total unilateral lung gangrene was attributed to hilar vessel involvement following treatment of a massive hilar recurrence of Hodgkin''s disease.

abstract:
  The conducting airways play a pivotal role in the spectrum of pulmonary pathology, not only as conduits for injurious agents to enter the lung, but also as an anatomic compartment that is affected by a diverse array of primary or secondary bronchocentric diseases. This chapter discusses aspiration and bronchial obstruction in detail, with emphasis on the aspiration of toxic, infective, or particulate matter. Lung abscess, a frequent complication of obstruction or aspiration, is also reviewed. Both aspiration and lung abscess are reconsidered within the context of pulmonary infectious disease mainly in Chapter 8 on bacterial infections, and to some extent in the chapters on mycobacterial (Chapter 9), fungal (Chapter 10), and parasitic diseases (Chapter 14).


id: cord-017252-88b3preq
title: Pneumonia
author: Morgan, Carrie I.
date: 2014-02-20
txt: ./txt/cord-017252-88b3preq.txt
cache: ./cache/cord-017252-88b3preq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121765/
doi: 10.1007/978-1-4471-6356-5_6
summary:
  Despite immunizations and public health initiatives, the most common bacterial causes of CAP have remained largely unchanged over the last several decades and include: Streptococcus pneumoniae , Staphylococcus aureus , Haemophilus infl uenzae (including non-typable strains) and Moraxella catarrhalis [ 7 , 8 , 21 , 23 ] . Chest CT is helpful to further evaluate diffi cult cases, particularly immunocompromised children with ill-defi ned infi ltrates on CXR, complex empyema or effusion, or recurrent or chronic pneumonia [ 11 ] . Respiratory failure in an immunocompromised child frequently necessitates a chest CT to better visualize the pattern and extent of disease, aid in diagnosis of the etiology, determine the need for more invasive procedures, and to increase the sensitivity of assessing treatment response [ 11 ] . Etiology of community-acquired pneumonia in hospitalized school-age children: evidence for high prevalence of viral infections

abstract:
  Respiratory diagnoses continue to make up a large number of admissions to the pediatric intensive care unit (PICU), most notably lower respiratory infections including pneumonia. This chapter will focus on pediatric community-acquired pneumonia (CAP), immunocompromised pneumonia, and aspiration pneumonia. The pathogenesis for developing pneumonia varies; it can occur by direct inhalation of infectious particles in the air or aspiration, direct extension from the upper airways, and hematogenous spread. There are multiple levels of defense against pathogen invasion including anatomic barriers, as well as innate and adaptive immunity, which may be compromised in PICU patients. The etiologies of pediatric pneumonia vary depending on age, host condition, and environmental factors like time of year and location. Viruses remain the most common form of lower respiratory tract infection in children, especially in neonates. Community-acquired bacterial pneumonia continues to be most prevalent in younger children as well, most often affecting children less than 5 years of age who are otherwise healthy. Despite immunizations and public health initiatives, the most common bacterial causes of CAP have remained largely unchanged over the last several decades and include: Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae (including non-typable strains) and Moraxella catarrhalis. Pulmonary infection in an immunocompromised host provides a much broader differential and must be aggressively treated without delay. This chapter will also address various imaging modalities and typical findings with pediatric pneumonia. Methods for pathogen identification are broad and range from non-specific markers of illness to invasive techniques for culture. The mainstay of therapy continues to be antibiotics tailored to the patient and presumed etiology; more novel therapies may include corticosteroids or macrolide antibiotics for immune modulation. In those patients with pneumonia with effusion or empyema, drainage therapies with thoracostomy tubes or a VATS procedure may be indicated.


id: cord-017392-ja9b5vy9
title: Adjunctive and Supportive Measures for Community-Acquired Pneumonia
author: Waterer, G. W.
date: 2010-05-20
txt: ./txt/cord-017392-ja9b5vy9.txt
cache: ./cache/cord-017392-ja9b5vy9.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121945/
doi: 10.1007/978-3-540-34406-3_38
summary:
  Randomized, controlled trials have shown corticosteroids reduce mortality in AIDS patients with Pneumocystis carinii pneumonia and significant hypoxia, if instituted at or prior to the onset of anti-pneumocystis therapy [8, 9] . Anecdotally, corticosteroids are frequently used in the setting of severe fungal pneumonia, particularly due to Histoplasmosis [11, 12] , and a small controlled trial of 55 patients supported their use in miliary tuberculosis [13] . Following the success of pre-antibiotic corticosteroids in children with meningitis [14] , Marik and colleagues [15] studied the effect of a single dose of hydrocortisone (10 mg/kg) 30 min prior to antibiotic therapy in a small randomized placebo controlled trial of 30 adult patients with severe CAP (SCAP). Once respiratory failure has ensued, supportive measures such as patient positioning and differential lung ventilation can improve oxygenation at no additional risk in some patients, particularly those with severe unilateral pneumonia.

abstract:
  The widespread introduction of penicillin in the 1940s resulted in a substantial reduction in mortality from community-acquired pneumonia (CAP). However, despite significant advances in medical science, only a small improvement has occurred since, particularly in patients with bacteremic pneumococcal pneumonia [1, 2]. Even modern intensive care has only made a small difference to the mortality in patients with severe pneumonia [3, 4]. While the aging population, increased number of patients with severe co-morbid illnesses, and the human immunodeficiency virus (HIV) epidemic have certainly contributed to the persistently high mortality rate [2, 5, 6], apparently healthy, immunocompetent patients continue to die from CAP. Disturbingly, a recent British Thoracic Society study concluded that no available therapy could substantially reduce the mortality rate from severe CAP in young adults [7].


id: cord-017489-ftz9190a
title: Viruses in the Intensive Care Unit (ICU)
author: Richards, Guy A.
date: 2005
txt: ./txt/cord-017489-ftz9190a.txt
cache: ./cache/cord-017489-ftz9190a.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122063/
doi: 10.1007/0-387-23380-6_3
summary:
  Pneumonia is the most common complication, which occurs in high-risk patients including those with comorbid illness such as cardiovascular or pulmonary disease, diabetes, renal failure, immunosuppression, the elderly, or residents of nursing homes. A study performed in our ICU indicates that corticosteroids may dramatically alter the course of the most severe disease and should be considered in addition to antiviral therapy along with appropriate supportive care in any previously well patient with life threatening varicella pneumonia (42). Patients with HIV or AIDS (acquired immunodeficiency syndrome) who are hospitalized with chickenpox appear to be at high risk for developing varicella pneumonia, which manifests in a similar clinical fashion to that in immunocompetent individuals. In another study of 68 adult patients admitted with measles diagnosed on clinical and serological grounds, 9 required intensive care, six mechanical ventilation for approximately 15 days, and two deaths occurred.

abstract:
  Whereas viruses are not usually considered to be important causes of ICU admission this review has demonstrated this perception to be incorrect. Viruses and their manifestations differ from continent to continent and hemisphere to hemisphere and it is essential that the intensivist be familiar with diagnosis and management of these ubiquitous organisms.


id: cord-018134-k4vdqlgs
title: Pneumonia
author: Eisenberg, Ronald L.
date: 2019-11-01
txt: ./txt/cord-018134-k4vdqlgs.txt
cache: ./cache/cord-018134-k4vdqlgs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122935/
doi: 10.1007/978-3-030-16826-1_6
summary:
  • Gram-negative bacterial pneumonia that is most common in debilitated middle-aged and older men with alcoholism (about two-thirds of cases); high mortality rate • Tends to form a voluminous exudate that produces a homogeneous parenchymal consolidation containing an air bronchogram • Lobar enlargement (especially the right upper) with the characteristic bulging fissure sign (Fig. 6 .17) ○ Bulging fissure sign also in Haemophilus influenzae pneumonia (predominantly in compromised hosts, such as chronic pulmonary disease, immune deficiency, alcoholism, diabetes) (see Fig. e6 .22) • Most frequently result from infectious particles reaching the lung from an infected heart valve (especially the tricuspid), intravenous catheter, or injected debris • Persons at risk include drug abusers, immunocompromised patients, individuals with septal defects, and those with indwelling venous catheters, pacemakers, or prosthetic heart valves • Initially, multiple ill-defined round or wedge-shaped opacities with a swirling pattern that are usually peripheral and tend to involve the lower lobes (starry night sign -mimicking the brush strokes in van Gogh''s painting of that name) • Cavitary pulmonary nodules tend to develop rapidly (1-2 days) 

abstract:
  This chapter describes the imaging patterns of pneumonia (lobar, lobular, interstitial, round) and its complications (abscess, empyema, pneumatocele); bacterial, fungal, and viral infections; and the many manifestations of pulmonary tuberculosis. ELECTRONIC SUPPLEMENTARY MATERIAL : The online version of this chapter (10.1007/978-3-030-16826-1_6) contains supplementary material, which is available to authorized users.


id: cord-018408-ttae193b
title: Pneumonia and Empyema
author: Haddad, Imad Y.
date: 2008-11-15
txt: ./txt/cord-018408-ttae193b.txt
cache: ./cache/cord-018408-ttae193b.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123273/
doi: 10.1007/978-1-84800-925-7_17
abstract: nan
summary:
  Second, patients with genetic or acquired immune defi ciency commonly develop severe pneumonia with opportunistic infections that usually do not infect healthy children. These immunocompromised patients commonly have been given chemo-radiotherapy for cancer or are receiving immune-suppressive agents to prevent rejection episodes following solid organ and hematopoietic stem cell transplantation. The pathogens that commonly produce CAP or VAP, such as Streptococcus pneumoniae, Gram-negative bacilli, and Staphylococcus aureus, are relatively virulent bacteria so that only a small inoculum is required and the aspiration is usually subtle. Bacterial organisms recovered from tracheal secretions obtained through an endotracheal tube may or may not refl ect the causative agent(s) responsible for lower respiratory tract infection. In addition, recipients of solid organ and hematopoietic stem cell transplantation (HSCT) are frequently given life-long treatment with immunosuppressive agents designed to prevent graft rejection or graft-versus-host disease. Early-onset nosocomial pneumonia and VAP are commonly caused by antibiotic-sensitive, community-acquired organisms (e.g., Strep.


id: cord-019089-oots4fe4
title: Infections
author: Laya, Bernard F.
date: 2013-08-31
txt: ./txt/cord-019089-oots4fe4.txt
cache: ./cache/cord-019089-oots4fe4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124155/
doi: 10.1007/978-3-642-35573-8_13
summary:
  Imaging can also help evaluate complications to pneumonia and exclude other causes of respiratory distress including underlying developmental anomalies, foreign body, gastroesophageal reflux disease, and aspiration. Viruses are the most frequent cause of community-acquired pneumonia in infants older than 4 months and in preschool-aged children, with respiratory syncytial virus (RSV) being the most common. For school-aged children (6-16 years old), the incidence of bacterial infections from Streptococcus increases, although viral disease remains the most common cause (Condon 1991 ; Ostapchuk et al. Mycoplasma pneumoniae causes 30 % of lower respiratory tract infections in school-aged children (Condon 1991 ; Donnelly 2001 ) . However, lung parenchymal, pleural, and lymph node infl ammatory abnormalities can be visualized and characterized by MRI in children with pulmonary infections. Swine-origin infl uenza A (H1N1) viral infection in children: initial chest radiographic fi ndings

abstract:
  Lower respiratory tract infection is a very common illness in children and is a significant cause of morbidity and mortality. Clinical signs and symptoms are nonspecific especially in infants and younger children and some even present with nonrespiratory complaints. Infectious agents causing pneumonia is not limited to viruses and bacteria, but it could also be due to Mycoplasma, Mycobacteria, fungi, protozoa, and parasites. Coinfection with two or more microbial agents can also occur. The etiologic agent of lower respiratory infection in a child is often difficult to obtain, but the patient’s age can help narrow the possible cause. Microbiological tests are important but could be difficult to obtain especially in younger children. Various medical imaging modalities not only play an important role as an aid in diagnosis but can also help during and after therapy. Imaging can also help evaluate complications to pneumonia and exclude other causes of respiratory distress including underlying developmental anomalies, foreign body, gastroesophageal reflux disease, and aspiration. In this chapter, the imaging modalities utilized in the detection of pulmonary infections will be discussed. The spectrum of typical imaging findings for various etiologic agents in both immunocompetent and immunocompromised children will be presented.


id: cord-021816-gk8rwyq4
title: Pneumonia
author: Weinberger, Steven E.
date: 2018-02-22
txt: ./txt/cord-021816-gk8rwyq4.txt
cache: ./cache/cord-021816-gk8rwyq4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152063/
doi: 10.1016/b978-0-323-52371-4.00026-x
summary:
  In practice, several factors frequently cause enough impairment of host defenses to contribute to the development of pneumonia, even though individuals with such impairment are not considered "immunosuppressed." Viral upper respiratory tract infections, ethanol abuse, cigarette smoking, heart failure, and preexisting chronic obstructive pulmonary disease (COPD) are a few of the contributing factors. Three major settings in which this organism is seen as a cause of pneumonia are (1) as a secondary complication of respiratory tract infection with the influenza virus; (2) in the hospitalized patient, who often has some impairment of host defense mechanisms and whose oropharynx has been colonized by Staphylococcus; and (3) as a complication of widespread dissemination of staphylococcal organisms through the bloodstream. One issue that has sparked controversy is whether an attempt should be made to identify a specific etiologic agent, using Gram stain and culture, in patients with community-acquired pneumonia, or whether empirical therapy should be used based on the patient''s risk factors, clinical characteristics, and local bacterial resistance patterns.

abstract:
  By nearly any criteria, pneumonia (infection of the pulmonary parenchyma) must be considered one of the most important categories of disease affecting the respiratory system. This chapter is organized primarily as a general discussion of the clinical problem of pneumonia. As appropriate, the focus on individual etiologic agents highlights some characteristic features of each that are particularly useful to the physician. Also covered is a commonly used categorization of pneumonia based on the clinical setting: community-acquired versus nosocomial (hospital-acquired) pneumonia. In current clinical practice, the approach to evaluation and management of these two types of pneumonia is often quite different. The chapter concludes with a brief discussion of several infections that were uncommon or primarily of historical interest until recently, as the threat of bioterrorism emerged. In addition to reviewing inhalational anthrax, the chapter briefly describes two other organisms considered to be of concern as potential weapons of bioterrorism: Yersinia pestis (the cause of plague) and Francisella tularensis (the cause of tularemia).


id: cord-023942-vrs3je1x
title: Acute Pulmonary Infections
author: Powers, Karen S.
date: 2011-12-16
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178869/
doi: 10.1007/978-0-85729-923-9_25
abstract:
  Acute lower respiratory infection is a common cause of morbidity in infants and children, and at times, requires intensive care and mechanical ventilation. Viral bronchiolitis and bacterial pneumonia account for the majority of lower respiratory tract infections that lead to respiratory insufficiency and pediatric intensive care admission. Twenty-seven percent of children who require mechanical ventilation for at least 24 h in pediatric intensive care units are diagnosed with bronchiolitis and 16% have the diagnosis of pneumonia. The median length of time intubated for an acute pulmonary infection leading to respiratory failure is approximately 7 days.


id: cord-026005-f2khcjdy
title: Respiratory System, Mediastinum, and Pleurae
author: López, Alfonso
date: 2017-02-17
txt: ./txt/cord-026005-f2khcjdy.txt
cache: ./cache/cord-026005-f2khcjdy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271179/
doi: 10.1016/b978-0-323-35775-3.00009-6
abstract: nan
summary:
  Microscopic examination of properly collected, stored, and processed samples may reveal many erythrocytes and siderophages in pulmonary hemorrhage or left-sided heart failure; inclusion bodies or syncytial cells in viral pneumonias; increased number of leukocytes in pulmonary inflammation; abundant mucus in asthma or equine recurrent airway obstruction (RAO); the presence of pulmonary pathogens, such as parasites, fungi, and bacteria; or tumor cells in cases of pulmonary neoplasia. The portal of entry for the respiratory form is typically aerogenous, and the disease is generally transient; thus the primary viral-induced lesions in the nasal mucosa and lungs are rarely seen at necropsy unless complicated by secondary bacterial rhinitis, pharyngitis, or bronchopneumonia. Laryngeal edema occurs in pigs with edema disease; in horses with purpura hemorrhagica; in cattle with acute interstitial pneumonia; in cats with systemic anaphylaxis; and in all species as a result of trauma, improper endotracheal tubing, inhalation of irritant gases (e.g., smoke), local inflammation, and animal species is classified as fibrinous, catarrhal, purulent, or granulomatous (Figs.


id: cord-027678-k64whepc
title: Pneumonia
author: Chan, Kai Man
date: 2020-06-22
txt: ./txt/cord-027678-k64whepc.txt
cache: ./cache/cord-027678-k64whepc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310946/
doi: 10.1016/b978-0-7020-4762-6.00036-9
abstract: nan
summary:
  The differential diagnosis and the likely causative organisms can be narrowed by using epidemiological clues, the most important of which are whether the pneumonia is community-acquired or healthcare-associated and whether the patient is immunocompromised. An acute infection of the pulmonary parenchyma that is associated with at least some symptoms of acute infection, accompanied by an acute infiltrate on a chest radiograph (CXR), or auscultatory findings consistent with pneumonia (e.g. altered breath sounds, localised crackles) in a patient not hospitalised or residing in a long-term care facility for ≥14 days prior to the onset of symptoms. Diagnosis may be difficult: the clinical features of pneumonia are non-specific and many non-infectious conditions (e.g. atelectasis, pulmonary embolus, aspiration, heart Table 36 .2 Procedure for obtaining microbiological samples using bronchoscopy and protected specimen brushing and/or bronchoalveolar lavage 35, 49 Infection control


id: cord-028328-5lews3uw
title: COMMUNITY-ACQUIRED PNEUMONIA
author: Haas, Andrew R.
date: 2020-06-22
txt: ./txt/cord-028328-5lews3uw.txt
cache: ./cache/cord-028328-5lews3uw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332233/
doi: 10.1016/b978-1-4160-3291-5.50082-2
abstract: nan
summary:
  With the development of the fl uoroquinolones, effective high levels of lung penetration have been achieved without the development of resistance to treat even those patients with severe pneumonia using a single agent once a day (except those with risk factors for P. Although an antipneumococcal fl uoroquinolone would be equally effective, use of one of these agents in this Chapter 78 Community-Acquired Pneumonia 1085 Practice: Therapy of Infectious Diseases low-risk patient population is likely unnecessary and may promote selection pressure for resistance. Recognition of the clinical syndrome consistent with pneumonia, assessing patients'' risk factors for specifi c organisms, determining their medical comorbidities, and evaluating their severity of illness will allow the clinician to ascertain pertinent pathogens and choose appropriate empirical coverage for CAP. A fi ve-year study of severe community-acquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit


id: cord-029183-3aotgq6m
author: Monard, Céline
date: 2020-07-14
txt: ./txt/cord-029183-3aotgq6m.txt
cache: ./cache/cord-029183-3aotgq6m.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359443/
doi: 10.1186/s13054-020-03114-y
summary:
  We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP). CONCLUSIONS: Use of a syndromic rm-PCR test has the potential to reduce unnecessary antimicrobial exposure and increase the appropriateness of empirical antibiotic therapy in adult patients with pneumonia. Therefore, in pneumonia patients, international guidelines state that an attempt should be made to obtain respiratory samples and recommend to start early empirical treatment while awaiting for the results of culture and antimicrobial susceptibility testing (AST) [3] . The BioFire® FilmArray® Pneumonia Panel (bioMerieux S.A., Marcy-l''Etoile, France) is a novel assay able to simultaneously identify 27 of the most common pathogens involved in lower respiratory tract infections (semi-quantitative results for 11 Gram-negative and 4 Gram-positive bacteria, qualitative results for 3 atypical bacteria and 9 viruses) as well as 7 antibiotic resistance genes (Fig. 1) .

title:
  Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia

abstract:
  BACKGROUND: Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP). METHODS: This retrospective multicenter study was conducted in four French university hospitals. Respiratory samples were obtained from patients with clinical and radiological signs of pneumonia and simultaneously tested using conventional microbiological methods and the rm-PCR. A committee composed of an intensivist, a microbiologist, and an infectious diseases specialist retrospectively assessed all medical files and agreed on the most appropriate antimicrobial therapy for each pneumonia episode, according to the results of rm-PCR and blinded to the culture results. The rm-PCR-guided antimicrobial regimen was compared to the empirical treatment routinely administered to the patient in standard care. RESULTS: We included 159 pneumonia episodes. Most patients were hospitalized in intensive care units (n = 129, 81%), and episodes were HAP (n = 68, 43%), CAP (n = 54, 34%), and VAP (n = 37, 23%). Conventional culture isolated ≥ 1 microorganism(s) at significant level in 95 (60%) patients. The syndromic rm-PCR detected at least one bacteria in 132 (83%) episodes. Based on the results of the rm-PCR, the multidisciplinary committee proposed a modification of the empirical therapy in 123 (77%) pneumonia episodes. The modification was a de-escalation in 63 (40%), an escalation in 35 (22%), and undetermined in 25 (16%) patients. In microbiologically documented episodes (n = 95), the rm-PCR increased appropriateness of the empirical therapy to 83 (87%), as compared to 73 (77%) in routine care. CONCLUSIONS: Use of a syndromic rm-PCR test has the potential to reduce unnecessary antimicrobial exposure and increase the appropriateness of empirical antibiotic therapy in adult patients with pneumonia.


id: cord-104392-egkd5o1u
title: World Pneumonia Day — November 12, 2014
author: nan
date: 2014-11-07
txt: ./txt/cord-104392-egkd5o1u.txt
cache: ./cache/cord-104392-egkd5o1u.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779488/
doi: nan
abstract: nan
summary:
  The United States has made great strides in protecting children from the serious, and sometimes deadly, effects of pneumonia through recent vaccination efforts. Tennessee, for example, is experiencing historically low rates of pneumonia hospitalizations in children aged <2 years since pneumococcal conjugate vaccines were introduced in 2000 (1). Globally, pneumonia kills nearly 1 million children aged <5 years each year (3). In addition to bacterial pathogens, many viruses such as respiratory syncytial virus, influenza, and measles also are major causes of pneumonia globally. Additional information regarding World Pneumonia Day is available at http://worldpneumoniaday.org. Declines in pneumonia hospitalizations of children aged <2 years associated with introduction of 13-valent pneumococcal conjugate vaccine-Tennessee Effect of 13-valent pneumococcal conjugate vaccine on admissions to hospital 2 years after its introduction in the USA: a time series analysis Updated information on the epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) infection and guidance for the public, clinicians, and public health authorities


id: cord-254852-qr5gdmbc
title: Guidelines for the Evaluation and Treatment of Pneumonia
author: Grief, Samuel N.
date: 2018-08-14
txt: ./txt/cord-254852-qr5gdmbc.txt
cache: ./cache/cord-254852-qr5gdmbc.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/30115336/
doi: 10.1016/j.pop.2018.04.001
summary:
  A 2015 prospective, multi-center study by the Centers for Disease Control and Prevention identified a responsible pathogen in only 38% of cases of community-acquired pneumonia (CAP) in adults requiring hospitalization. 13 However, more extensive diagnostic testing should be considered in patients who are at risk for infection with unusual pathogens, who are not responding to treatment, or when additional testing is likely to change antibiotic management (Table 3) . Their analysis of 13 randomized controlled trials found significantly decreased mortality in severe pneumonia, decreased need for mechanical ventilation, decreased occurrence of acute respiratory distress syndrome, decreased time to clinical stability, and shorter duration of hospitalization. Elderly patients with pneumonia may not exhibit typical symptoms or physical examination findings seen in younger adults, such as pleuritic chest pain, cough, fever, and leukocytosis. Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associate pneumonia and blood stream infection: a meta-analysis

abstract:
  Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia.


id: cord-254874-ug0ler5e
author: Ramos-Rincón, José M.
date: 2019-09-05
txt: ./txt/cord-254874-ug0ler5e.txt
cache: ./cache/cord-254874-ug0ler5e.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12874-019-0819-4
doi: 10.1186/s12874-019-0819-4
summary:
  BACKGROUND: This article describes a bibliometric review of the scientific production, geographical distribution, collaboration, impact, and subject area focus of pneumonia research indexed on the Web of Science over a 15-year period. The only document types we studied were original articles and reviews, analyzing descriptive indicators by five-year periods and the scientific production by country, adjusting for population, economic, and research-related parameters. In this study, by analyzing scientific papers on pneumonia published in the main international scientific journals, we aimed to identify the scientific contribution of different countries to the worldwide research effort, the most cited landmark articles, the degree and nature of scientific collaboration, and the topics addressed. Specifically, we will analyze: (1) the evolution of scientific production; (2) its distribution by countries and regions; (3) the impact of the research papers; and (4) the degree of international collaboration.

title:
  A snapshot of pneumonia research activity and collaboration patterns (2001–2015): a global bibliometric analysis

abstract:
  BACKGROUND: This article describes a bibliometric review of the scientific production, geographical distribution, collaboration, impact, and subject area focus of pneumonia research indexed on the Web of Science over a 15-year period. METHODS: We searched the Web of Science database using the Medical Subject Heading (MeSH) of “Pneumonia” from January 1, 2001 to December 31, 2015. The only document types we studied were original articles and reviews, analyzing descriptive indicators by five-year periods and the scientific production by country, adjusting for population, economic, and research-related parameters. RESULTS: A total of 22,694 references were retrieved. The number of publications increased steadily over time, from 981 publications in 2001 to 1977 in 2015 (R(2) = 0.956). The most productive country was the USA (38.49%), followed by the UK (7.18%) and Japan (5.46%). Research production from China increased by more than 1000%. By geographical area, North America (42.08%) and Europe (40.79%) were most dominant. Scientific production in low- and middle-income countries more than tripled, although their overall contribution to the field remained limited (< 15%). Overall, 18.8% of papers were the result of an international collaboration, although this proportion was much higher in sub-Saharan Africa (46.08%) and South Asia (23.43%). According to the specific MeSH terms used, articles focused mainly on “Pneumonia, Bacterial” (19.99%), followed by “Pneumonia, Pneumococcal” (7.02%) and “Pneumonia, Ventilator-Associated” (6.79%). CONCLUSIONS: Pneumonia research increased steadily over the 15-year study period, with Europe and North America leading scientific production. About a fifth of all papers reflected international collaborations, and these were most evident in papers from sub-Saharan Africa and South Asia. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12874-019-0819-4) contains supplementary material, which is available to authorized users.


id: cord-256008-lwki1rzc
title: Detection of COVID-19 from Chest X-Ray Images Using Convolutional Neural Networks
author: Sekeroglu, Boran
date: 2020-09-18
txt: ./txt/cord-256008-lwki1rzc.txt
cache: ./cache/cord-256008-lwki1rzc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1177/2472630320958376
doi: 10.1177/2472630320958376
summary:
  When the images fed ConvNets directly (Experiments 11-17), we observed that the increment of the convolutional layer number of ConvNets reduces the scores obtained by the neural network up to 4%, similar to COVID-19/Normal results. Similar results were obtained in the experiments, and nB produced the highest mean ROC AUC, mean sensitivity, and mean accuracy scores (88.92, 80.00, and 96.96%, respectively) for statistical measurement experiments of COVID-19/Pneumonia classification. Inception-V3 produced higher results than other pre-trained networks; however, the highest mean ROC AUC score in transfer learning experiments was obtained by DenseNet121 (96.48%). In COVID-19/Normal classification, the highest mean specificity (when the 100.0% scores of pre-trained networks are not considered because of not learning another class) and the highest mean accuracy results were obtained in Exp.14 (99.78 and 99.11%, respectively), which consisted of the deepest architecture in ConvNet experiments ( Table 4 ).

abstract:
  The detection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), using chest X-ray images has life-saving importance for both patients and doctors. In addition, in countries that are unable to purchase laboratory kits for testing, this becomes even more vital. In this study, we aimed to present the use of deep learning for the high-accuracy detection of COVID-19 using chest X-ray images. Publicly available X-ray images (1583 healthy, 4292 pneumonia, and 225 confirmed COVID-19) were used in the experiments, which involved the training of deep learning and machine learning classifiers. Thirty-eight experiments were performed using convolutional neural networks, 10 experiments were performed using five machine learning models, and 14 experiments were performed using the state-of-the-art pre-trained networks for transfer learning. Images and statistical data were considered separately in the experiments to evaluate the performances of models, and eightfold cross-validation was used. A mean sensitivity of 93.84%, mean specificity of 99.18%, mean accuracy of 98.50%, and mean receiver operating characteristics–area under the curve scores of 96.51% are achieved. A convolutional neural network without pre-processing and with minimized layers is capable of detecting COVID-19 in a limited number of, and in imbalanced, chest X-ray images.


id: cord-256424-t3dtabi4
title: Repertoire of Intensive Care Unit Pneumonia Microbiota
author: Bousbia, Sabri
date: 2012-02-28
txt: ./txt/cord-256424-t3dtabi4.txt
cache: ./cache/cord-256424-t3dtabi4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/22389704/
doi: 10.1371/journal.pone.0032486
summary:
  Recently, the bacterial microbiota of patients with cystic fibrosis and ventilator-associated pneumonia (VAP) were studied using 16S rDNA gene amplification followed by clone libraries sequencing [9] [10] [11] . Bacterial microbiota as evaluated by 16S rDNA Molecular assays were positive for at least one bacterium for 129 out of 185 bronchoalveolar lavage (BAL) samples from patients with pneumonia as well as from 13 out of 25 from control individuals (p = 0.07). Fungal microbiota obtained from patients showed the presence of 22 different species belonging to 2 phyla (8 orders, 11 families and 12 genera) among which 6 phylotypes had not been previously identified in BAL fluids from pneumonia. Indeed, our study reveals that some pathogens that till now had been considered typical for ICU pneumonia, such as Pseudomonas aeruginosa and Streptococcus species, or viruses, such CMV and HSV, can be detected as commonly in controls as in patients (Fig. S1 and S2 ).

abstract:
  Despite the considerable number of studies reported to date, the causative agents of pneumonia are not completely identified. We comprehensively applied modern and traditional laboratory diagnostic techniques to identify microbiota in patients who were admitted to or developed pneumonia in intensive care units (ICUs). During a three-year period, we tested the bronchoalveolar lavage (BAL) of patients with ventilator-associated pneumonia, community-acquired pneumonia, non-ventilator ICU pneumonia and aspiration pneumonia, and compared the results with those from patients without pneumonia (controls). Samples were tested by amplification of 16S rDNA, 18S rDNA genes followed by cloning and sequencing and by PCR to target specific pathogens. We also included culture, amoeba co-culture, detection of antibodies to selected agents and urinary antigen tests. Based on molecular testing, we identified a wide repertoire of 160 bacterial species of which 73 have not been previously reported in pneumonia. Moreover, we found 37 putative new bacterial phylotypes with a 16S rDNA gene divergence ≥98% from known phylotypes. We also identified 24 fungal species of which 6 have not been previously reported in pneumonia and 7 viruses. Patients can present up to 16 different microorganisms in a single BAL (mean ± SD; 3.77±2.93). Some pathogens considered to be typical for ICU pneumonia such as Pseudomonas aeruginosa and Streptococcus species can be detected as commonly in controls as in pneumonia patients which strikingly highlights the existence of a core pulmonary microbiota. Differences in the microbiota of different forms of pneumonia were documented.


id: cord-259731-kiccsa89
author: Chen, Wei-Chieh
date: 2019-02-27
txt: ./txt/cord-259731-kiccsa89.txt
cache: ./cache/cord-259731-kiccsa89.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0965229918309993
doi: 10.1016/j.ctim.2019.01.008
summary:
  title: Adjuvant therapy with traditional Chinese medicine in a heart failure patient complicated by hospital-acquired pneumonia: A case report OBJECTIVE: We report a case of congestive heart failure complicated by hospital-acquired pneumonia that was successfully treated with traditional Chinese medicine (TCM) and antibiotics. Broad spectrum antibiotics did not relieve the fever or the purulent sputum; therefore, the patient requested TCM for integrated therapy, and was subsequently treated with a regiment of "clearing heat and damp excreting" decoction according to TCM theory. CONCLUSION: Integrated therapy with a "clearing heat and damp excreting" decoction may have improved hospital-acquired pneumonia in a patient comorbid with congestive heart failure. We report a HAP patient comorbid with CHF who experienced rapid and significant improvement in symptoms and image findings following treatment with TCM adjuvant therapy. Because the bacterial cultures from sputum and blood were all negative, we believe that the antipyretic, anti-inflammatory, and antitussive effects of the TCM regiment acted against the persistent inflammation in this patient.

title:
  Adjuvant therapy with traditional Chinese medicine in a heart failure patient complicated by hospital-acquired pneumonia: A case report

abstract:
  OBJECTIVE: We report a case of congestive heart failure complicated by hospital-acquired pneumonia that was successfully treated with traditional Chinese medicine (TCM) and antibiotics. CLINICAL FEATURES AND OUTCOME: A 33-year-old man with a history of heart failure developed pneumonia during hospitalization. After the standard antibiotic therapy for 3 days, he continued to experience persistent fever and progressive cough with purulent sputum. Broad spectrum antibiotics did not relieve the fever or the purulent sputum; therefore, the patient requested TCM for integrated therapy, and was subsequently treated with a regiment of “clearing heat and damp excreting” decoction according to TCM theory. After three days of TCM combination therapy, the pneumonia patches significantly improved on chest X-ray. His sputum was obviously decreased in amount and the fever was complete remission in the 5(th) day of TCM adjuvant therapy. CONCLUSION: Integrated therapy with a “clearing heat and damp excreting” decoction may have improved hospital-acquired pneumonia in a patient comorbid with congestive heart failure. The anti-pyretic, anti-inflammatory, antitussive and diuretic effects of TCM may be responsible for the observed improvement. Further experimental studies are warranted to confirm the efficacy and mechanism of TCM action in the treatment of pneumonia.


id: cord-260679-tm1s6wvj
title: Pneumonia—Overview
author: Lim, Wei Shen
date: 2020-05-20
txt: ./txt/cord-260679-tm1s6wvj.txt
cache: ./cache/cord-260679-tm1s6wvj.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/B9780128012383116368
doi: 10.1016/b978-0-12-801238-3.11636-8
summary:
  Within the grouping of hospital-acquired pneumonia (HAP), further distinction is usually made according to whether the patient was on an intensive care unit, or intubated (ventilator-acquired pneumonia (VAP)) at the time of infection (Torres et al., 2017; Kalil et al., 2016) . A definitive diagnosis of pneumonia comprises four aspects: (i) symptoms and signs of a respiratory tract infection, (ii) radiological changes, (iii) identification of a putative pathogen and (iv) a treatment response, or clinical course, consistent with pneumonia. A meta-analysis of individual participant data from 26 RCTs found that PCT-directed treatment in the management of acute respiratory tract infections (of varying types and severity, including CAP and HAP) was associated with a reduction in antibiotic exposure (5.0 vs. The respiratory pathogens commonly implicated in patients with CAP remain important aetiological agents in all other types of pneumonia, including HAP and pneumonia in the immunocompromised host (Table 8 ).

abstract:
  Pneumonia is very common and continues to exact a high burden on health. The Global Burden of Disease Study 2015 found lower respiratory infections (LRIs) were the leading infectious cause of death and the fifth leading cause of death overall. Pneumococcal pneumonia caused 55% of LRI deaths in all ages (1.5 million deaths). Novel pathogens, particularly viruses, continue to emerge as causes of pneumonia. The rise of drug-resistance among common respiratory pathogens is a further challenge. Pneumonia is commonly classified according to patient location at the time of infection, leading to the categories of community-acquired, hospital-acquired and ventilator-acquired pneumonia.


id: cord-260750-utbuj5iz
title: Bacterial Pneumonia in Dogs and Cats
author: Dear, Jonathan D.
date: 2013-11-21
txt: ./txt/cord-260750-utbuj5iz.txt
cache: ./cache/cord-260750-utbuj5iz.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/24268339/
doi: 10.1016/j.cvsm.2013.09.003
summary:
  3 Often, such diseases are acute and self-limiting, but in a subset of dogs inflammation associated with these organisms immobilizes the host''s immune defenses and predisposes infection with other (often bacterial) respiratory pathogens. Young animals are especially prone to the development of bacterial pneumonia because of their naive immune systems, and when coupled with alterations to the innate immune system, such as primary ciliary dyskinesia (PCD) or complement deficiency, the risk of life-threatening infection increases greatly (see Veterinary Clinics of North America 2007;37(5):845-60 for a comprehensive review of respiratory defenses in health and disease). 4, [11] [12] [13] DIAGNOSIS Bacterial pneumonia implies sepsis of the lower airway and lungs, so the diagnosis is confirmed by showing septic suppurative inflammation on airway cytology obtained through bronchoalveolar lavage (BAL) or tracheal wash, along with a positive microbiology culture.

abstract:
  Bacterial pneumonia is a common clinical diagnosis in dogs but seems to occur less commonly in cats. Underlying causes include viral infection, aspiration injury, and foreign body inhalation. Identification of the organisms involved in disease, appropriate use of antibiotics and adjunct therapy, and control of risk factors for pneumonia improve management.


id: cord-261118-rzdxdzp5
title: Drug hypersensitivity causing organizing eosinophilic pneumonia in a pediatric patient
author: Jenks, Christopher L.
date: 2015-03-17
txt: ./txt/cord-261118-rzdxdzp5.txt
cache: ./cache/cord-261118-rzdxdzp5.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0147956315000539
doi: 10.1016/j.hrtlng.2015.02.007
summary:
  title: Drug hypersensitivity causing organizing eosinophilic pneumonia in a pediatric patient The presentation is typically rapid over the course of 1e5 days, and generally involves fever, myalgias, pleuritic chest pain, crackles on lung exam, plus or minus peripheral eosinophilia as was the case in our patient. Bronchoalveolar lavage is the diagnostic study of choice to diagnose an eosinophilic lung disease as it may be the only clue revealing a high eosinophil count (typically >25% when the normal in BAL fluid is <1%). 4 There have been very few reported cases of organizing eosinophilic pneumonia being associated with pulmonary embolism or a pneumomediastinum. Eosinophilic pneumonia has no obvious association with pulmonary embolism but still could be the possible etiology. 5 At 8 weeks of life the patient had a lung biopsy which showed the eosinophilic pneumonia. If corticosteroids fail to improve the patient''s condition, other treatment options could include IVIG, and cyclosporine A.

abstract:
  OBJECTIVE: To describe a relatively rare hypersentivity reaction with pulmonary manifestations in a pediatric patient. DATA SOURCES: Electronic medical records. STUDY SELECTION: Patient treatment in the pediatric critical care unit. DATA EXTRACTION AND SYNTHESIS: Electronic medical records. CONCLUSIONS: Eosinophilic pneumonias are rare in the pediatric population. Peripheral eosinophilia is not necessary to make the diagnosis. Bronchoalveolar lavage is the diagnostic study of choice. Lung biopsies are rarely needed to make the diagnosis. The treatment of choice is steroids. If steroids fail to improve the patient's condition, consider IVIG, and cyclosporine A.


id: cord-261410-kb91eagd
author: Park, Ji Young
date: 2017-01-23
txt: ./txt/cord-261410-kb91eagd.txt
cache: ./cache/cord-261410-kb91eagd.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28114362/
doi: 10.1371/journal.pone.0170592
summary:
  The clinical features of respiratory adenoviral infection among military personnel were described previously; however, HAdV pneumonia in immunocompetent individuals and risk factors of disease progression to severe pneumonia or acute respiratory failure have not been well studied. All military trainees or active duty members, but not officers, were eligible for enrollment if they were !18 years old and had been admitted to the study hospital for pneumonia, defined by acute respiratory symptoms (fever, cough, sputum, dyspnea, and pleuritic chest pain) and pulmonary infiltrates on chest X-rays or computed tomography (CT) scans. Most HAdV pneumonia patients were basic military trainees or personnel who had recently completed training; active duty service personnel were not usually affected, even during outbreak peaks. Our results show that an outbreak of HAdV pneumonia occurred in Korean military training centers and indicate that emergent-type HAdV-55 infections might have caused the outbreak.

title:
  Clinical Features and Courses of Adenovirus Pneumonia in Healthy Young Adults during an Outbreak among Korean Military Personnel

abstract:
  BACKGROUND: The number of pneumonia patients increased suddenly in Korean military hospitals in late December 2014, indicating the urgent need for an epidemic outbreak investigation. METHODS: We conducted a prospective study of pneumonia etiology among immunocompetent young adults admitted to Daejeon Armed Forces hospital. Patient blood and sputum samples were subjected to conventional culture, serology, and polymerase chain reaction tests for respiratory viruses and atypical pathogens. RESULTS: From January to May 2015, we enrolled 191 (189 male) adults with pneumonia; the mean age was 20.1 ± 1.3 years. Five patients had severe pneumonia, and one died. Pathogenic human adenoviruses were most common (HAdV, 153/191 [80.1%]), indicating a HAdV pneumonia outbreak. Genotyping of 35 isolates indicated that 34 matched HAdV-55 and one matched HAdV-2. HAdV pneumonia infected recruit trainees most frequently. High and prolonged fever, nasal congestion, sore throat, and pharyngeal inflammation were significantly more common in the HAdV pneumonia group, compared to patients with other or unknown causes of pneumonia. Only 12% of HAdV pneumonia patients displayed leukocytosis, whereas febrile leukopenia (62.7%) and thrombocytopenia (41%) were commonly observed. HAdV pneumonia patient chest CT scans displayed ground glass opacity (with or without septal thickness) with consolidation in 50.0% of patients. CONCLUSIONS: An outbreak of HAdV respiratory infection occurred at the Korean military training center. HAdV pneumonia exhibited specific laboratory and clinical features, and although most patients were cured without complication, some progressed to respiratory failure and fatality. Therefore, HAdV vaccine should be provided to military trainees in Korea.


id: cord-266455-rbblg4pu
title: Rapid syndromic molecular testing in pneumonia: The current landscape and future potential
author: Poole, Stephen
date: 2019-12-03
txt: ./txt/cord-266455-rbblg4pu.txt
cache: ./cache/cord-266455-rbblg4pu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31809764/
doi: 10.1016/j.jinf.2019.11.021
summary:
  Syndromic diagnostic testing using novel, rapid multiplexed molecular platforms represents a new opportunity for rapidly targeted antimicrobial therapy to improve patient outcomes and facilitate antibiotic stewardship. This is an FDA approved and CE marked platform that uses nested real-time PCR to detect 34 clinically important respiratory targets (15 semi-quantitative bacterial targets, 3 qualitative atypical bacterial targets, 8 [30] [31] [32] Furthermore, the pneumonia panel detects pathogens in a much higher proportion of samples than culture. Rapid syndromic molecular platforms have the potential to significantly improve the use of antibiotics and clinical outcomes in patient with pneumonia, but high quality randomised controlled trials are urgently required to evaluate their clinical impact. an observational study comparing the performance of two multiplex PCR platforms against routine microbiology for the detection of potential pathogens in patients with suspected hospital acquired/ventilator associated pneumonia (HAP/VAP) across

abstract:
  Community acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and ventilator associated pneumonia (VAP) are all associated with significant mortality and cause huge expense to health care services around the world. Early, appropriate antimicrobial therapy is crucial for effective treatment. Syndromic diagnostic testing using novel, rapid multiplexed molecular platforms represents a new opportunity for rapidly targeted antimicrobial therapy to improve patient outcomes and facilitate antibiotic stewardship. In this article we review the currently available testing platforms and discuss the potential benefits and pitfalls of rapid testing in pneumonia.


id: cord-266516-0ure8256
title: Pneumonia in the tropics
author: Lim, Tow Keang
date: 2017-08-01
txt: ./txt/cord-266516-0ure8256.txt
cache: ./cache/cord-266516-0ure8256.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28763150/
doi: 10.1111/resp.13137
summary:
  The complex interplay of climate change, human migration influences and socio‐economic factors lead to changing patterns of respiratory infections in tropical climate but also increasingly in temperate countries. But, as human migration patterns evolve, we expect to see more TB cases in higher income as well as temperate countries, and rise in infections like scrub typhus from ecotourism activities. In this review, we highlight aetiologies of pneumonia seen more commonly in the tropics compared with temperate regions, their disease burden, variable clinical presentations as well as impact on healthcare delivery. Prevalent in poultry and wild birds, animal-to-human transmission occurs to cause a spectrum of pneumonia/ pneumonitis, culminating in acute respiratory distress syndrome (ARDS). In a series of severe CAP cases in Singapore, patients who had Gram-negative organisms isolated tended to have a worse outcome including a higher mortality, especially for patients with Pseudomonas and Burkholderia pseudomallei infections.

abstract:
  Pneumonia in the tropics poses a heavy disease burden. The complex interplay of climate change, human migration influences and socio‐economic factors lead to changing patterns of respiratory infections in tropical climate but also increasingly in temperate countries. Tropical and poorer countries, especially South East Asia, also bear the brunt of the global tuberculosis (TB) pandemic, accounting for almost one‐third of the burden. But, as human migration patterns evolve, we expect to see more TB cases in higher income as well as temperate countries, and rise in infections like scrub typhus from ecotourism activities. Fuelled by the ease of air travel, novel zoonotic infections originating from the tropics have led to global respiratory pandemics. As such, clinicians worldwide should be aware of these new conditions as well as classical tropical bacterial pneumonias such as melioidosis. Rarer entities such as co‐infections of leptospirosis and chikungunya or dengue will need careful consideration as well. In this review, we highlight aetiologies of pneumonia seen more commonly in the tropics compared with temperate regions, their disease burden, variable clinical presentations as well as impact on healthcare delivery.


id: cord-273096-pgda7i3u
title: A 72-Year-Old Woman With Respiratory Failure and Bilateral Ground-Glass Opacities
author: Baba, Yuri
date: 2020-07-02
txt: ./txt/cord-273096-pgda7i3u.txt
cache: ./cache/cord-273096-pgda7i3u.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0012369220302506
doi: 10.1016/j.chest.2019.11.054
summary:
  CHEST 2020; 158(1):e41-e45 KEY WORDS: bronchoscopy; herpes simplex virus pneumonia; immunoperoxidase staining A 72-year-old Japanese housewife was admitted to our hospital due to anorexia and dyspnea on exertion. Laboratory data on admission showed a WBC count of 8,800/mm 3 with infectious symptoms, or a history suggestive of drug-induced lung diseases but did have fine crackles and diffuse, bilateral patchy ground-glass opacities in her chest, 1 we initially suspected acute interstitial pneumonia and administered prednisolone (50 mg/d), which is often used in the treatment of acute interstitial pneumonia. Immunoperoxidase staining for herpes simplex virus type 1 (HSV1) of lymphocytes using bronchial washing fluid was positive (Fig 2C) Diagnosis: Viral Pneumonia due to HSV1 e42 Chest Imaging and Pathology for Clinicians coronavirus, human metapneumovirus, and adenovirus, but HSV was not included in previous reports investigating the frequency of viral infection in community-acquired pneumonia.

abstract:
  A 72-year-old woman with diabetes mellitus was admitted to our hospital because of dyspnea on exertion. Sputum cytologic evaluation revealed intranuclear inclusion bodies in the cells; we therefore considered viral pneumonia and performed a bronchoscopy. The bronchial washing fluid was positive for immunoperoxidase staining of herpes simplex virus type 1 (HSV1) and HSV1 polymerase chain reaction. The patient was diagnosed as having pneumonia due to HSV1 and was successfully treated with acyclovir.


id: cord-275828-c6d6nk7x
author: Mikasa, Keiichi
date: 2016-07-31
txt: ./txt/cord-275828-c6d6nk7x.txt
cache: ./cache/cord-275828-c6d6nk7x.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S1341321X16000283
doi: 10.1016/j.jiac.2015.12.019
abstract: nan
summary:
  -SBT/ABPC, intravenous drip, 3 g/3e4 times a day -CTRX, intravenous drip, 1 g/twice a day or 2 g/once a day -CTX, intravenous drip, 1e2 g/2e3 times a day -LVFX, intravenous drip, 500 mg/once a day (2) Cases of late-onset hospital-acquired pneumonia or ventilator-associated pneumonia in which the risk of resistant bacteria is high An antimicrobial drug with anti-pseudomonal activity that targets non-glucose-fermentative gram-negative rod should be administered [50, 51, 68] -To treat polymicrobial infection, the administration of an antimicrobial drug with an activity against obligate anaerobe is not always necessary [67, 70] . -SBT/ABPC, intravenous drip, 3 g/3e4 times a day -CTRX, intravenous drip, 2 g/once a day or 1 g/twice a day -CTX, intravenous drip, 1e2 g/2e3 times a day -LVFX, intravenous drip, 500 mg/once a day (2) Late-onset hospital-acquired pneumonia or cases in which there is a risk of multi-drug-resistant bacteria In addition to the above pathogens, the involvement of non-glucose-fermentative gram negative bacteria or ESBLproducing enteric bacteria must be considered. For the treatment of immunodeficiency-/blood disease-related pneumonia in children, antimicrobial drug therapy should also be basically selected, considering causative microorganisms.

title:
  JAID/JSC Guidelines for the Treatment of Respiratory Infectious Diseases: The Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy – The JAID/JSC Guide to Clinical Management of Infectious Disease/Guideline-preparing Committee Respiratory Infectious Disease WG


id: cord-282301-7hjeaf1s
title: Pediatric Round Pneumonia
author: Liu, Yen-Lin
date: 2013-03-13
txt: ./txt/cord-282301-7hjeaf1s.txt
cache: ./cache/cord-282301-7hjeaf1s.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/23597522/
doi: 10.1016/j.pedneo.2013.01.014
summary:
  We herein report the case of a 7-year-old boy who presented with prolonged fever, cough, and chest X-rays showing a well-demarcated round mass measuring 5.9 × 5.6 × 4.3 cm in the left lower lung field, findings which were typical for round pneumonia. We herein report the case of a 7year-old boy who presented with prolonged fever, cough, and chest X-rays showing a welldemarcated round mass measuring 5.9 Â 5.6 Â 4.3 cm in the left lower lung field, findings which were typical for round pneumonia. Recent evidence suggests treating classical round pneumonia with antibiotics first and waiving unwarranted advanced imaging studies, while alternative etiologies such as abscesses, tuberculosis, nonbacterial infections, congenital malformations, or neoplasms should still be considered in patients with atypical features or poor treatment response. Recent evidence suggests treating classical round pneumonia with antibiotics first and waiving unwarranted advanced imaging studies, while alternative etiologies such as abscesses, tuberculosis, nonbacterial infections, congenital malformations, or neoplasms should still be considered in patients with atypical features or poor treatment response.

abstract:
  “Round pneumonia” or “spherical pneumonia” is a well-characterized clinical entity that seems to be less addressed by pediatricians in Taiwan. We herein report the case of a 7-year-old boy who presented with prolonged fever, cough, and chest X-rays showing a well-demarcated round mass measuring 5.9 × 5.6 × 4.3 cm in the left lower lung field, findings which were typical for round pneumonia. The urinary pneumococcal antigen test was positive, and serum anti-Mycoplasma pneumoniae antibody titer measurement using a microparticle agglutination method was 1:160 (+). After oral administration of antibiotics including azithromycin and amoxicillin/clavulanate, which was subsequently replaced by ceftibuten due to moderate diarrhea, the fever subsided 2 days later and the round patch had completely resolved on the 18th day after the diagnosis. Recent evidence suggests treating classical round pneumonia with antibiotics first and waiving unwarranted advanced imaging studies, while alternative etiologies such as abscesses, tuberculosis, nonbacterial infections, congenital malformations, or neoplasms should still be considered in patients with atypical features or poor treatment response.


id: cord-283667-jqlz7yt8
author: Katz, Sophie E.
date: 2018-03-31
txt: ./txt/cord-283667-jqlz7yt8.txt
cache: ./cache/cord-283667-jqlz7yt8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0891552017301071
doi: 10.1016/j.idc.2017.11.002
summary:
  That study used traditional culture methods, pneumolysin-based polymerase chain reaction (PCR) assays, viral direct fluorescent antibody tests, and serologic tests for viruses, Mycoplasma spp, and Chlamydia spp to identify pathogens in 154 hospitalized children with radiographically confirmed lower respiratory infections at a single institution. A majority of patients (60%) were noted to have infection with typical respiratory bacteria (most commonly, Streptococcus pneumoniae, detected in 73% of children with documented bacterial disease), with viruses identified in 45% of children. The multicenter Centers for Disease Control and Prevention (CDC) Etiology of Pneumonia in the Community (EPIC) Study was a prospective, population-based surveillance study of greater than 2300 pediatric CAP hospitalizations in the United States conducted from 2010 to 2012. To evaluate the impact of CRP in the etiologic diagnosis of pneumonia, a meta-analysis of 8 studies with more than 1200 children with viral or bacterial causes of CAP demonstrated that CRP levels greater than or equal to 40 mg/L to 60 mg/L were associated with only a 64% positive predictive value for identifying children with bacterial pneumonia.

title:
  Pediatric Community-Acquired Pneumonia in the United States Changing Epidemiology, Diagnostic and Therapeutic Challenges, and Areas for Future Research

abstract:
  Community-acquired pneumonia (CAP) is one of the most common serious infections in childhood. This review focuses on pediatric CAP in the United States and other industrialized nations, specifically highlighting the changing epidemiology of CAP, diagnostic and therapeutic challenges, and areas for further research.


id: cord-287145-w518a0wa
author: Habib, Nahida
date: 2020-10-30
txt: ./txt/cord-287145-w518a0wa.txt
cache: ./cache/cord-287145-w518a0wa.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s42979-020-00373-y
doi: 10.1007/s42979-020-00373-y
summary:
  This paper proposes an ensemble method-based pneumonia diagnosis from Chest X-ray images. This paper proposed an ensemble technique of two CNN models-fine-tuned CheXNet and VGG-19 models for the diagnosis of pediatric pneumonia from Chest X-ray images. For the detection and classification of Pneumonia from Normal images different ML algorithms-Random Forest (RF), Adaptive Boosting (AdaBoost), K-Nearest Neighbors (KNN) are applied on the features afterword''s. Chest X-ray is easy to use medical imaging and diagnostic technique performed by expert radiologists to diagnose pneumonia, tuberculosis, interstitial lung disease, and early lung cancer [13] . The CheXNet deep CNN model uses this NIH CXR dataset and is said to exceed the average radiologist performance on the pneumonia detection task [8] . The proposed methodology includes image preprocessing using an image enhancement technique and resizing of images, augmentation of training images, finetuning CNN models, model''s training, extraction of CNN''s feature vector, ensemble of extracted feature vectors, dataset imbalance handling and Pneumonia classification using different machine learning algorithms.

title:
  Ensemble of CheXNet and VGG-19 Feature Extractor with Random Forest Classifier for Pediatric Pneumonia Detection

abstract:
  Pneumonia, an acute respiratory infection, causes serious breathing hindrance by damaging lung/s. Recovery of pneumonia patients depends on the early diagnosis of the disease and proper treatment. This paper proposes an ensemble method-based pneumonia diagnosis from Chest X-ray images. The deep Convolutional Neural Networks (CNNs)—CheXNet and VGG-19 are trained and used to extract features from given X-ray images. These features are then ensembled for classification. To overcome data irregularity problem, Random Under Sampler (RUS), Random Over Sampler (ROS) and Synthetic Minority Oversampling Technique (SMOTE) are applied on the ensembled feature vector. The ensembled feature vector is then classified using several Machine Learning (ML) classification techniques (Random Forest, Adaptive Boosting, K-Nearest Neighbors). Among these methods, Random Forest got better performance metrics than others on the available standard dataset. Comparison with existing methods shows that the proposed method attains improved classification accuracy, AUC values and outperforms all other models providing 98.93% accurate prediction. The model also exhibits potential generalization capacity when tested on different dataset. Outcomes of this study can be great to use for pneumonia diagnosis from chest X-ray images.


id: cord-288305-qt2a4pxs
title: Radiographic follow‐up of pneumonia in children
author: Virkki, R.
date: 2005-07-11
txt: ./txt/cord-288305-qt2a4pxs.txt
cache: ./cache/cord-288305-qt2a4pxs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/16010671/
doi: 10.1002/ppul.20258
summary:
  This study assessed the clinical value of routine follow‐up chest radiographs in hospitalized children with community‐acquired pneumonia. This prospective study was undertaken to investigate the resolution of chest radiographic changes in children with viral and bacterial pneumonia, and to assess the clinical value of information obtained from follow-up radiographs taken 3-7 weeks after a diagnosis of pneumonia. For a long-term perspective, 8-10 years later, the medical records of patients were reviewed, and a questionnaire was sent to the parents to elicit the illness history after the time of follow-up chest radiograph. As part of a 3-year prospective study of the etiology and clinical profile of childhood community-acquired pneumonia, 3, 6, 9, 10 we studied follow-up chest radiographs. No single etiologic agent predicted the persistence of radiographic changes (data not shown), and the numbers of viral and bacterial infections showed no significant differences between the original patient population and those with residual findings on follow-up radiograph ( Table 3 ).

abstract:
  This study assessed the clinical value of routine follow‐up chest radiographs in hospitalized children with community‐acquired pneumonia. The study population consisted of 196 children hospitalized for community‐acquired pneumonia diagnosed between 1993–1995. Seventeen infective agents (10 viruses and 7 bacteria) were sought. Chest radiographs were taken on admission and 3–7 weeks later. All children were treated with antibiotics. Data on the course of illness over the following 8–10 years were obtained from patient files and questionnaires sent to parents. A potential causative agent was found in 165 (84%) of 196 cases. On follow‐up chest radiographs, residual or new changes were seen in 30% of cases. The residual changes tended to be more common after mixed viral‐bacterial infection (43%) than after sole viral (25%) or sole bacterial (20%) infection. Interstitial infiltrates (66%), atelectasis (46%), and enlarged lymph nodes were the most common sequelae seen on follow‐up. Residual findings on follow‐up radiographs did not affect the treatment of the children. No further chest radiographs were taken. During the 8–10‐year follow‐up of 194 children, no illnesses appeared that were associated with previous pneumonia. Twenty‐six children had a new episode of pneumonia, 7 of them had asthma, and 6 had different underlying illnesses. In conclusion, routine follow‐up chest radiographs are not needed in childhood community‐acquired pneumonia if the child has a clinically uneventful recovery. Pediatr Pulmonol. © 2005 Wiley‐Liss, Inc.


id: cord-291400-o9skj94r
title: Re-evaluation of the therapy of severe pneumonia caused by Streptococcus pneumoniae
author: Plouffe, Joseph F.
date: 2004-12-31
txt: ./txt/cord-291400-o9skj94r.txt
cache: ./cache/cord-291400-o9skj94r.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0891552004001023
doi: 10.1016/j.idc.2004.07.010
summary:
  Several retrospective reviews of bacteremic pneumococcal pneumonia suggest that dual therapy with a beta-lactam and a macrolide antimicrobial agent is associated with a lower case fatality rate than therapy with a beta-lactam alone. With the advent of modern microbiology, Streptococcus pneumoniae (pneumococcus) was identified as the cause of community-acquired pneumonia (CAP) in the most patients [1] . Changes that have been associated with improvements in CFR in some series of patients with CAP include more rapid antibiotic delivery [31] , combination therapy with a cephalosporin with good pneumococcal activity and macrolide (versus the cephalosporin alone), and therapy with a fluoroquinolone (ciprofloxacin; versus a cephalosporin alone) [32] . A previous study of patients with CAP, but not nonbacteremic pneumococcal pneumonia, found that treated with blactamase inhibitors and a macrolide were less effective than treatment with a cephalosporin alone [32] .

abstract:
  Pneumonia caused by Streptococcus pneumoniae is the most deadly form of community-acquired pneumonia. The death rate of bacteremic pneumococcal pneumonia has remained constant over the past 50 years. Several retrospective reviews of bacteremic pneumococcal pneumonia suggest that dual therapy with a beta-lactam and a macrolide antimicrobial agent is associated with a lower case fatality rate than therapy with a beta-lactam alone. These studies are reviewed, potential mechanisms are suggested, and future studies are discussed.


id: cord-292094-vmsdhccp
author: Mandell, Lionel A.
date: 2007-03-01
txt: ./txt/cord-292094-vmsdhccp.txt
cache: ./cache/cord-292094-vmsdhccp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17278083/
doi: 10.1086/511159
abstract: nan
summary:
  Severity-of-illness scores, such as the CURB-65 criteria (confusion, uremia, respiratory rate, low blood pressure, age 65 years or greater), or prognostic models, such as the Pneumonia Severity Index (PSI), can be used to identify patients with CAP who may be candidates for outpatient treatment. A respiratory fluoroquinolone should be used for penicillin-allergic patients.) Increasing resistance rates have suggested that empirical therapy with a macrolide alone can be used only for the treat-ment of carefully selected hospitalized patients with nonsevere disease and without risk factors for infection with drug-resistant pathogens. Advantages include the high specificity, the ability of some assays to distinguish between influenza A and B, the rapidity with which the results can be obtained, the possibly reduced use of antibacterial agents, and the utility of establishing this diagnosis for epidemiologic purposes, especially in hospitalized patients who may require infection control precautions.

title:
  Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults


id: cord-294270-do6i6ymq
title: Pneumonia
author: Banu, Buyukaydin
date: 2019-11-29
url: https://api.elsevier.com/content/article/pii/B9780128012383621748
doi: 10.1016/b978-0-12-801238-3.62174-8
abstract:
  Pneumonia remains the main cause of morbidity and mortality from infectious diseases in the world. The important reason for the increased global mortality is the impact of pneumonia on chronic diseases especially in the elderly population and the virulence factors of the causative microorganisms. Because elderly individuals present with comorbidities, particular attention should be paid for multidrug-resistant pathogens. Streptococcus pneumoniae remains the most frequently encountered pathogen. Enteric gram-negative rods, as well as anaerobes, should be considered in patients with aspiration pneumonia. Interventions for modifiable risk factors will reduce the risk of this infection. The adequacy of the initial antimicrobial therapy and determination of patients’ follow-up place is a key factor for prognosis. Also, vaccination is one of the most important preventive measures. In this section it was focused on several aspects, including the atypical presentation of pneumonia in the elderly, the methods to evaluate the severity of illness, the appropriate take care place and the management with prevention strategies.


id: cord-294546-0otd1heg
author: Prendki, V.
date: 2019-01-12
txt: ./txt/cord-294546-0otd1heg.txt
cache: ./cache/cord-294546-0otd1heg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.cmi.2018.12.037
doi: 10.1016/j.cmi.2018.12.037
summary:
  CONCLUSION: Comprehensive molecular testing of NPS increases the number of pathogens detected compared with routine methods, but results are poorly predictive of the presence of pneumonia. showed in a randomized controlled trial (107 individuals with lower respiratory tract infections, mean age 65 years) that PCR for viruses and atypical bacteria in nasopharyngeal and oropharyngeal swabs (NPS) allowed the identification of additional pathogens but did not reduce antibiotic use or costs [7] . Individuals admitted to hospital for suspected pneumonia had NPS collected at inclusion for the detection of multiple bacterial and viral pathogens using multiplex PCR (comprehensive molecular testing), in addition to routine testing. Demographic data, co-morbidities, vital signs, clinical findings, severity scores, results of standard laboratory tests, blood, sputum and urine cultures, urinary antigen detection, PCR for respiratory viruses on NPS, and antimicrobial therapy administered were recorded prospectively.

title:
  Accuracy of comprehensive PCR analysis of nasopharyngeal and oropharyngeal swabs for CT-scan-confirmed pneumonia in elderly patients: a prospective cohort study

abstract:
  OBJECTIVES: We aimed to assess the accuracy of PCR detection of viruses and bacteria on nasopharyngeal and oropharyngeal swabs (NPS) for the diagnosis of pneumonia in elderly individuals. METHODS: We included consecutive hospitalized elderly individuals suspected of having pneumonia. At inclusion, NPS were collected from all participants and tested by PCR for the presence of viral and bacterial respiratory pathogens (index test, defined as comprehensive molecular testing). Routine diagnostic tests (blood and sputum culture, urine antigen detection) were also performed. The reference standard was the presence of pneumonia on a low-dose CT scan as assessed by two independent expert radiologists. RESULTS: The diagnosis of pneumonia was confirmed in 127 of 199 (64%) included patients (mean age 83 years, community-acquired pneumonia in 105 (83%)). A pathogen was identified by comprehensive molecular testing in 114 patients (57%) and by routine methods in 22 (11%). Comprehensive molecular testing was positive for viruses in 62 patients (31%) and for bacteria in 73 (37%). The sensitivity and specificity were 61% (95% CI 53%–69%) and 50% (95% CI 39%–61%) for comprehensive molecular testing, and 14% (95% CI 82%–21%) and 94% (95% CI 86%–98%) for routine testing, respectively. Positive likelihood ratio was 2.55 for routine methods and 1.23 for comprehensive molecular testing. CONCLUSION: Comprehensive molecular testing of NPS increases the number of pathogens detected compared with routine methods, but results are poorly predictive of the presence of pneumonia. Hence, comprehensive molecular testing is unlikely to impact clinical decision-making (NCT02467192). CLINICAL TRIALS REGISTRATION: NCT02467192.


id: cord-295201-u2dola34
author: Morimoto, Konosuke
date: 2015-03-30
txt: ./txt/cord-295201-u2dola34.txt
cache: ./cache/cord-295201-u2dola34.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25822890/
doi: 10.1371/journal.pone.0122247
summary:
  This study was conducted to elucidate the burden of community-onset pneumonia (COP) and its etiologic fractions in Japan, the world''s most aged society. All pneumonia patients aged ≥15 years, including those with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP), were enrolled at four community hospitals on four major islands. The age-group specific incidence rates of pneumonia, hospitalization and death in the four prefectures were estimated using the surveillance data and the national statistics. Assuming that these proportions of pneumonia etiologies were constant across all prefectures, the estimated annual number of COP in the entire Japanese adult population was 1,880,000; of these, 1,300,000 cases (70%) occurred in people aged !65 years (Fig 2) . The burden was particularly high among the elderly population; 85.8% of aspiration-associated pneumonia cases occurred in patients aged !65 years. Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study

title:
  The Burden and Etiology of Community-Onset Pneumonia in the Aging Japanese Population: A Multicenter Prospective Study

abstract:
  BACKGROUND: The increasing burden of pneumonia in adults is an emerging health issue in the era of global population aging. This study was conducted to elucidate the burden of community-onset pneumonia (COP) and its etiologic fractions in Japan, the world’s most aged society. METHODS: A multicenter prospective surveillance for COP was conducted from September 2011 to January 2013 in Japan. All pneumonia patients aged ≥15 years, including those with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP), were enrolled at four community hospitals on four major islands. The COP burden was estimated based on the surveillance data and national statistics. RESULTS: A total of 1,772 COP episodes out of 932,080 hospital visits were enrolled during the surveillance. The estimated overall incidence rates of adult COP, hospitalization, and in-hospital death were 16.9 (95% confidence interval, 13.6 to 20.9), 5.3 (4.5 to 6.2), and 0.7 (0.6 to 0.8) per 1,000 person-years (PY), respectively. The incidence rates sharply increased with age; the incidence in people aged ≥85 years was 10-fold higher than that in people aged 15-64 years. The estimated annual number of adult COP cases in the entire Japanese population was 1,880,000, and 69.4% were aged ≥65 years. Aspiration-associated pneumonia (630,000) was the leading etiologic category, followed by Streptococcus pneumoniae-associated pneumonia (530,000), Haemophilus influenzae-associated pneumonia (420,000), and respiratory virus-associated pneumonia (420,000), including influenza-associated pneumonia (30,000). CONCLUSIONS: A substantial portion of the COP burden occurs among elderly members of the Japanese adult population. In addition to the introduction of effective vaccines for S. pneumoniae and influenza, multidimensional approaches are needed to reduce the pneumonia burden in an aging society.


id: cord-297494-6yxmaihl
author: Katsurada, Naoko
date: 2017-12-06
txt: ./txt/cord-297494-6yxmaihl.txt
cache: ./cache/cord-297494-6yxmaihl.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1186/s12879-017-2858-y
doi: 10.1186/s12879-017-2858-y
summary:
  However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54–7.42). We conducted this prospective multicentre study to determine the distribution of viruses associated with pneumonia in adults and to establish their virus-specific effects on pneumonia mortality stratified by age group and comorbidity status. To the best of our knowledge, this study is the first to systematically investigate virus-specific effects on pneumonia mortality by age group and comorbidity status among adults. In our study, multiple viruses were identified in 5.1% of virus-associated pneumonia and were associated with higher mortality than single viral infection in patients with chronic respiratory disease and other comorbidities. Systematic reviews have shown that multiple viral infections in patients with respiratory disease are not associated with disease severity [27, 28] ; however, the majority of previous studies included young children but not adults.

title:
  The impact of virus infections on pneumonia mortality is complex in adults: a prospective multicentre observational study

abstract:
  BACKGROUND: Various viruses are known to be associated with pneumonia. However, the impact of viral infections on adult pneumonia mortality remains unclear. This study aimed to clarify the effect of virus infection on pneumonia mortality among adults stratified by virus type and patient comorbidities. METHODS: This multicentre prospective study enrolled pneumonia patients aged ≥15 years from September 2011 to August 2014. Sputum samples were tested by in-house multiplex polymerase chain reaction assays to identify 13 respiratory viruses. Viral infection status and its effect on in-hospital mortality were examined by age group and comorbidity status. RESULTS: A total of 2617 patients were enrolled in the study and 77.8% was aged ≥65 years. 574 (21.9%) did not have comorbidities, 790 (30.2%) had chronic respiratory disease, and 1253 (47.9%) had other comorbidities. Viruses were detected in 605 (23.1%) patients. Human rhinovirus (9.8%) was the most frequently identified virus, followed by influenza A (3.9%) and respiratory syncytial virus (3.9%). Respiratory syncytial virus was more frequently identified in patients with chronic respiratory disease (4.7%) than those with other comorbidities (4.2%) and without comorbidities (2.1%) (p = 0.037). The frequencies of other viruses were almost identical between the three groups. Virus detection overall was not associated with increased mortality (adjusted risk ratio (ARR) 0.76, 95% CI 0.53–1.09). However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54–7.42). Intriguingly, paramyxoviruses were associated with dramatically lower mortality in patients with other comorbidities (ARR 0.10, 95% CI 0.01–0.70) but not with chronic respiratory disease. These effects were not affected by age group. CONCLUSIONS: The impact of virus infections on pneumonia mortality varies by virus type and comorbidity status in adults. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-017-2858-y) contains supplementary material, which is available to authorized users.


id: cord-300356-oorac5he
title: Community-Acquired Pneumonia: An Unfinished Battle
author: Nair, Girish B.
date: 2011-10-05
txt: ./txt/cord-300356-oorac5he.txt
cache: ./cache/cord-300356-oorac5he.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0025712511000927
doi: 10.1016/j.mcna.2011.08.007
summary:
  20 Risk factors for community-acquired P aeruginosa pneumonia include bronchiectasis, immunocompromised state, use of multiple courses of antibiotics, prolonged glucocorticoids in patients with COPD, and recent hospitalization. One of the most important decisions in the management of pneumonia is to assess the severity of the disease, which can be used to predict mortality risk and may be Nair & Niederman a surrogate measure to define the site of care (outpatient, hospital ward, or ICU). 61, 62 Although administration of therapy within 4 to 6 hours of arrival at the hospital can reduce mortality, it is important to only use antibiotics when the diagnosis is certain, because indiscriminate use of antibiotics in the absence of radiographic pneumonia has limited benefit and a real risk of Community-Acquired Pneumonia antibiotic-associated adverse events, including drug-induced infectious diarrhea.

abstract:
  Community-acquired pneumonia remains a common illness with substantial morbidity and mortality. Current management challenges focus on identifying the likely etiologic pathogens based on an assessment of host risk factors, while attempting to make a specific etiologic diagnosis, which is often not possible. Therapy is necessarily empiric and focuses on pneumococcus and atypical pathogens for all patients, with consideration of other pathogens based on specific patient risk factors. It is important to understand the expected response to effective therapy, and to identify and manage clinical failure at the earliest possible time point. Prevention is focused on smoking cessation and vaccination against pneumococcus and influenza.


id: cord-302111-kg0dmgq0
author: Darden, Dijoia B.
date: 2020-04-29
txt: ./txt/cord-302111-kg0dmgq0.txt
cache: ./cache/cord-302111-kg0dmgq0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32426751/
doi: 10.1097/cce.0000000000000109
summary:
  Given the rapidly emerging pandemic associated with the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019, it is important to review the clinical presentation and immunologic changes associated with viral pneumonia. Given the rapidly emerging pandemic associated with the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019, it is important to review the clinical presentation and immunologic changes associated with viral pneumonia. Key Words: coronavirus; immunology; influenza virus; severe acute respiratory syndrome; viral pneumonia P neumonia is the leading infectious cause of hospitalization among adults and children in the United States (1) . Given the rapid spread of this virus and its association with severe pulmonary disease, the purpose of this review is to provide an overview of the presentation and immunology of viral pneumonia, principles of early management, and application to COVID-19.

title:
  The Clinical Presentation and Immunology of Viral Pneumonia and Implications for Management of Coronavirus Disease 2019

abstract:
  This review will briefly examine the clinical presentation and important immunology of viral pneumonia with a focus on severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019). DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS: The most relevant, original and review literature were assessed for inclusion in this review. Sources included the Centers for Disease Control and Prevention, World Health Organization, and PubMed. CONCLUSIONS: Pneumonia is a leading cause of hospitalization and death worldwide, with viral etiologies being very common. Given the rapidly emerging pandemic associated with the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019, it is important to review the clinical presentation and immunologic changes associated with viral pneumonia. Symptoms of viral pneumonia include common respiratory tract infection symptoms of cough, fever, and shortness of breath. Immunologic changes include up-regulation of airway pro-inflammatory cytokines and pathogen- and damage-associated molecular patterns contributing to cytokine and genomic changes. Coronavirus disease 2019 clinical presentation is typical of viral pneumonia with an increased prevalence of early pulmonary infiltrates and lymphopenia. Principles of early coronavirus disease 2019 management and isolation as well as potential therapeutic approaches to the emerging pandemic are discussed.


id: cord-302226-0rhgmtbo
author: Bajpai, Vijeta
date: 2019
txt: ./txt/cord-302226-0rhgmtbo.txt
cache: ./cache/cord-302226-0rhgmtbo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31929704/
doi: 10.4103/jlp.jlp_6_19
summary:
  title: Spectrum of respiratory viral infections in liver disease patients with cirrhosis admitted in critical care unit BACKGROUND: Clinical significance of respiratory viruses (RVs) as an etiology of pneumonia in liver disease patients with cirrhosis is usually underestimated. Therefore, the aim of this study was to evaluate the spectrum of RVs in cirrhotic patients with pneumonia admitted in critical care units (CCUs) and its impact on the clinical outcome of cirrhotic patients. [7, 8, 14] The current study has found that respiratory viral infections other than influenza virus infection are also an important etiology of pneumonia in liver disease patients with cirrhosis admitted in CCUs. Transmission dynamics and seasonal distribution of RVs are key importance in understanding and limiting burden of morbidity and mortality of pneumonia patients in CCUs.

title:
  Spectrum of respiratory viral infections in liver disease patients with cirrhosis admitted in critical care unit

abstract:
  BACKGROUND: Clinical significance of respiratory viruses (RVs) as an etiology of pneumonia in liver disease patients with cirrhosis is usually underestimated. Therefore, the aim of this study was to evaluate the spectrum of RVs in cirrhotic patients with pneumonia admitted in critical care units (CCUs) and its impact on the clinical outcome of cirrhotic patients. MATERIAL AND METHOD: A prospective study was conducted in a tertiary care CCU, and consecutive cirrhotic patients with pneumonia were included. Bronchoalveolar lavage or throat swab/nasal swab was collected in viral transport medium for analysis of RVs by multiplex real-time polymerase chain reaction. A total of 135 cirrhotic patients were included, viral and bacterial etiology of pneumonia was identified, and analysis was done with the clinical outcome. RESULTS: Overall, RVs were detected in 30 (22.2%) cirrhotic patients and viral–bacterial coinfection in 16 (11.8%) cirrhotic patients. The most common virus detected was rhinovirus in 9 (30%) patients. Mortality in cirrhotic patients with RV infection was significantly higher in comparison to cirrhotic patients with no RV infection (25 [83.3%] and 11 [12.3%], respectively, P < 0.001). CONCLUSION: Respiratory viruses in cirrhotic patients with pneumonia are associated with poor clinical outcome.


id: cord-303079-tglvxelu
title: Community‐acquired pneumonia: An Asia Pacific perspective
author: Liam, Chong‐Kin
date: 2007-02-13
txt: ./txt/cord-303079-tglvxelu.txt
cache: ./cache/cord-303079-tglvxelu.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17298446/
doi: 10.1111/j.1440-1843.2006.01013.x
abstract: nan
summary:
  Community-acquired pneumonia (CAP) is a common illness that is potentially life-threatening especially in older adults and those with comorbid disease. Studies conducted in Japan, Korea and Thailand showed that the aetiology of CAP is similar to that reported in the West except for the low incidence of Legionella pneumonia. Furthermore, the PSI is more useful for identifying low-risk patients who may be safely treated as outpatients rather than those with severe CAP. pneumoniae, after controlling for comorbid illness, although patients infected by resistant organisms may have more severe disease and suppurative complications as well as a more prolonged hospital stay. Etiology of community-acquired pneumonia in hospitalized patients: a 3-year prospective study in Japan Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study Prospective study of the aetiology of adult community acquired bacterial pneumonia needing hospitalisation in Singapore A study on community acquired pneumonia in adults requiring hospital admission in Penang


id: cord-304277-aek6mvdw
author: Ishiguro, Takashi
date: 2019-09-11
txt: ./txt/cord-304277-aek6mvdw.txt
cache: ./cache/cord-304277-aek6mvdw.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31511487/
doi: 10.2169/internalmedicine.3435-19
summary:
  We initially suspected these patients of having influenza-associated pneumonia and cryptogenic organizing pneumonia, respectively, and performed bronchoalveolar lavage, but only human parainfluenza virus-1 infection was detected by multiplex polymerase chain reaction testing. We recently experienced two cases of pneumonia in which HPIV-1 was isolated from bronchoalveolar lavage (BAL) fluid and confirmed by a multiplex polymerase chain reaction (PCR) test (Fast Track Diagnostics Resp 21 Kit, Silema, Malta), which detects the following respiratory pathogens: influenza A and B viruses; coronaviruses NL63, 229E, OC43, and HKU1; human parainfluenza viruses 1, 2, 3, and 4; human metapneumovirus A/B; rhinovirus; respiratory syncytial virus A/B; adenovirus; enterovirus; human parechovirus; bocavirus; and Mycoplasma pneumoniae. However, previous reports that investigated virus infections in patients with pneumonia used nasopharyngeal or oropharyngeal swabs to detect viruses, which raises the possibility of upper respiratory tract infection by HPIV. Furthermore, these studies include mixed viral and bacterial infections, and the clinical characteristics of the immunocompetent patients with primary HPIV pneumonia are not fully known.

title:
  Two Cases of Primary Human Parainfluenza Virus 1 Pneumonia in Which Bronchoalveolar Lavage Fluid Yielded Human Parainfluenza Virus 1

abstract:
  Two patients, a 76-year-old woman and 66-year-old woman, presented to our hospital with symptoms of lower respiratory tract infection. Both patients showed chest imaging findings of bilateral ground-glass opacities and consolidations. We initially suspected these patients of having influenza-associated pneumonia and cryptogenic organizing pneumonia, respectively, and performed bronchoalveolar lavage, but only human parainfluenza virus-1 infection was detected by multiplex polymerase chain reaction testing. These findings suggest that pneumonia due to human parainfluenza virus-1 should be included in the differential diagnosis of such cases.


id: cord-304356-jyp9gjh9
author: Grant, Rogan A.
date: 2020-08-05
url: https://doi.org/10.1101/2020.08.05.238188
doi: 10.1101/2020.08.05.238188
title:
  Alveolitis in severe SARS-CoV-2 pneumonia is driven by self-sustaining circuits between infected alveolar macrophages and T cells

abstract:
  Some patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) develop severe pneumonia and the acute respiratory distress syndrome (ARDS) [1]. Distinct clinical features in these patients have led to speculation that the immune response to virus in the SARS-CoV-2-infected alveolus differs from other types of pneumonia [2]. We collected bronchoalveolar lavage fluid samples from 86 patients with SARS-CoV-2-induced respiratory failure and 252 patients with known or suspected pneumonia from other pathogens and subjected them to flow cytometry and bulk transcriptomic profiling. We performed single cell RNA-Seq in 5 bronchoalveolar lavage fluid samples collected from patients with severe COVID-19 within 48 hours of intubation. In the majority of patients with SARS-CoV-2 infection at the onset of mechanical ventilation, the alveolar space is persistently enriched in alveolar macrophages and T cells without neutrophilia. Bulk and single cell transcriptomic profiling suggest SARS-CoV-2 infects alveolar macrophages that respond by recruiting T cells. These T cells release interferon-gamma to induce inflammatory cytokine release from alveolar macrophages and further promote T cell recruitment. Our results suggest SARS-CoV-2 causes a slowly unfolding, spatially-limited alveolitis in which alveolar macrophages harboring SARS-CoV-2 transcripts and T cells form a positive feedback loop that drives progressive alveolar inflammation. This manuscript is accompanied by an online resource: https://www.nupulmonary.org/covid-19/ One sentence summary SARS-CoV-2-infected alveolar macrophages form positive feedback loops with T cells in patients with severe COVID-19.


id: cord-305547-e66o5j85
author: Bénet, Thomas
date: 2015-12-22
txt: ./txt/cord-305547-e66o5j85.txt
cache: ./cache/cord-305547-e66o5j85.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1371/journal.pone.0145447
doi: 10.1371/journal.pone.0145447
summary:
  title: Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6–7.0), human metapneumovirus (aOR = 17.2, 95% CI: 2.0–151.4), respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3–23.3), and influenza A virus (aOR = 10.7, 95% CI: 1.0–112.2) were associated with pneumonia, independently of patient age, gender, period, and other pathogens. The primary objective of this prospective case-control study was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children in Mali. pneumoniae, human metapneumovirus, RSV, and influenza A were the main microbial agents associated with pneumonia among children in Mali, independently of patient age, gender, period, and other pathogens. recently observed, in a pneumonia cases-control study implemented in hospitals of Utah, that detection respiratory syncytial virus, human metapneumovirus and influenza from nasopharyngeal or oropharyngeal sample of patients with pneumonia probably indicates an etiologic role [24] .

title:
  Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study

abstract:
  BACKGROUND: There are very limited data on children with pneumonia in Mali. The objective was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children <5 years of age in Mali. METHODS: A prospective hospital-based case-control study was implemented in the Pediatric department of Gabriel Touré University Hospital at Bamako, Mali, between July 2011-December 2012. Cases were children with radiologically-confirmed pneumonia; Controls were hospitalized children without respiratory features, matched for age and period. Respiratory specimens, were collected to identify 19 viruses and 5 bacteria. Whole blood was collected from cases only. Factors associated with pneumonia were assessed by multivariate logistic regression. RESULTS: Overall, 118 cases and 98 controls were analyzed; 44.1% were female, median age was 11 months. Among pneumonia cases, 30.5% were hypoxemic at admission, mortality was 4.2%. Pneumonia cases differed from the controls regarding clinical signs and symptoms but not in terms of past medical history. Multivariate analysis of nasal swab findings disclosed that S. pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6–7.0), human metapneumovirus (aOR = 17.2, 95% CI: 2.0–151.4), respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3–23.3), and influenza A virus (aOR = 10.7, 95% CI: 1.0–112.2) were associated with pneumonia, independently of patient age, gender, period, and other pathogens. Distribution of S. pneumoniae and RSV differed by season with higher rates of S. pneumoniae in January-June and of RSV in July-September. Pneumococcal serotypes 1 and 5 were more frequent in pneumonia cases than in the controls (P = 0.009, and P = 0.04, respectively). CONCLUSIONS: In this non-PCV population from Mali, pneumonia in children was mainly attributed to S. pneumoniae, RSV, human metapneumovirus, and influenza A virus. Increased pneumococcal conjugate vaccine coverage in children could significantly reduce the burden of pneumonia in sub-Saharan African countries.


id: cord-305786-06dpjik8
title: Pneumonia in Hospitalized Children
author: Sandora, Thomas J.
date: 2005-07-09
txt: ./txt/cord-305786-06dpjik8.txt
cache: ./cache/cord-305786-06dpjik8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0031395505000672
doi: 10.1016/j.pcl.2005.03.004
summary:
  Fever and cough are also frequently present in children with pneumonia, and clinical signs may include retractions or abnormal auscultatory findings, such as rales or decreased breath sounds, which tend to be more specific as indicators of lower respiratory tract infection [23] [24] [25] [26] . Published studies of adult patients with CAP have shown that adherence to a treatment guideline results in improvement in several outcomes, including lower costs, decreased length of stay, more appropriate antibiotic usage, and lower mortality rates [56] [57] [58] [59] [60] [61] . Empiric coverage for pneumonia in patients in the intensive care unit or others at risk for nosocomial infections should include broad-spectrum agents that provide coverage for these antibiotic-resistant organisms (and any organisms known to be a frequent cause of hospital-acquired infections in the institution) until a specific diagnosis can be made and antimicrobial susceptibilities are available.

abstract:
  Pneumonia is one of the most common infections in the pediatric age group and one of the leading diagnoses that results in overnight hospital admission for children. Various micro-organisms can cause pneumonia, and etiologies differ by age. Clinical manifestations vary, and diagnostic testing is frequently not standardized. Hospital management should emphasize timely diagnosis and prompt initiation of antimicrobial therapy when appropriate. Issues of particular relevance to inpatient management are emphasized in this article.


id: cord-307638-fffjcnak
title: Respiratory infections in the Asia‐Pacific region: Problems and cautious optimism
author: Waterer, Grant
date: 2017-12-21
txt: ./txt/cord-307638-fffjcnak.txt
cache: ./cache/cord-307638-fffjcnak.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1111/resp.13238
doi: 10.1111/resp.13238
abstract: nan
summary:
  Over the past 12 months, Respirology has published a series of excellent reviews outlining the challenges that respiratory infections continue to pose to the Asia-Pacific region and beyond. Equally, they argue that more resources are desperately needed to adequately control tuberculosis, and especially drug-resistant diseases, in the developing world. Rather than poverty, malnutrition and overcrowding driving the problem as with tuberculosis, frequent use and misuse of broadspectrum antibiotics in patients with a fundamental inability to resist infection (such as in those with severe chronic obstructive airway disease, bronchiectasis, cystic fibrosis or major organ failure requiring prolonged stays in intensive care units) are responsible for MDR-GNB. As Rodrigo-Troyano and Sibila point out, unlike tuberculosis, there has been very little progress in antibiotic development for MDR-GNB and case reports are increasing for pan-resistant organisms immune to all known therapies. Regional differences in antibiotic-resistant pathogens in patients with pneumonia: implications for clinicians


id: cord-308916-6p2qutc5
title: Community-acquired pneumonia in children — a changing spectrum of disease
author: le Roux, David M.
date: 2017-09-21
txt: ./txt/cord-308916-6p2qutc5.txt
cache: ./cache/cord-308916-6p2qutc5.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/29043417/
doi: 10.1007/s00247-017-3827-8
summary:
  New conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae have contributed to decreases in radiologic, clinical and complicated pneumonia cases and have reduced hospitalization and mortality. In a review of four randomized controlled trials and two case-control studies of Haemophilus influenzae type B conjugate vaccination in high-burden communities, the vaccination was associated with an 18% decrease in radiologic pneumonia [13] . However, given the high mortality from pneumonia in low-and middle-income countries, the lack of easy access to care, and the high prevalence of risk factors for severe disease, revised World Health Organization pneumonia guidelines still recommend antibiotic treatment for all children who meet the WHO pneumonia case definitions [80] . Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than 5 years of age for prevention of pneumonia: updated analysis using World Health Organization standardized interpretation of chest radiographs

abstract:
  Pneumonia remains the leading cause of death in children outside the neonatal period, despite advances in prevention and management. Over the last 20 years, there has been a substantial decrease in the incidence of childhood pneumonia and pneumonia-associated mortality. New conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae have contributed to decreases in radiologic, clinical and complicated pneumonia cases and have reduced hospitalization and mortality. The importance of co-infections with multiple pathogens and the predominance of viral-associated disease are emerging. Better access to effective preventative and management strategies is needed in low- and middle-income countries, while new strategies are needed to address the residual burden of disease once these have been implemented.


id: cord-310840-h49dx92d
title: Pneumonia in Normal and Immunocompromised Children: An Overview and Update
author: Eslamy, Hedieh K.
date: 2011-09-30
txt: ./txt/cord-310840-h49dx92d.txt
cache: ./cache/cord-310840-h49dx92d.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0033838911000777
doi: 10.1016/j.rcl.2011.06.007
summary:
  The role of imaging is to detect the presence of pneumonia, and determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as effusion/empyema and suppurative lung changes. The role of imaging, including chest radiographs, ultrasound (US) and computed tomography (CT), is to detect the presence of pneumonia, determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as parapneumonic effusion/ empyema and suppurative lung complications. CT is often used to further evaluate: (1) suppurative lung complications and to differentiate these from parapneumonic effusion/empyema; (2) patients with recurrent or chronic pneumonia and concern for an underlying lesion; and (3) immunocompromised children with noncontributory or confusing chest radiographs and clinical findings that could be secondary to lung infection. The chest radiograph of acute focal pneumonia usually shows a dense, typically more peripheral airspace opacity, which may appear segmental, lobar, or spherical ( Figs.

abstract:
  Pneumonia is an infection of the lung parenchyma caused by a wide variety of organisms in pediatric patients. The role of imaging is to detect the presence of pneumonia, and determine its location and extent, exclude other thoracic causes of respiratory symptoms, and show complications such as effusion/empyema and suppurative lung changes. The overarching goal of this article is to review cause, role of imaging, imaging techniques, and the spectrum of acute and chronic pneumonias in children. Pneumonia in the neonate and immunocompromised host is also discussed.


id: cord-312266-hnbgaxft
title: Current therapeutics and prophylactic approaches to treat pneumonia
author: Krishnamurthy, A.
date: 2016-08-05
txt: ./txt/cord-312266-hnbgaxft.txt
cache: ./cache/cord-312266-hnbgaxft.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/B9780128045435000178
doi: 10.1016/b978-0-12-804543-5.00017-8
summary:
  The Haemophilus influenzae type b (Hib) vaccine and the pneumococcal conjugate vaccines are increasingly available in both developed as well as developing countries, especially the 7-and 13-valent pneumococcal conjugate vaccines which have shown effectiveness in reducing the incidence and severity of pneumonia and other lower respiratory infections in children. 61 The efficacy of ribavirin for the treatment of RSV CAP in infants is debatable, as certain in vitro studies have shown activity of ribavirin against RSV, but its usage for RSV infection is not routinely recommended in the management of lower respiratory tract disease because of the high cost, aerosol administration, and possible toxic effects among healthcare providers. 90 Zabofloxacin: is being developed as a new fluoroquinolone antibiotic that is a potent and selective inhibitor of the essential bacterial type II topoisomerases and topoisomerase IV and is indicated for community-acquired respiratory infections due to Gram-positive bacteria.

abstract:
  Bacterial pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Mycoplasma pneumoniae, and Klebsiella pneumoniae represents a frequent cause of mortality worldwide. The increased incidence of pneumococcal diseases in both developed and developing countries is alarmingly high, affecting infants and aged adult populations. The growing rate of antibiotic resistance and biofilm formation on medical device surfaces poses a greater challenge for treating respiratory infections. Over recent years, a better understanding of bacterial growth, metabolism, and virulence has offered several potential targets for developing therapeutics against bacterial pneumonia. This chapter will discuss the current and developing trends in treating bacterial pneumonia.


id: cord-314359-fw14b5cv
title: Respiratory infections in immunocompromised patients: Lung findings using chest computed tomography
author: Bajaj, Satish Kumar
date: 2016-11-23
txt: ./txt/cord-314359-fw14b5cv.txt
cache: ./cache/cord-314359-fw14b5cv.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S2352621116300742
doi: 10.1016/j.jrid.2016.11.001
summary:
  Patient who present with classical symptoms like fever, rigors, chills, cough with expectoration, chest pain, dyspnea and whose chest radiographic findings are suggestive of common bacterial infections is considered to have typical pneumonia. Clinical features such as patient age, immune status, time of year, illness in other family members, community outbreaks, different stages of the underlying disease at onset, severity and duration of symptoms, and presence of a rash remain important in diagnosing viral causes of atypical pneumonia in immune-competent as well as ICPs. CXR is an essential tool for rapid diagnosis of lung changes and may also be help in follow up of the treatment response. However, in hospitalized patients with similar radiological features without any relevant clinical and laboratory findings consistent with lung infection, a possible diagnosis of atelectasis, old changes and organizing pneumonias following a course of antibiotics should be considered.

abstract:
  Respiratory infections and subsequent complications are one of the leading causes of high mortality in immunocompromised patients. Although chest radiograph and computed tomography are the commonly used diagnostic tools for the early diagnosis of lung manifestations of infections, they lack the specificity for the wide range of chest infections which can occur in immunocompromised patients. Systematic analysis of the imaging findings in correlation with the clinical settings along with comparison with the old images can expedite early and accurate diagnosis for subsequent appropriate management. Computer tomography findings in immunocompromised patients with respiratory infections, with regards to various clinical settings, will be discussed here.


id: cord-315834-ashjw2xs
title: Clinical Features Predicting Mortality Risk in Patients With Viral Pneumonia: The MuLBSTA Score
author: Guo, Lingxi
date: 2019-12-03
txt: ./txt/cord-315834-ashjw2xs.txt
cache: ./cache/cord-315834-ashjw2xs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31849894/
doi: 10.3389/fmicb.2019.02752
summary:
  title: Clinical Features Predicting Mortality Risk in Patients With Viral Pneumonia: The MuLBSTA Score OBJECTIVE: The aim of this study was to further clarify clinical characteristics and predict mortality risk among patients with viral pneumonia. CONCLUSION: Here, we designed an easy-to-use clinically predictive tool for assessing 90-day mortality risk of viral pneumonia. Influenza and other respiratory viruses are common reasons of acute pneumonia which can result in significant morbidity or mortality in the setting of high-risk factors such as extremes of age, pregnancy, obesity or chronic pre-existing conditions. Other reported risk factors for influenza pneumonia such as PO2/FiO2, lymphocyte count, and antigen-specific T cells are likewise useful in predicting mortality and deciding on appropriate management (Viasus et al., 2011; Shi et al., 2017) . In patients hospitalized with viral pneumonia, a simple prognostic tool was made for overall mortality which is useful for prediction several days after admission upon obtaining culture results.

abstract:
  OBJECTIVE: The aim of this study was to further clarify clinical characteristics and predict mortality risk among patients with viral pneumonia. METHODS: A total of 528 patients with viral pneumonia at RuiJin hospital in Shanghai from May 2015 to May 2019 were recruited. Multiplex real-time RT-PCR was used to detect respiratory viruses. Demographic information, comorbidities, routine laboratory examinations, immunological indexes, etiological detections, radiological images and treatment were collected on admission. RESULTS: 76 (14.4%) patients died within 90 days in hospital. A predictive MuLBSTA score was calculated on the basis of a multivariate logistic regression model in order to predict mortality with a weighted score that included multilobular infiltrates (OR = 5.20, 95% CI 1.41–12.52, p = 0.010; 5 points), lymphocyte ≤ 0.8(∗)10(9)/L (OR = 4.53, 95% CI 2.55–8.05, p < 0.001; 4 points), bacterial coinfection (OR = 3.71, 95% CI 2.11–6.51, p < 0.001; 4 points), acute-smoker (OR = 3.19, 95% CI 1.34–6.26, p = 0.001; 3 points), quit-smoker (OR = 2.18, 95% CI 0.99–4.82, p = 0.054; 2 points), hypertension (OR = 2.39, 95% CI 1.55–4.26, p = 0.003; 2 points) and age ≥60 years (OR = 2.14, 95% CI 1.04–4.39, p = 0.038; 2 points). 12 points was used as a cut-off value for mortality risk stratification. This model showed sensitivity of 0.776, specificity of 0.778 and a better predictive ability than CURB-65 (AUROC = 0.773 vs. 0.717, p < 0.001). CONCLUSION: Here, we designed an easy-to-use clinically predictive tool for assessing 90-day mortality risk of viral pneumonia. It can accurately stratify hospitalized patients with viral pneumonia into relevant risk categories and could provide guidance to make further clinical decisions.


id: cord-315860-9j667c03
author: Jullien, Sophie
date: 2020-04-10
url: https://www.sciencedirect.com/science/article/pii/S1201971220302332
doi: 10.1016/j.ijid.2020.04.017
title:
  Pneumonia in children admitted to the national referral hospital in Bhutan: A prospective cohort study

abstract:
  OBJECTIVES: The study aim was to describe the etiological profile and clinical characteristics of pneumonia among children hospitalized in Thimphu, Bhutan. METHODS: This prospective study enrolled children aged 2–59 months admitted to the Jigme Dorji Wangchuck National Referral Hospital with World Health Organization (WHO)-defined clinical pneumonia. Demographic and clinico-radiological data were collected through questionnaires, physical examination, and chest radiography. Blood samples and nasopharyngeal washing were collected for microbiological analysis including culture and molecular methods. RESULTS: From July 2017 to June 2018, 189 children were enrolled, of which 53.4% were infants. Pneumonia-related admissions were less frequent over the winter. Chest radiographies were obtained in 149 children; endpoints included pneumonia in 39 cases (26.2%), other infiltrates in 31 (20.8%), and were normal in 79 children (53.0%). Non-contaminated bacterial growth was detected in 8/152 (5.3%) blood cultures, with only two cases of Streptococcus pneumoniae. Viral detection in upper respiratory secretions was common, with at least one virus detected in 103/115 (89.6%). The three most-commonly isolated viruses were respiratory syncytial virus (52/115; 45.2%), rhinovirus (42/115; 36.5%), and human parainfluenza virus (19/115; 16.5%). A third of patients with viral infections showed mixed infections. Case fatality rate was 3.2% (6/189). CONCLUSION: Respiratory viral infections predominated among this cohort of WHO-defined clinical pneumonia cases, whereas bacterial aetiologies were uncommon, highlighting the epidemiologic transition that Bhutan seems to have reached.


id: cord-317024-1rhzhpij
title: Atualização em pneumonia comunitária viral()
author: Rocha Neto, Ozéas Galeno da
date: 2013-09-23
url: https://www.ncbi.nlm.nih.gov/pubmed/23440146/
doi: 10.1590/s0104-42302013000100015
abstract:
  Viral pneumonia is a prevalent cause of respiratory infection in immunocompetent adults. It has varied presentation, from mild to severe respiratory failure, requiring mechanical ventilation. However, in Brazil, there have been few studies on the clinical presentation and diagnosis of this infection. Thus, the authors of the present article intend to review the main viral agents that cause community-acquired pneumonia and to discuss the currently available diagnostic and therapeutic methods.


id: cord-319002-xmsfkaoc
title: Community-Acquired Pneumonia in HIV-Infected Individuals
author: Brown, James
date: 2014-02-22
txt: ./txt/cord-319002-xmsfkaoc.txt
cache: ./cache/cord-319002-xmsfkaoc.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s11908-014-0397-x
doi: 10.1007/s11908-014-0397-x
summary:
  Studies in populations other than in Europe and the US have confirmed the importance of bacterial pneumonia in HIV-infected individuals, with recent work in Taiwan showing this to be the most common respiratory complication of HIV infection in those with CD4 counts above 200 cells/μL [9] . This may be due to the high levels of immunocompromise in this population despite the availability of ART, although an increase in invasive pneumococcal disease was found amongst women in that study, suggesting that general uptake of the childhood pneumococcal conjugate vaccination (PCV; which now forms part of the childhood immunization schedule in South Africa) may be particularly effective at reducing rates of invasive pneumococcal disease amongst HIV-infected adults in this community. Several interventions can be made that have been shown to reduce this risk; these include: the use of ART and achievement of an undetectable plasma HIV load, smoking cessation, and the uptake of the pneumococcal and influenza immunizations, which international guidelines recommend for HIV-infected individuals.

abstract:
  Community-acquired pneumonia continues to be an important complication of HIV infection. Rates of pneumonia decrease with the use of antiretroviral therapy but continue to be higher than in HIV uninfected individuals. Risk factors for pneumonia include low blood CD4+ count, unsuppressed plasma HIV load, smoking, injection drug use and renal impairment. Immunization against Streptococcus pneumoniae and smoking cessation can reduce this risk. It is unclear whether newly reported viral respiratory pathogens (such as the Middle East respiratory syndrome coronavirus, will be more of a problem in HIV-infected individuals than the general population.


id: cord-320438-9j41eyw3
title: Pulmonary infections
author: Daltro, Pedro
date: 2011-04-27
txt: ./txt/cord-320438-9j41eyw3.txt
cache: ./cache/cord-320438-9j41eyw3.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1007/s00247-011-2012-8
doi: 10.1007/s00247-011-2012-8
summary:
  This paper reviews the most common imaging findings of pulmonary infection in children. This paper reviews the most common causes of pulmonary infection in children, emphasizing the imaging findings. As with other viral infections, focal or diffuse interstitial opacities are the initial chest radiograph presentation, but they can progress rapidly to bilateral areas of consolidation (Fig. 3 ). These children are prone to repeated bacterial infections with associated pneumonia leading to postinfectious bronchiectasis (Fig. 18) . Chest radiograph and CT findings show Fig. 16 Axial CT shows the typical halo sign in an immunocompromised child with invasive aspergillosis chronic or recurrent pneumonia, usually by Aspergillus or Candida organisms. The most common chest radiograph and CT findings are diffuse reticular interstitial opacities that can progress to massive alveolar consolidations resulting in acute respiratory distress syndrome in infants (Fig. 20) .

abstract:
  This paper reviews the most common imaging findings of pulmonary infection in children. Pneumonia is a leading cause of mortality in children in developing and industrialized countries. While the imaging findings usually are nonspecific, correlation with the patient’s age, immune status and pertinent history can limit the differential diagnoses. The paper will review the common and unique features of pneumonia caused by specific organisms and in specific patient populations.


id: cord-321514-knyw023l
author: Bénet, Thomas
date: 2017-07-12
txt: ./txt/cord-321514-knyw023l.txt
cache: ./cache/cord-321514-knyw023l.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/28719310/
doi: 10.4269/ajtmh.16-0733
summary:
  The objectives were to evaluate the microbiological agents linked with hypoxemia in hospitalized children with pneumonia from developing countries, to identify predictors of hypoxemia, and to characterize factors associated with in-hospital mortality. The objectives of the present study are to assess the microbiological agents linked to hypoxemia in hospitalized children with pneumonia in developing countries, to identify clinical and para-clinical predictors of hypoxemia and to pinpoint factors associated with death within 2 weeks after admission. The present study selectively comprised sites with better quality data on oxygen saturation (SO 2 ) at admission, mortality among pneumonia cases, and documented recording of patient follow-up during hospitalization. One of the objectives of this study was to assess microbiological agents and other predictors of hypoxemia and death in under 5-year-old hospitalized children with pneumonia from developing countries.

title:
  Severity of Pneumonia in Under 5-Year-Old Children from Developing Countries: A Multicenter, Prospective, Observational Study

abstract:
  Pneumonia is the leading cause of death in children. The objectives were to evaluate the microbiological agents linked with hypoxemia in hospitalized children with pneumonia from developing countries, to identify predictors of hypoxemia, and to characterize factors associated with in-hospital mortality. A multicenter, observational study was conducted in five hospitals, from India (Lucknow, Vadu), Madagascar (Antananarivo), Mali (Bamako), and Paraguay (San Lorenzo). Children aged 2–60 months with radiologically confirmed pneumonia were enrolled prospectively. Respiratory and whole blood specimens were collected, identifying viruses and bacteria by real-time multiplex polymerase chain reaction (PCR). Microbiological agents linked with hypoxemia at admission (oxygen saturation < 90%) were analyzed by multivariate logistic regression, and factors associated with 14-day in-hospital mortality were assessed by bivariate Cox regression. Overall, 405 pneumonia cases (3,338 hospitalization days) were analyzed; 13 patients died within 14 days of hospitalization. Hypoxemia prevalence was 17.3%. Detection of human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) in respiratory samples was independently associated with increased risk of hypoxemia (adjusted odds ratio [aOR] = 2.4, 95% confidence interval [95% CI] = 1.0–5.8 and aOR = 2.5, 95% CI = 1.1–5.3, respectively). Lower chest indrawing and cyanosis were predictive of hypoxemia (positive likelihood ratios = 2.3 and 2.4, respectively). Predictors of death were Streptococcus pneumoniae detection by blood PCR (crude hazard ratio [cHR] = 4.6, 95% CI = 1.5–14.0), procalcitonin ≥ 50 ng/mL (cHR = 22.4, 95% CI = 7.3–68.5) and hypoxemia (cHR = 4.8, 95% CI = 1.6–14.4). These findings were consistent on bivariate analysis. hMPV and RSV in respiratory samples were linked with hypoxemia, and S. pneumoniae in blood was associated with increased risk of death among hospitalized children with pneumonia in developing countries.


id: cord-322104-f1dukpso
title: PNEUMONIA | Community Acquired Pneumonia, Bacterial and Other Common Pathogens
author: Niederman, M.S.
date: 2006-05-13
url: https://api.elsevier.com/content/article/pii/B0123708796003100
doi: 10.1016/b0-12-370879-6/00310-0
abstract:
  Community-acquired pneumonia (CAP) is the number one cause of death from infectious diseases in the US, and the patient population that is affected is becoming increasingly more complex due to the presence of chronic illness which is commonly managed in outpatients who are at risk for pneumonia. The number one pathogen causing CAP is pneumococcus, which is commonly resistant to multiple antibiotics, thus complicating management. Other common pathogens include atypical organisms (Chlamydophila pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae), Hemophilus influenzae, enteric Gram-negatives (especially in those with chronic illness and aspiration risk factors), and Staphylococcus aureus. Successful management requires careful assessment of disease severity so that a site-of-care decision can be made (outpatient, inpatient, intensive care unit), appropriate samples for diagnostic testing collected, and antibiotic therapy initiated in a timely and accurate fashion. Initial antibiotic therapy is empiric, but even with extensive diagnostic testing, less than half of all patients have an etiologic pathogen identified. All patients with CAP require therapy for pneumococcus, atypical pathogens, and other organisms, as dictated by the presence of specific risk factors. Because pneumonia has both short-term and long-term impact on mortality, it is also important to focus on prevention of this illness, which requires smoking cessation, and giving at-risk individuals both pneumococal and influenza vaccines.


id: cord-323112-e78zpa9c
title: Respiratory infections: A current and future threat
author: WATERER, Grant
date: 2009-07-16
txt: ./txt/cord-323112-e78zpa9c.txt
cache: ./cache/cord-323112-e78zpa9c.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/19659646/
doi: 10.1111/j.1440-1843.2009.01554.x
summary:
  This review will focus on the human, pathogen and environmental factors that contribute to the continued global burden or respiratory diseases with a particular focus on areas where we might hope to see some progress in the coming decades. 14 While it is clear that strict infection control can reduce nosocomial infection rates, 15 the practical necessity of pooling vulnerable hosts together combined with the inevitable ageing of health-care facilities will ensure that nosocomial outbreaks continue to be a problem. In recent years the marked increase in tumour necrosis factor antagonists and monoclonal antibodies targeting specific lymphoid populations in patients with inflammatory arthritis (and especially rheumatoid disease) has significantly over taken patients on immunosuppressant therapy after solid organ transplantation as the major cause of iatrogenic immunosuppression. New therapeutic and diagnostic approaches coupled with clinical vigilance, strict infection control and solid public health measures are the hopes for reducing the burden of pulmonary infectious disease over the coming decades.

abstract:
  Despite all the medical progress in the last 50 years pulmonary infections continue to exact and extremely high human and economic cost. This review will focus on the human, pathogen and environmental factors that contribute to the continued global burden or respiratory diseases with a particular focus on areas where we might hope to see some progress in the coming decades.


id: cord-323473-e2pgjynr
title: Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines
author: Cevey-Macherel, Manon
date: 2009-02-24
url: https://www.ncbi.nlm.nih.gov/pubmed/19238436/
doi: 10.1007/s00431-009-0943-y
abstract:
  Community-acquired pneumonia (CAP) is a major cause of death in developing countries and of morbidity in developed countries. The objective of the study was to define the causative agents among children hospitalized for CAP defined by WHO guidelines and to correlate etiology with clinical severity and surrogate markers. Investigations included an extensive etiological workup. A potential causative agent was detected in 86% of the 99 enrolled patients, with evidence of bacterial (53%), viral (67%), and mixed (33%) infections. Streptococcus pneumoniae was accounted for in 46% of CAP. Dehydration was the only clinical sign associated with bacterial pneumonia. CRP and PCT were significantly higher in bacterial infections. Increasing the number of diagnostic tests identifies potential causes of CAP in up to 86% of children, indicating a high prevalence of viruses and frequent co-infections. The high proportion of pneumococcal infections re-emphasizes the importance of pneumococcal immunization.


id: cord-323742-rt0g0ufe
author: Carter, Michael J.
date: 2020-01-17
url: https://doi.org/10.3389/fcimb.2019.00459
doi: 10.3389/fcimb.2019.00459
title:
  Assessment of an Antibody-in-Lymphocyte Supernatant Assay for the Etiological Diagnosis of Pneumococcal Pneumonia in Children

abstract:
  New diagnostic tests for the etiology of childhood pneumonia are needed. We evaluated the antibody-in-lymphocyte supernatant (ALS) assay to detect immunoglobulin (Ig) G secretion from ex vivo peripheral blood mononuclear cell (PBMC) culture, as a potential diagnostic test for pneumococcal pneumonia. We enrolled 348 children with pneumonia admitted to Patan Hospital, Kathmandu, Nepal between December 2015 and September 2016. PBMCs sampled from participants were incubated for 48 h before harvesting of cell culture supernatant (ALS). We used a fluorescence-based multiplexed immunoassay to measure the concentration of IgG in ALS against five conserved pneumococcal protein antigens. Of children with pneumonia, 68 had a confirmed etiological diagnosis: 12 children had pneumococcal pneumonia (defined as blood or pleural fluid culture-confirmed; or plasma CRP concentration ≥60 mg/l and nasopharyngeal carriage of serotype 1 pneumococci), and 56 children had non-pneumococcal pneumonia. Children with non-pneumococcal pneumonia had either a bacterial pathogen isolated from blood (six children); or C-reactive protein <60 mg/l, absence of radiographic consolidation and detection of a pathogenic virus by multiplex PCR (respiratory syncytial virus, influenza viruses, or parainfluenza viruses; 23 children). Concentrations of ALS IgG to all five pneumococcal proteins were significantly higher in children with pneumococcal pneumonia than in children with non-pneumococcal pneumonia. The concentration of IgG in ALS to the best-performing antigen discriminated between children with pneumococcal and non-pneumococcal pneumonia with a sensitivity of 1.0 (95% CI 0.73–1.0), specificity of 0.66 (95% CI 0.52–0.78) and area under the receiver-operating characteristic curve (AUROCC) 0.85 (95% CI 0.75–0.94). Children with pneumococcal pneumonia were older than children with non-pneumococcal pneumonia (median 5.6 and 2.0 years, respectively, p < 0.001). When the analysis was limited to children ≥2 years of age, assay of IgG ALS to pneumococcal proteins was unable to discriminate between children with pneumococcal pneumonia and non-pneumococcal pneumonia (AUROCC 0.67, 95% CI 0.47–0.88). This method detected spontaneous secretion of IgG to pneumococcal protein antigens from cultured PBMCs. However, when stratified by age group, assay of IgG in ALS to pneumococcal proteins showed limited utility as a test to discriminate between pneumococcal and non-pneumococcal pneumonia in children.


id: cord-326751-fn43p19j
title: Community-acquired and nosocomial pneumonia
author: Herold, Christian J.
date: 2004-01-29
url: https://www.ncbi.nlm.nih.gov/pubmed/14749949/
doi: 10.1007/s00330-003-2162-7
abstract:
  Pneumonia is one of the leading causes of morbidity, hospitalization, and mortality in both industrialized and developing countries. In particular, pulmonary infections acquired in the community, and pneumonias arising in the hospital setting, represent a major medical and economic problem and thus a continuous challenge to health care. For the radiologist, it is important to understand that community-acquired pneumonia (CAP) and nosocomial pneumonia (NP) share a number of characteristics, but should, in many respects be regarded as separate entities. CAP and NP arise in different populations, host different spectra of causative pathogens, and pose different challenges to both the clinician and the radiologist. CAP is generally seen in outpatients, is most frequently caused by Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, and Chlamydia, and its radiologic diagnosis is relatively straightforward. NP, in contrast, develops in the hospital setting, is commonly caused by gram-negative bacteria, and may generate substantial problems for the radiologist. Overall, both for CAP and NP, imaging is an integral component of the diagnosis, important for classification and differential diagnosis, and helpful for follow-up.


id: cord-334470-tg8yqzrt
title: Is low dose radiation therapy a potential treatment for COVID-19 pneumonia?
author: Kirkby, Charles
date: 2020-04-06
txt: ./txt/cord-334470-tg8yqzrt.txt
cache: ./cache/cord-334470-tg8yqzrt.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.radonc.2020.04.004
doi: 10.1016/j.radonc.2020.04.004
abstract: nan
summary:
  title: Is low dose radiation therapy a potential treatment for COVID-19 pneumonia? We would like to draw the radiotherapy community''s attention to the potential for low doses (< 100 cGy) of low LET radiation to treat viral pneumonia as a possible therapy for COVID-19 patients. A review showed low doses from kilovoltage x-rays reduced pneumonia mortality from roughly 30 percent to 10 percent on average.(2) Doses reported were generally in the 20 -few hundred Roentgen range, which given the attenuation through chest wall would likely have resulted in mean lung doses in the tens to < 100 cGy range. Therefore, it stands to reason that an LDRT treatment of 30 to 100 cGy to the lungs of a patient with COVID-19 pneumonia could reduce the inflammation and relieve the life-threatening symptoms.


id: cord-340766-aic570x8
author: Kim, Se Jin
date: 2015-04-15
txt: ./txt/cord-340766-aic570x8.txt
cache: ./cache/cord-340766-aic570x8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25875735/
doi: 10.1371/journal.pone.0122642
summary:
  The present study describes in detail the clinical characteristics and favorable treatment outcomes of non-immunocompromised adults who had experienced severe AdV pneumonia and received early cidofovir administration. Only non-immunocompromised adult patients who fulfilled the criteria for severe community-acquired pneumonia, set out in the Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines [23] , and admitted to the intensive care unit with progressive respiratory failure, defined as a partial pressure of arterial oxygen (PaO 2 )/fraction of inspired oxygen (FiO 2 ) ratio of < 300 mmHg and/or tachypnea (respiration rate >30 breaths/min) [24] , were included in the analysis. Our data suggest that early administration of cidofovir in the course of treatment for respiratory failure as a result of AdV pneumonia in non-immunocompromised patients could be a treatment strategy worth considering, especially in cases of HAdV-55 infection. Our data suggest that early administration of cidofovir in the course of treatment for respiratory failure as a result of AdV pneumonia in non-immunocompromised patients could be a treatment strategy worth considering, especially in cases of HAdV-55 infection.

title:
  Outcomes of Early Administration of Cidofovir in Non-Immunocompromised Patients with Severe Adenovirus Pneumonia

abstract:
  The benefits of treatment with antiviral therapy for severe adenovirus (AdV) pneumonia are not well established. We described the clinical characteristics and treatment outcomes of early cidofovir treatment of severe AdV pneumonia in non-immunocompromised patients. We retrospectively reviewed the medical records of all patients diagnosed with severe AdV pneumonia between 2012 and 2014. A total of seven non-immunocompromised patients with severe AdV pneumonia were identified, and all isolates typed (n = 6) were human AdV-B55. All patients had progressive respiratory failure with lobar consolidation with or without patchy ground glass opacity. Three patients required vasopressors and mechanical ventilation. All patients had abnormal laboratory findings including: leukopenia, thrombocytopenia, or elevated liver enzymes. After admission, all patients received antiviral therapy with cidofovir, and the median time from admission to cidofovir administration was 48 h and median the time from onset of symptoms to cidofovir administration was 7.1 days. After cidofovir administration, complete symptomatic improvement occurred after a median of 12 days and radiographic resolution occurred after a median of 21 days. Consequently, all patients completely improved without complications. Our data suggest that early administration of cidofovir in the course of treatment for respiratory failure as a result of AdV pneumonia in non-immunocompromised patients could be a treatment strategy worth considering, especially in cases of HAdV-55 infection.


id: cord-345211-4ivqlsgt
title: How recent advances in molecular tests could impact the diagnosis of pneumonia
author: Murdoch, David R.
date: 2016-03-07
url: https://www.ncbi.nlm.nih.gov/pubmed/26891612/
doi: 10.1586/14737159.2016.1156536
abstract:
  Molecular diagnostic tests have been the single major development in pneumonia diagnostics over recent years. Nucleic acid detection tests (NATs) have greatly improved the ability to detect respiratory viruses and bacterial pathogens that do not normally colonize the respiratory tract. In contrast, NATs do not yet have an established role for diagnosing pneumonia caused by bacteria that commonly colonize the nasopharynx due to difficulties discriminating between pathogens and coincidental carriage strains. New approaches are needed to distinguish infection from colonization, such as through use of quantitative methods and identification of discriminating cut-off levels. The recent realization that the lung microbiome exists has provided new insights into the pathogenesis of pneumonia involving the interaction between multiple microorganisms. New developments in molecular diagnostics must account for this new paradigm.


id: cord-347691-ia2i8svg
title: Multimodality imaging of COVID-19 pneumonia: from diagnosis to follow-up. A comprehensive review
author: Larici, Anna Rita
date: 2020-08-17
txt: ./txt/cord-347691-ia2i8svg.txt
cache: ./cache/cord-347691-ia2i8svg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ejrad.2020.109217
doi: 10.1016/j.ejrad.2020.109217
summary:
  The purpose of this comprehensive review is to understand the diagnostic capabilities and limitations of chest X-ray (CXR) and high-resolution computed tomography (HRCT) in defining the common imaging features of COVID-19 pneumonia and correlating them with the underlying pathogenic mechanisms. As suggested in the recently published WHO (World Health Organization) advice guide for the diagnosis and management of COVID-19, chest imaging should be used for diagnostic purpose in symptomatic patients if RT-PCR is not available or its results are delayed, or in case of negative result in the presence of a high clinical suspicion of COVID-19 [11] . Apart from recognizing COVID-19 pneumonia features, imaging -especially CT -may reveal possible alternative diagnoses (e.g. pulmonary oedema, alveolar haemorrhage, other type of lung infections) that justify patient''s respiratory symptoms [25, 26] .

abstract:
  Due to its pandemic diffusion, SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection represents a global threat. Despite a multiorgan involvement has been described, pneumonia is the most common manifestation of COVID-19 (Coronavirus disease 2019) and it is associated with a high morbidity and a considerable mortality. Especially in the areas with high disease burden, chest imaging plays a crucial role to speed up the diagnostic process and to aid the patient management. The purpose of this comprehensive review is to understand the diagnostic capabilities and limitations of chest X-ray (CXR) and high-resolution computed tomography (HRCT) in defining the common imaging features of COVID-19 pneumonia and correlating them with the underlying pathogenic mechanisms. The evolution of lung abnormalities over time, the uncommon findings, the possible complications, and the main differential diagnosis occurring in the pandemic phase of SARS-CoV-2 infection are also discussed.


id: cord-352532-xqphom6x
title: 1 Tropical Lung Diseases
author: Papanikolaou, Ilias C
date: 2013-12-31
txt: ./txt/cord-352532-xqphom6x.txt
cache: ./cache/cord-352532-xqphom6x.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/B9781416043904000011
doi: 10.1016/b978-1-4160-4390-4.00001-1
abstract: nan
summary:
  The following are the common tropical pulmonary conditions: l pneumonia: typical and atypical l eosinophilic pneumonias and tropical pulmonary eosinophilia l bronchiectasis, asthma and chronic obstructive pulmonary disease (COPD) l pleural effusion l nontuberculous granulomatous lung disease l occupational lung diseases. A reasonable approach to the patient with lung disease in the tropic starts with age, occupational exposure, physical examination, HIV status, chest x-ray and blood tests. • If wheezing (even if it disappeared after rapidly acting bronchodilator) give an inhaled bronchodilator for 5 days* • Soothe the throat and relieve the cough with a safe remedy • If coughing for more than 3 weeks or if having recurrent wheezing, refer for assessment for TB or asthma • Advise the mother when to return immediately • Follow-up in 5 days if not improving A blood count usually reveals leukocytosis in bacterial pneumonia, leukopenia in viral infection, and eosinophilia in parasitic infestation.


