scholarly journals Admission profile and management of community acquired pneumonia in Nigeria-5 year experience in a tertiary hospital

2011 ◽  
Vol 105 (2) ◽  
pp. 298-302 ◽  
Author(s):  
Cajetan C. Onyedum ◽  
J.C. Chukwuka
Keyword(s):  
Tertiary Hospital ◽  
Community Acquired Pneumonia

scholarly journals Assessment of Analysis of Urinary Pneumococcal Antigen by Immunochromatography for Etiologic Diagnosis of Community-Acquired Pneumonia in Adults

2006 ◽  
Vol 13 (10) ◽  
pp. 1092-1097 ◽  
Author(s):  
Maria Luisa Briones ◽  
José Blanquer ◽  
David Ferrando ◽  
Maria Luisa Blasco ◽  
Concepción Gimeno ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Diagnostic Techniques ◽  
Community Acquired Pneumonia ◽  
Etiologic Agent ◽  
Chronic Obstructive ◽  
Pneumococcal Infections ◽  
Obstructive Pulmonary Disease ◽  
Pneumococcal Antigen ◽  
A Prospective Study ◽  
Etiologic Diagnosis

ABSTRACT The limitations of conventional microbiologic methods (CMM) for etiologic diagnosis of community pneumococcal pneumonia have made faster diagnostic techniques necessary. Our aim was to evaluate the usefulness of the immunochromatography (ICT) technique for detecting urinary Streptococcus pneumoniae antigen in the etiologic diagnosis of community-acquired pneumonias (CAP). This was a prospective study on in-patients with CAP in a tertiary hospital conducted from October 2000 to March 2004. Apart from using CMM to reach an etiologic diagnosis, we determined pneumococcal antigen in concentrated urine by ICT. We also determined the urinary pneumococcal antigen (UPA) content in patients from two control groups to calculate the specificity of the technique. One group was comprised of in-patients diagnosed with chronic obstructive pulmonary disease (COPD) or asthma, with respiratory infection, and without pneumonia; the other group included fractures. We studied 959 pneumonia patients and determined UPA content in 911 (95%) of them. We diagnosed the etiology of 253 cases (28%) using CMM; S. pneumoniae was the most common etiologic agent (57 cases). ICT analysis was positive for 279 patients (31%). Using this technique, the percentage of diagnoses of pneumococcal pneumonias increased by 26%, while the overall etiologic diagnosis increased from 28 to 49%. The technique sensitivity was 81%; the specificity oscillated between 80% in CAP with nonpneumococcal etiology and 99% for patients with fractures without infections. Determination of UPA is a rapid, simple analysis with good sensitivity and specificity, which increased the percentage of etiologic diagnoses. Positive UPA may persist in COPD patients with probable pneumococcal colonization or recent pneumococcal infections.

scholarly journals Ability of the LACE index to predict 30-day hospital readmissions in patients with community-acquired pneumonia

2020 ◽  
Vol 6 (2) ◽  
pp. 00301-2019
Author(s):  
Claudia C. Dobler ◽  
Maryam Hakim ◽  
Sidhartha Singh ◽  
Matthew Jennings ◽  
Grant Waterer ◽  
...  
Keyword(s):  
Prediction Models ◽  
Hospital Readmissions ◽  
Predictive Ability ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Day Hospital ◽  
Discriminative Ability ◽  
Obstructive Pulmonary Disease ◽  
C Statistic

Background and objectiveHospital readmissions within 30 days are used as an indicator of quality of hospital care. We aimed to evaluate the ability of the LACE (Length of stay, Acuity of admission, Comorbidities based on Charlson comorbidity score and number of Emergency visits in the last 6 months) index to predict the risk of 30-day readmissions in patients hospitalised for community-acquired pneumonia (CAP).MethodsIn this retrospective cohort study a LACE index score was calculated for patients with a principal diagnosis of CAP admitted to a tertiary hospital in Sydney, Australia. The predictive ability of the LACE score for 30-day readmissions was assessed using receiver operator characteristic curves with C-statistic.ResultsOf 3996 patients admitted to hospital for CAP at least once, 8.0% (n=327) died in hospital and 14.6% (n=584) were readmitted within 30 days. 17.8% (113 of 636) of all 30-day readmissions were again due to CAP, followed by readmissions for chronic obstructive pulmonary disease, heart failure and chest pain. The LACE index had moderate discriminative ability to predict 30-day readmission (C-statistic=0.6395) but performed poorly for the prediction of 30-day readmissions due to CAP (C-statistic=0.5760).ConclusionsThe ability of the LACE index to predict all-cause 30-day hospital readmissions is comparable to more complex pneumonia-specific indices with moderate discrimination. For the prediction of 30-day readmissions due to CAP, the performance of the LACE index and modified risk prediction models using readily available variables (sex, age, specific comorbidities, after-hours, weekend, winter or summer admission) is insufficient.

scholarly journals A retrospective observational study to estimate use of biomarkers to predict severity of community acquired pneumonia in children

2021 ◽  
Author(s):  
Anam Bashir ◽  
Raheel Khan ◽  
Stephanie Thompson ◽  
Manuel Caceres
Keyword(s):  
Area Under The Curve ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Minimal Research

Purpose: Multiple studies have investigated the role of biomarkers in predicting pneumonia severity in adults but minimal research exists for children. The aim of this study was to determine if the following biomarkers: white blood cell count (WBC), platelet count, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-lymphocyte ratio, neutrophil count, or band count predict community associated pneumonia (CAP) severity in children. Methods: A retrospective chart review was conducted on pediatric patients (aged 60 days to 18 years) diagnosed with CAP, admitted to a regional, tertiary hospital. Patients were stratified into two severity cohorts, mild (no ICU care), and moderate /severe (required ICU care). Biomarker values were then compared between the severity cohorts and area under the curve (AUC), cut-off values, performance characteristics were calculated. Results: A total of 108 patients met inclusion criteria. Among the biomarkers examined, elevated levels of CRP (51.7 mg/L in mild vs. 104.8 mg/L in moderate/severe, p = 0.003, PCT (0.29 ng/ml in mild vs. 4.02 ng/ml in moderate/severe, p = 0.001) and band counts (8% in mild vs. 15% moderate/severe, p = 0.009) were associated with increased pneumonia severity. In predicting moderate/severe CAP, PCT had the highest AUC of 0.77 (p = 0.001) followed by bands AUC of 0.69 (p = 0.009) and CRP AUC of 0.67 (p = 0.003). The cut-off for PCT of 0.55ng/ml had a sensitivity of 83% and a specificity of 65%. A cut-off level of 53.1 mg/L for CRP had a sensitivity of 79% and specificity of 52%. A cut off level of 12.5% bands had a sensitivity of 61% and specificity of 71%. Conclusion: Biomarkers, in particular PCT, obtained early in hospitalization appear to perform as predictors for CAP severity in children and may be beneficial in guiding CAP management

scholarly journals Etiology and clinical profile of inpatients with Community acquired pneumonia in Manipal Teaching hospital, Pokhara, Nepal

2012 ◽  
Vol 1 (2) ◽  
pp. 84-88 ◽  
Author(s):  
R Shrestha ◽  
N Paudel ◽  
B Barakoti ◽  
D Dhungana ◽  
P Sharma
Keyword(s):  
Hospital Stay ◽  
Treatment Options ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Clinical Profile ◽  
Smear Microscopy ◽  
Duration Of Hospital Stay ◽  
Co Morbidity ◽  
Severity Of The Disease ◽  
Gram Negative Organisms

Background: Community acquired pneumonia (CAP) is major cause of morbidity in adults. The presentation may be varied. Severity of the disease is seen to be more if co-morbid conditions are present, especially chronic lung disease. This study was done to analyze the etiology and clinical profile of community acquired pneumonia admitted in a tertiary hospital in Western Nepal, to focus on treatment options and improve outcomes. Methods: Etiology and clinical profile of 100 patients of CAP was studied retrospectively from April 2010 to March 2011. Data regarding clinical features, physical examination, chest x-ray, sputum samples for smear microscopy and culture was collected in a preformed proforma and analyzed. Results: Mean age of patients was 51 years. Forty one patients had associated co-morbidity. None of the patients were vaccinated against influenza and pneumococcus. The duration of hospital stay was longer in patients with higher CURB-65 score. The commonest mode of presentation was cough (76) followed by fever (64). Etiology was determined in 24 patients, commonest being Streptococcus pneumonia which was most commonly sensitive to penicillin group of antibiotics followed by cephalosporines. The mortality rate was 1%. Two patients required care in Intensive care unit and 97 were discharged after improving. Conclusion: Etiology of pneumonia could be identified in 24% of cases. Pneumococcus was found mostly sensitive to penicillins and cepahalosporines. Gram negative organisms were mostly sensitive to ciprofloxacin and aminoglycoside. None of the patients were vaccinated against H.influenza or S.pneumoniae. Higher CURB-65 score was associated with longer duration of hospital stay. DOI: http://dx.doi.org/10.3126/njms.v1i2.6605 Nepal Journal of Medical Sciences. 2012;1(2): 84-8

scholarly journals Clinical utility of serum procalcitonin in adult patients admitted with community-acquired pneumonia in Ilorin, Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Olutobi Babatope Ojuawo ◽  
Ademola Emmanuel Fawibe ◽  
Olufemi Olumuyiwa Desalu ◽  
Adeniyi Olatunji Aladesanmi ◽  
Ayotade Boluwatife Ojuawo ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Complete Blood Count ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Baseline Serum ◽  
Cell Counts ◽  
Atypical Pathogens ◽  
Significant Difference ◽  
Pre Treatment ◽  
Single Center Observational Study

Objectives: The usefulness of biomarkers in community acquired pneumonia (CAP) has been under the research light with limited reports from Africa. This study aimed at evaluating the clinical usefulness of serum procalcitonin (PCT) in patients admitted with CAP in a tertiary hospital in Ilorin, Nigeria. Materials and Methods: This was prospective single center observational study of 102 admitted patients with clinical and radiologic features of CAP. All the patients had serum PCT assay, complete blood count, blood culture, sputum microbiology, and serological evaluation for atypical pathogens. Repeat PCT assay was done following 1 week of antibiotic therapy. The patients were classified into one of two diagnostic groups: Those with microbiologically confirmed bacterial CAP and those without bacterial CAP. Results: Over half (58/102; 56.8%) of the patients had microbiologically confirmed bacterial CAP. The baseline serum PCT concentrations were significantly higher in patients with bacterial CAP when compared to the non-bacterial CAP group (2.55 ± 0.14 vs. 0.94 ± 0.61 ng/ml; P < 0.001). There was also a statistically significant difference between the pre- and post-treatment serum PCT concentrations in the bacterial CAP group (P < 0.001) and the non-bacterial CAP group (P = 0.006). The area under the receiver operating characteristic (AUC) for pre-treatment PCT in diagnosing bacterial CAP was 0.795 (95% confidence level [CI]: 0.709–0.881) with a sensitivity of 67.2% and specificity of 79.5% at an optimal cutoff of 1.5 ng/ml. Overall, the biomarker was independently associated with white cell counts >10 × 109/L (AOR = 6.28; 95% CI: 1.30–30.32, P = 0.02). The baseline mean serum PCT levels were also significantly higher in patients admitted for 7 or more days (P = 0.010). Conclusion: Serum PCT had good diagnostic strength in patients admitted with bacterial CAP in Ilorin. The biomarker can also assist clinicians with predicting the pathogenic group and monitoring clinical progress of CAP.

scholarly journals Hepatosplenic T cell lymphoma presenting as multiorgan failure

2019 ◽  
Vol 12 (3) ◽  
pp. e228186
Author(s):  
Puraskar Pateria ◽  
Annalise Martin ◽  
Tze Sheng Khor ◽  
Vanoo Jayasekeran
Keyword(s):  
T Cell ◽  
Cell Lymphoma ◽  
Multiorgan Failure ◽  
Poor Response ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
T Cell Lymphoma ◽  
History Of ◽  
Hepatosplenic T Cell Lymphoma ◽  
Underlying Chronic Liver Disease

A 59-year-oldwoman presented with a 2-month history of malaise, abdominal distention and unintentional weight loss. She was initially managed as community acquired pneumonia with a suspicion of underlying chronic liver disease but she deteriorated rapidly into a multiorgan failure necessitating transfer to intensive care unit of a tertiary hospital. She was investigated with liver and bone marrow biopsy that confirmed the diagnosis of hepatosplenic T cell lymphoma. She was treated with cyclophosphamide, doxorubicin, vincristine, etoposide and prednisolone chemotherapy that was changed to salvage ifosfamide carboplatin etoposide (ICE) chemotherapy due to poor response with first-line chemotherapy and disease progression. Unfortunately, her disease progressed further and she opted for palliative management.

scholarly journals Initial Management Of Patients With Community-Acquired Pneumonia In A Tertiary Hospital In Sri Lanka

2009 ◽  
Vol 1 (1) ◽  
pp. 32
Author(s):  
Rashan Haniffa ◽  
Hemal Ariyaratne ◽  
Shyam Fernando ◽  
Senaka Rajapakse
Keyword(s):  
Sri Lanka ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Initial Management

scholarly journals Management and outcome of community acquired pneumonia: hospital based study

2018 ◽  
Vol 6 (7) ◽  
pp. 2271
Author(s):  
Avinash Lamb ◽  
Amol Harinathrao Patil
Keyword(s):  
Respiratory Tract Infections ◽  
Prospective Observational Study ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
High Rate ◽  
Response To Treatment ◽  
Lower Respiratory Tract Infections ◽  
Gujarat State ◽  
Tract Infections ◽  
Complications And Mortality

Background: Lower Respiratory Tract infections are responsible for one-fifth of the deaths caused due to infectious diseases in India and Pneumonia is a major culprit. Timely and appropriate empirical treatment based on knowledge of local etiological factors is important in the management of the disease. Data related to investigation profile and therapy as well as morbidity and mortality is available from different geographic regions. Present study describes the management and outcome of disease data from a tertiary hospital at Rajkot in Gujarat state during the study period.Methods: The present prospective observational study was completed in the study duration (November 2014 to April 2016) at tuberculosis and chest diseases Department of PDU Hospital at Rajkot, Gujarat. 50 patients above 12 years of age with CAP on clinical diagnosis assisted by radiology were included in the study. The haematology profile, therapy, complications and mortality were described.Results: Haemoglobin was below 10gm percent in 22% cases. Leucocytosis was observed in 72% cases. Ten percent patients were seropositive for HIV. There was a moderate response to treatment with penicillin group of drugs (approximately 22%). Many patients had to be offered other group of drugs like Cephalosporins, macrolides and quinolones for clinical response. Most common complications observed were: Delayed resolution in 12 (24%) patients, synpneumonic effusion in 6 (12%) and septicaemia in 3 (6%) patients. Mortality rate was 6% during the study period.Conclusions: The results indicate a low response to treatment by penicillin group antibiotics and a high rate of complications. Mortality is similar to reports from India.

Sign in / Sign up

Export Citation Format

Share Document