scholarly journals Improved Diagnostics Help to Identify Clinical Features and Biomarkers That Predict Mycoplasma pneumoniae Community-acquired Pneumonia in Children

2019 ◽  
Vol 71 (7) ◽  
pp. 1645-1654 ◽  
Author(s):  
Patrick M Meyer Sauteur ◽  
Selina Krautter ◽  
Lilliam Ambroggio ◽  
Michelle Seiler ◽  
Paolo Paioni ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Respiratory Symptoms ◽  
Characteristic Curve ◽  
Underlying Disease ◽  
Community Acquired Pneumonia ◽  
Immunoglobulin M ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Reactive Protein

Abstract Background There are no reliable signs or symptoms that differentiate Mycoplasma pneumoniae (Mp) infection in community-acquired pneumonia (CAP) from other etiologies. Additionally, current diagnostic tests do not reliably distinguish between Mp infection and carriage. We previously determined that the measurement of Mp-specific immunoglobulin M antibody-secreting cells (ASCs) by enzyme-linked immunospot assay allowed for differentiation between infection and carriage. Using this new diagnostic test, we aimed to identify clinical and laboratory features associated with Mp infection. Methods This is a prospective cohort study of children, 3–18 years of age, with CAP from 2016 to 2017. Clinical features and biomarkers were compared between Mp-positive and -negative groups by Mann-Whitney U test or Fisher exact test, as appropriate. Area under the receiver operating characteristic curve (AUC) differences and optimal thresholds were determined by using the DeLong test and Youden J statistic, respectively. Results Of 63 CAP patients, 29 were Mp-positive (46%). Mp positivity was statistically associated with older age (median, 8.6 vs 4.7 years), no underlying disease, family with respiratory symptoms, prior antibiotic treatment, prolonged prodromal respiratory symptoms and fever, and extrapulmonary (skin) manifestations. Lower levels of C-reactive protein, white blood cell count, absolute neutrophil count, and procalcitonin (PCT), specifically PCT <0.25 μg/L, were statistically associated with Mp infection. A combination of age >5 years (AUC = 0.77), prodromal fever and respiratory symptoms >6 days (AUC = 0.79), and PCT <0.25 μg/L (AUC = 0.81) improved diagnostic performance (AUC = 0.90) (P = .05). Conclusions A combination of clinical features and biomarkers may aid physicians in identifying patients at high risk for Mp CAP.

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Do clinical features and MRI suggest the same nerve root in acute cervical radiculopathy

2006 ◽  
Vol 62 (2) ◽  
Author(s):  
M. Conradie ◽  
M. M. Bester ◽  
L. C. Crous ◽  
M. Kidd
Keyword(s):  
Clinical Features ◽  
Nerve Root ◽  
Distribution Patterns ◽  
Cervical Radiculopathy ◽  
Fisher Exact Test ◽  
Motor Weakness ◽  
Exact Test ◽  
Clinical Presentations ◽  
Standardized Interview ◽  
Magnetic Resonance Imaging Mri

Different proposed pathophysiological mechanisms can result in variable clinical presentations of cervical radiculopathy (CR), often making it difficult to detect minor nerve root (NR) conditions. This descriptive study determined (1) the level(s) of  NR involvement suggested by the distribution patterns of clinical features and detected by magnetic resonance imaging (MRI) and (2) the most common associations between the different variables in patients diagnosed with acute CR by a neurosurgeon. A physiotherapist blinded to the level(s) of NR involvement performed a standardized interview on 21 subjects to determine the distribution patterns of pain and paraesthesia, and a neurological examination. The Fisher exact test was used to determine associations between the different variables. Only seven subjects presented clinically and radiologically with the same single-level NR involvement. Multiple- level presentations occurred which might be due to dermatomal overlapping, central sensitization or the possible involvement of two adjacent NR levels. Distribution patterns of motor weakness, pain and paraesthesia, and to a lesser extent sensory and reflex changes, have value in identifying the compressed NR level. For this sample the distri-bution patterns of radicular features identified C6 and C8 with more certainty than C7.

scholarly journals Chlamydia pneumoniae and Mycoplasma pneumoniae pneumonia: comparison of clinical, epidemiological characteristics and laboratory profiles

2005 ◽  
Vol 134 (3) ◽  
pp. 548-555 ◽  
Author(s):  
I. PULJIZ ◽  
I. KUZMAN ◽  
O. DAKOVIC-RODE ◽  
N. SCHÖNWALD ◽  
B. MISE
Keyword(s):  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Aspartate Aminotransferase ◽  
Chlamydia Pneumoniae ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Epidemiological Characteristics ◽  
Mycoplasma Pneumoniae Pneumonia

The purpose of our retrospective 3-year study was to analyse and compare clinical and epidemiological characteristics in hospitalized patients older than 6 years with community-acquired pneumonia (CAP) caused by Chlamydia pneumoniae (87 patients) and Mycoplasma pneumoniae (147 patients). C. pneumoniae and M. pneumoniae infection was confirmed by serology. C. pneumoniae patients were older (42·12 vs. 24·64 years), and were less likely to have a cough, rhinitis, and hoarseness (P<0·001). C. pneumoniae patients had higher levels of C-reactive protein (CRP), and aspartate aminotransferase (AST) than M. pneumoniae patients (P<0·001). Pleural effusion was recorded more frequently in patients with M. pneumoniae (8·84 vs. 3·37%). There were no characteristic epidemiological and clinical findings that would distinguish CAP caused by M. pneumoniae from C. pneumoniae. However, some factors are indicative for C. pneumoniae such as older age, lack of cough, rhinitis, hoarseness, and higher value of CRP, and AST.

scholarly journals Rhabdomyolysis: An Unusual Presentation of Mycoplasma pneumoniae Infection in an Adult—A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Jaspreet Kaler ◽  
Osama Mukhtar ◽  
Bilal Khan ◽  
Binav Shrestha ◽  
Ravinder Kaler ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Community Acquired Pneumonia ◽  
Immunoglobulin M ◽  
Review Of The Literature ◽  
Mycoplasma Infection ◽  
Radiographic Evidence ◽  
X Ray ◽  
Intravenous Hydration ◽  
Chest X Ray ◽  
Mycoplasma Pneumoniae Infection

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia, and many extrapulmonary manifestations have been described, but rhabdomyolysis is infrequently reported in adults. Of the few cases that have been reported in adults, it was almost exclusively seen when pneumonia was present. We report a case of a 30-year-old male who came in with complaints of fever and myalgia for three days. Immunoglobulin M antibodies for Mycoplasma pneumoniae were positive and trending up, despite having no radiographic evidence of pneumonia on chest X-ray or CT scan. He was treated successfully with levofloxacin and intravenous hydration. Later, his condition was clinically and biochemically improved, and he was discharged. Our patient did not present with typical respiratory tract symptoms of a mycoplasma infection. In addition, there was an absence of pneumonia on imaging, suggesting that rhabdomyolysis secondary to mycoplasma might be underdiagnosed and go untreated in the setting of low clinical suspicion. Upon review of the literature, there is only one other case of mycoplasma infection where rhabdomyolysis occurred in the absence of pneumonia. However, the degree of rhabdomyolysis in our case was much more severe. Although rare, when faced with rhabdomyolysis, Mycoplasma pneumoniae should be kept as a differential diagnosis even in the absence of pneumonia on radiological imaging.

scholarly journals Clinical features, diagnosis and treatment of respiratory M. pneumoniae infection in children

2019 ◽  
pp. 91-98
Author(s):  
A. L. Zaplatnikov ◽  
A. A. Girina ◽  
I. D. Maykova ◽  
N. V. Karoid ◽  
I. V. Lepiseva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Rational Choice ◽  
Diagnostic Criteria ◽  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Respiratory Infections ◽  
State Of The Art ◽  
Community Acquired Pneumonia ◽  
Diagnosis And Treatment

The article describes state-of-the-art knowledge regarding etiology, epidemiology, clinical features and diagnostic criteria for respiratory infections caused by Mycoplasma pneumoniae (M. pneumoniae). It presents the characteristics of the main forms of lesions in mycoplasma infections of the respiratory tract – pharyngitis, bronchitis and pneumonia. Particular attention is paid to the differential diagnosis of community-acquired pneumonia of pneumococcal and mycoplasma etiology. The issues of rational choice of initial etiotropic therapy for the treatment of respiratory mycoplasmosis in children are discussed.

scholarly journals Two new inflammatory markers related to the CURB-65 score for disease severity in patients with community-acquired pneumonia: The hypersensitive C-reactive protein to albumin ratio and fibrinogen to albumin ratio

2021 ◽  
Vol 16 (1) ◽  
pp. 84-91
Author(s):  
Bing Luo ◽  
Minjie Sun ◽  
Xingxing Huo ◽  
Yun Wang
Keyword(s):  
Inflammatory Markers ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Low Risk ◽  
Control Group ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
The Relationship

Abstract Background The objective of this study was to investigate the relationship among hypersensitive C-reactive protein to albumin ratio (CAR), fibrinogen to albumin ratio (FAR), and the CURB-65 score for community-acquired pneumonia (CAP) severity. Methods Clinical data and laboratory indicators of 82 patients with CAP and 40 healthy subjects were retrospectively analysed. The relationship among CAR, FAR, and the severity of CAP was then analysed. Results CAR and FAR in patients with low-risk CAP were significantly higher than those in the normal control group (P < 0.05). CAR and FAR in patients with medium–high-risk CAP were further increased compared with those in patients with low-risk CAP (P < 0.05). CAR and FAR were positively correlated with hypersensitive C-reactive protein, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and CURB-65 scores (P < 0.05). In the receiver operating characteristic curve for predicting severe CAP, the area under the curve of combining four biomarkers (CAR + FAR + NLR + PLR) was the largest. CAR was also an independent risk factor for severe CAP (OR = 8.789, 95% CI: 1.543–50.064, P = 0.014). Conclusions CAR and FAR may be used as the inflammatory markers for CAP severity evaluation.

scholarly journals FOXF1 as an Immunohistochemical Marker of Hilar Cholangiocarcinoma or Metastatic Pancreatic Ductal Adenocarcinoma. Single Institution Experience

2021 ◽  
Vol 27 ◽  
Author(s):  
Jan Hrudka ◽  
Zuzana Prouzová ◽  
Katarína Mydlíková ◽  
Kristína Jedličková ◽  
Michal Holešta ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Prognostic Significance ◽  
High Sensitivity ◽  
Ductal Adenocarcinoma ◽  
Fisher Exact Test ◽  
C Reactive Protein ◽  
Single Institution ◽  
Liver Malignancy ◽  
Exact Test ◽  
Reactive Protein

Cholangiocarcinoma (CCA) is a liver malignancy associated with a poor prognosis. Its main subtypes are peripheral/intrahepatic and hilar/extrahepatic CCA. Several molecular, morphological and clinical similarities between hilar/extrahepatic CCA and pancreatic ductal adenocarcinoma (PDAC) have been described. FOXF1 is a transcription factor which has been described to have prognostic significance in various tumors and it is involved in the development of bile ducts. The aim of this study is to determine occurrence of nuclear expression of FOXF1 in both subtypes of CCA and metastatic PDAC and assess its potential usefulness as a diagnostic marker. Secondary aims were to investigate the use of C-reactive protein (CRP) immunohistochemistry for diagnosing intrahepatic peripheral CCA and the significance of histological features in CCA subtypes. 32 archive specimens of CCA, combined hepatocellular carcinoma-CCA (HCC-CCA) and liver metastasis of PDAC were stained by FOXF1 and CRP immunohistochemistry and evaluated to determine histological pattern. The CCAs were classified radiologically into peripheral/intrahepatic and hilar subtype. Using Fisher exact test, we identified nuclear FOXF1 as a fairly specific (87%) but insensitive (65%) marker of hilar and extrahepatic CCA and metastatic PDAC (p = 0.005). CRP immunohistochemistry was characterized by a high sensitivity and specificity, of 79% and 88%, respectively (p = 0.001). We did not identify any histomorphological features associated with either types of CCA or metastatic PDAC. As a conclusion of novel finding, FOXF1 immunohistochemistry may be regarded as a specific but insensitive marker of hilar/extrahepatic CCA and metastatic PDAC and it may help distinguish them from peripheral CCA.

scholarly journals Evaluating the predictive value of procalcitonin, cough duration, and heat peak in severe Mycoplasma pneumoniae pneumonia

2020 ◽  
Author(s):  
Ying Yang ◽  
Liqing Chen ◽  
Yan Liu
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Predictive Value ◽  
Characteristic Curve ◽  
General Group ◽  
Reactive Protein ◽  
Early Predictors ◽  
Detailed Medical History ◽  
Severe Group ◽  
Length Of Hospitalization ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Objective To investigate the predictive value of risk factors for severe Mycoplasma pneumoniae pneumonia (MPP). Methods Retrospective analyses were conducted on 342 children with acute MPP hospitalized between December 2015 and December 2018. Results A total of 342 cases were including in the analyses, with most cases involving infants and preschool-aged children. Patients were categorized as general and severe MPP. Patients in the severe group had increased heat peak, fever duration, cough duration, length of hospitalization, and levels of white blood cell, neutrophils, C-reactive protein, and procalcitonin, as well as reduced levels of lymphocytes and platelets compared to the general group. Logistic regression and receiver operating characteristic curve analyses showed that increased levels of procalcitonin (>0.67 ng/mL), prolonged cough duration (>13.5 days), and heat peak above 38.4°C may be early predictors for severe MPP. Conclusions The severity of MPP effects fever, cough duration, and inflammatory response. Taking a detailed medical history and early procalcitonin measurement may help detect severe MPP.

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