Chest medicine

2021 ◽  
pp. 167-222
Author(s):  
Stephen Graham
Keyword(s):  
Whooping Cough ◽  
Respiratory Infections ◽  
Lung Abscess ◽  
Chronic Obstructive ◽  
Atypical Pneumonia ◽  
Acute Severe Asthma ◽  
Recurrent Pneumonia ◽  
Obstructive Pulmonary Disease ◽  
Bacterial Tracheitis ◽  
Legionnaires Disease

Symptoms of respiratory disease, Pneumonia, Atypical pneumonia, Legionnaires' disease, Recurrent pneumonia, Nosocomial pneumonia, Aspiration pneumonia, Management of pneumonia: adults, Viral pneumonia SARS and HN, Management of pneumonia: children, Paediatric acute respiratory, infections: epiglottitis, Acute laryngotracheobronchitis: croup, Bacterial tracheitis, Bronchiolitis, Whooping cough, Lymphocytic interstitial pneumonitis, Diphtheria, Pleural effusion, Lung abscess, Fungal pulmonary infections, Paragonimiasis lung flukes, Tropical pulmonary eosinophilia, Asthma, Acute severe asthma, Chronic obstructive pulmonary disease, Bronchiectasis, Lung cancer, Interstitial lung disease, Acute respiratory distress syndrome, Pulmonary embolism, Pneumothorax

scholarly journals Profile of patients admitted in a pulmonology ward and developing Clostridium difficile enterocolitis

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 31-36
Author(s):  
Ioana Cojocaru ◽  
Livia Luculescu ◽  
Daniela Negoescu ◽  
Irina Strâmbu
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Respiratory Infections ◽  
Demographic Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Male Predominance ◽  
Number Of Patients ◽  
Lower Intestine

Abstract Clostridium difficile is an anaerobic bacterium than can colonise the lower intestine and cause enterocolitis in susceptible patients. Clostridium difficile infection (CDI) is typically a nosocomial infection, favoured by treatment with antibiotics (especially with broad-spectrum drugs), proton pump inhibitors, but also comorbidities, old age and prolonged hospitalisation. Based on the observation that in the past years, the frequency of nosocomial CDI has increased in the Institute of Pulmonology, Bucharest, this retrospective observational study aimed to analyse the characteristics of admitted patients who develop CDI, in order to identify possible particular features and risk factors. Accordingly, medical files from 80 patients admitted from January 2015 to August 2017 were analysed for demographic data, respiratory diagnosis, comorbidities, blood tests, treatments prescribed, time of CDI onset, evolution and outcome. The number of patients studied was 29 in 2015, 16 in 2016 and 35 in 2017, with slight male predominance. Totally, 54 patients (67.5%) had tuberculosis (pulmonary or pleural), 12 had lung cancer, five had respiratory infections, two had chronic obstructive pulmonary disease and seven had other diseases. All patients but nine were receiving antibiotics: tuberculosis drugs, cephalosporins, fluoroquinolones and beta-lactams. About half of the patients received proton pump inhibitors. Most patients had several comorbidities. Mean time since admittance to onset of diarrhoea was 20 days. CDI was treated with metronidazole or vancomycin. The evolution was favourable in 90% of patients, but eight patients (10%) died This study highlights a high frequency of CDI in patients treated for tuberculosis. Due to insufficient data, no epidemiological consideration could be made. Further studies are needed to assess the relationship among tuberculosis, tuberculosis treatment and CDI.

scholarly journals The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

2018 ◽  
Vol 52 (3) ◽  
pp. 1800328 ◽  
Author(s):  
Eva Polverino ◽  
Katerina Dimakou ◽  
John Hurst ◽  
Miguel-Angel Martinez-Garcia ◽  
Marc Miravitlles ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Upper Airway ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Future Directions ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Recurrent Respiratory Infections ◽  
Sputum Production ◽  
Syndromic Approach

Bronchiectasis is a clinical and radiological diagnosis associated with cough, sputum production and recurrent respiratory infections. The clinical presentation inevitably overlaps with other respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). In addition, 4–72% of patients with severe COPD are found to have radiological bronchiectasis on computed tomography, with similar frequencies (20–30%) now being reported in cohorts with severe or uncontrolled asthma. Co-diagnosis of bronchiectasis with another airway disease is associated with increased lung inflammation, frequent exacerbations, worse lung function and higher mortality. In addition, many patients with all three disorders have chronic rhinosinusitis and upper airway disease, resulting in a complex “mixed airway” phenotype.The management of asthma, bronchiectasis, COPD and upper airway diseases has traditionally been outlined in separate guidelines for each individual disorder. Recognition that the majority of patients have one or more overlapping pathologies requires that we re-evaluate how we treat airway disease. The concept of treatable traits promotes a holistic, pathophysiology-based approach to treatment rather than a syndromic approach and may be more appropriate for patients with overlapping features.Here, we review the current clinical definition, diagnosis, management and future directions for the overlap between bronchiectasis and other airway diseases.

Respiratory emergencies

2019 ◽  
pp. 171-226
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir H. Sam
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Acute Severe Asthma ◽  
Pleural Effusions ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Emergencies

This chapter discusses respiratory emergencies, including pneumonia (acute, Mycoplasma, Legionella, viral, Chlamydia), psittacosis, acute asthma, acute severe asthma, mild to moderate asthmatic attacks, acute exacerbation of chronic obstructive pulmonary disease (COPD), respiratory failure, adult respiratory distress syndrome, pneumothorax (acute, tension), haemoptysis, pleural effusions, chronic massive effusion, empyema, and acute upper airway obstruction.

scholarly journals Serum Procalcitonin Guided Antibiotic Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (2) ◽  
pp. 67-70
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Mohammad Omar Faruq
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Antibiotic Therapy ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Chronic Obstructive ◽  
Acute Phase Reactants ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Of Copd

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable, but progressive disease. Hospital admissions of patients with COPD are frequently due to acute exacerbations of COPD (AECOPD). AECOPD are very common, affecting about 20% of COPD patients. The bacterial infection plays an important role in the exacerbation of COPD patients. In addition, recent studies using molecular diagnostics indicate that a substantial proportion of AECOPD are associated with viral infection. Accurate methods to differentiate viral and bacterial respiratory infections to allow targeted antibiotic therapy would be beneficial. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin (PCT) levels appears to be useful in order to minimize this problem.Bangladesh Crit Care J September 2015; 3 (2): 67-70

scholarly journals COVID-19, COPD, and AECOPD: Immunological, Epidemiological, and Clinical Aspects

2021 ◽  
Vol 7 ◽  
Author(s):  
Francesca Polverino ◽  
Farrah Kheradmand
Keyword(s):  
Cigarette Smoke ◽  
Clinical Features ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Epidemiological Data ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Obstructive Pulmonary Disease ◽  
Ultimate Cause

The newly identified severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) causes several heterogeneous clinical conditions collectively known as Coronavirus disease-19 (COVID-19). Older patients with significant cardiovascular conditions and chronic obstructive pulmonary disease (COPD) are predisposed to a more severe disease complicated with acute respiratory distress syndrome (ARDS), which is associated with high morbidity and mortality. COPD is associated with increased susceptibility to respiratory infections, and viruses are among the top causes of acute exacerbations of COPD (AECOPD). Thus, COVID-19 could represent the ultimate cause of AECOPD. This review will examine the pathobiological processes underlying SARS-CoV-2 infection, including the effects of cigarette smoke and COPD on the immune system and vascular endothelium, and the known effects of cigarette smoke on the onset and progression of COVID-19. We will also review the epidemiological data on COVID-19 prevalence and outcome in patients with COPD and analyze the pathobiological and clinical features of SARS-CoV-2 infection in the context of other known viral causes of AECOPD. Overall, SARS-CoV-2 shares common pathobiological and clinical features with other viral agents responsible for increased morbidity, thus representing a novel cause of AECOPD with the potential for a more long-term adverse impact. Longitudinal studies aimed at COPD patients surviving COVID-19 are needed to identify therapeutic targets for SARS-CoV2 and prevent the disease's burden in this vulnerable population.

Cough

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Pulmonary Oedema ◽  
Whooping Cough ◽  
Cold Weather ◽  
Chronic Obstructive ◽  
British Thoracic Society ◽  
Pertussis Infection ◽  
Obstructive Pulmonary Disease ◽  
Open Questions ◽  
Drug History ◽  
Wet Cough

First, ask open questions about the cough itself: • Acute or chronic? The British Thoracic Society (BTS) defines acute as <3 weeks and chronic as >8 weeks. Between 3 and 8 weeks the cough may be due to recovering acute illness or developing chronic illness. • Constant or intermittent? A cough that is intermittent may suggest an extrinsic trigger (e.g. if the patient only coughs at work there may be an allergy to something in the workplace). A cough that is constant suggests an intrinsic cause. • Productive or dry? The presence of sputum indicates inflammation and/or infection. Patients with chronic obstructive pulmonary disease (COPD) have chronically inflamed airways and often produce white or clear sputum. Patients with infection have yellow or green sputum. Particularly large volumes of sputum, often green or rusty coloured, may be coughed up in bronchiectasis and lung abscesses. • Blood? More specifically: ■ Blood-streaked sputum? Suggests infection or bronchiectasis. ■ Pink and frothy sputum? Suggests pulmonary oedema. ■ Frank blood (haemoptysis)? See Chapter 8. Suggests tuberculosis (TB), lung cancer, pulmonary embolus, bronchiectasis, or other rarer causes (e.g. granulomatosis with polyangiitis (GPA, formerly known as Wegener’s granulomatosis), or Goodpasture’s syndrome). • Timing? Asthma is classically worse at night and early hours of the morning. Pulmonary oedema or gastro-oesophageal reflux disease (GORD) can also be worse at night due to the positional effects of lying flat. Patients often report sleeping propped up on pillows to mitigate these effects. Trigger factors such as pets, cold weather, or exercise indicate asthma, as does a worsening in spring/summer. • Character? A wheezy cough suggests airway obstruction due to asthma or COPD. A bovine cough (breathy) is characteristic of vocal cord paralysis. A dry cough is suggestive of a bronchitis (usually viral) or interstitial lung disease. A gurgling/wet cough is suggestive of bronchiectasis. Pertussis infection causes a ‘whooping’ cough. Second, ask directed questions about factors that might be triggering the cough: • Environmental irritants: Smoking? Occupation? Pets? Change of house, office, etc? • Past medical history: Asthma? GORD? Rhinitis/sinusitis? Heart failure? Recent chest infection? • Drug history? Angiotensin-converting enzyme (ACE) inhibitors in particular can cause a cough.

Sign in / Sign up

Export Citation Format

Share Document