Mycoplasma and Viral Pneumonia

Chest Imaging ◽  
2019 ◽  
pp. 227-232
Author(s):  
Diana Palacio
Keyword(s):  
Community Acquired Pneumonia ◽  
Radiographic Findings ◽  
Radiologic Findings ◽  
Ground Glass Attenuation ◽  
Mycoplasma Pneumonia ◽  
Causative Agents ◽  
Specific Finding ◽  
Normal Chest Radiograph ◽  
A Cell ◽  
Normal Chest

Mycoplasma pneumoniae and viruses remain among the most common causes of community acquired pneumonia (CAP), and account for approximately 30% or more of all cases. M. pneumoniae is a bacterium that lacks a cell wall, which results in certain microbiologic features absent in other bacteria. The combination of centrilobular nodules, peribronchial thickening and lobular ground-glass attenuation on CT is the most suggestive pattern identified in patients with M. pneumoniae pneumonia. Although cellular bronchiolitis is a non-specific finding, a patchy or clustered distribution should raise the possibility of infectious etiology, with the most likely causative agents being M. pneumoniae, tuberculosis and viral bronchiolitis. The radiologic findings of adult viral and M. pneumoniae pneumonias are variable and depend on the host and the virulence of the pathogen. The imaging findings in this chapter overlap with those found in in pneumonias caused by atypical microorganisms (e.g. virus, PCP pneumonia, etc.). CT imaging of immunocompetent patients with suspected viral or mycoplasma pneumonia is not indicated unless there is suspicion of complications. CT may be performed in patients with normal, equivocal, or nonspecific radiographic findings. Conversely, CT is often indicated in immunocompromised patients with a normal chest radiograph and suspected pulmonary infection.

Introduction to the Interpretation of Chest Radiographs during Donor Care

2005 ◽  
Vol 15 (3) ◽  
pp. 240-248 ◽  
Author(s):  
David J. Powner ◽  
Jean-Christophe Biebuyck
Keyword(s):  
Pleural Fluid ◽  
Chest Radiograph ◽  
Organ Procurement ◽  
Chest Radiographs ◽  
Radiographic Findings ◽  
Alveolar Air ◽  
Tube Position ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Technical Factors

Organ procurement coordinators often provide independent interpretations of chest radiographs during donor care. Catheter or tube position, lobar atelectasis, extra-alveolar air, air bronchograms, pleural fluid, and other findings are important throughout donor care and when deciding if a lung is acceptable for transplantation. Technical factors, features of a normal chest radiograph, and abnormal radiographic findings are reviewed and examples are presented.

Small Airway Disease after Mycoplasma Pneumonia in Children: HRCT Findings and Correlation with Radiographic Findings

2003 ◽  
Vol 48 (4) ◽  
pp. 361
Author(s):  
Jung Eun Cheon ◽  
Woo Sun Kim ◽  
In One Kim ◽  
Young Yull Koh ◽  
Hoan Jong Lee ◽  
...  
Keyword(s):  
Airway Disease ◽  
Small Airway ◽  
Radiographic Findings ◽  
Small Airway Disease ◽  
Mycoplasma Pneumonia

scholarly journals Clinical Features and Outcomes of Community-Acquired Pneumonia Caused by Haemophilus Influenza

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Saeed Shoar ◽  
Fernando H Centeno ◽  
Daniel M Musher
Keyword(s):  
Clinical Features ◽  
Alcohol Use Disorder ◽  
Pneumococcal Pneumonia ◽  
Severe Infection ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
Equal Frequency ◽  
Haemophilus Influenza ◽  
Radiologic Findings ◽  
Viral Coinfection

Abstract Background Long regarded as the second most common cause of community-acquired pneumonia (CAP), Haemophilus influenzae has recently been identified with almost equal frequency as pneumococcus in patients hospitalized for CAP. The literature lacks a detailed description of the presentation, clinical features, laboratory and radiologic findings, and outcomes in Haemophilus pneumonia. Methods During 2 prospective studies of patients hospitalized for CAP, we identified 33 patients with Haemophilus pneumonia. In order to provide context, we compared clinical findings in these patients with findings in 36 patients with pneumococcal pneumonia identified during the same period. We included and analyzed separately data from patients with viral coinfection. Patients with coinfection by other bacteria were excluded. Results Haemophilus pneumonia occurred in older adults who had underlying chronic lung disease, cardiac conditions, and alcohol use disorder, the same population at risk for pneumococcal pneumonia. However, in contrast to pneumococcal pneumonia, patients with Haemophilus pneumonia had less severe infection as shown by absence of septic shock on admission, less confusion, fewer cases of leukopenia or extreme leukocytosis, and no deaths at 30 days. Viral coinfection greatly increased the severity of Haemophilus, but not pneumococcal pneumonia. Conclusions We present the first thorough description of Haemophilus pneumonia, show that it is less severe than pneumococcal pneumonia, and document that viral coinfection greatly increases its severity. These distinctions are lost when the label CAP is liberally applied to all patients who come to the hospital from the community for pneumonia.

scholarly journals Influenza With an Infiltrate: Investigating the New Community-Acquired Pneumonia Guidelines

2020 ◽  
Vol 41 (S1) ◽  
pp. s302-s302
Author(s):  
Amanda Barner ◽  
Lou Ann Bruno-Murtha
Keyword(s):  
Demographic Data ◽  
Retrospective Chart Review ◽  
Vaccination Rate ◽  
Community Acquired Pneumonia ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Supporting Evidence ◽  
Radiographic Findings ◽  
Significant Difference ◽  
The Impact

Background: The Infectious Diseases Society of America released updated community-acquired pneumonia (CAP) guidelines in October 2019. One of the recommendations, with a low quality of supporting evidence, is the standard administration of antibiotics in adult patients with influenza and radiographic evidence of pneumonia. Procalcitonin (PCT) is not endorsed as a strategy to withhold antibiotic therapy, but it could be used to de-escalate appropriate patients after 48–72 hours. Radiographic findings are not indicative of the etiology of pneumonia. Prescribing antibiotics for all influenza-positive patients with an infiltrate has significant implications for stewardship. Therefore, we reviewed hospitalized, influenza-positive patients at our institution during the 2018–2019 season, and we sought to assess the impact of an abnormal chest x-ray (CXR) and PCT on antibiotic prescribing and outcomes. Methods: We conducted a retrospective chart review of all influenza-positive admissions at 2 urban, community-based, teaching hospitals. Demographic data, vaccination status, PCT levels, CXR findings, and treatment regimens were reviewed. The primary outcome was the difference in receipt of antibiotics between patients with a negative (<0.25 ng/mL) and positive PCT. Secondary outcomes included the impact of CXR result on antibiotic prescribing, duration, 30-day readmission, and 90-day mortality. Results: We reviewed the medical records of 117 patients; 43 (36.7%) received antibiotics. The vaccination rate was 36.7%. Also, 11% of patients required intensive care unit (ICU) admission and 84% received antibiotics. Moreover, 109 patients had a CXR: 61 (55.9%) were negative, 29 (26.6%) indeterminate, and 19 (17.4%) positive per radiologist interpretation. Patients with a positive PCT (OR, 12.7; 95% CI, 3.43–60.98; P < .0007) and an abnormal CXR (OR, 7.4; 95% CI, 2.9–20.1; P = .000003) were more likely to receive antibiotics. There was no significant difference in 30-day readmission (11.6% vs 13.5%; OR, 0.89; 95% CI, 0.21–3.08; P = 1) and 90-day mortality (11.6% vs 5.4%; OR, 2.37; 95% CI, 0.48–12.75; P = .28) between those that received antibiotics and those that did not, respectively. Furthermore, 30 patients (62.5%) with an abnormal CXR received antibiotics and 21 (43.7%) had negative PCT. There was no difference in 30-day readmission or 90-day mortality between those that did and did not receive antibiotics. Conclusions: Utilization of PCT allowed selective prescribing of antibiotics without impacting readmission or mortality. Antibiotics should be initiated for critically ill patients and based on clinical judgement, rather than for all influenza-positive patients with CXR abnormalities.Funding: NoneDisclosures: None

scholarly journals The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Camilla E. Le Roux ◽  
Sucari S.C. Vlok
Keyword(s):  
South Africa ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Communicable Disease ◽  
Diagnostic Dilemma ◽  
Extra Pulmonary Tuberculosis ◽  
Immunodeficiency Virus ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Extra Pulmonary

Extra-pulmonary tuberculosis (EPTB), caused by Mycobacterium tuberculosis, is the leading cause of communicable disease-related deaths in people with human immunodeficiency virus (HIV) worldwide and in South Africa. Mycobacterium tuberculosis disseminates haematogenously from an active primary lung focus and may affect extra-pulmonary sites in up to 15% of patients. Extra-pulmonary TB may present with a normal chest radiograph, which often causes a significant diagnostic dilemma. This review describes the main sites of involvement in EPTB, which is illustrated by local imaging examples.

Normal Chest Radiograph

2008 ◽  
pp. 3-33 ◽  
Author(s):  
Nestor L. Müller ◽  
C. Isabela S. Silva
Keyword(s):  
Chest Radiograph ◽  
Normal Chest Radiograph ◽  
Normal Chest

Hypoxia

2018 ◽  
pp. 168-171
Author(s):  
Drew Clare
Keyword(s):  
Mechanical Ventilation ◽  
Airway Obstruction ◽  
Pulmonary Embolus ◽  
Positive Pressure ◽  
Potential Development ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Chest X Ray ◽  
Fast Exam ◽  
Delayed Pneumothorax

The case illustrates the approach to an intubated patient on mechanical ventilation with desaturation and clinical deterioration. Included is a list of potential etiologies, including airway obstruction, pneumothorax, mucus plug/atelectasis, aspiration or infection, and pulmonary embolus as well as a description of how to systematically evaluate these patients. Various imaging modalities are reviewed, including the findings of a chest X-ray and results of a limited bedside ultrasound. The case highlights the potential development of a delayed pneumothorax or hemothorax, despite an initially normal chest radiograph, particularly with the addition of positive pressure ventilation. The case highlights the importance of the focused assessment with sonography for trauma (FAST) exam.

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