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 Clinical features of severe Mycoplasma pneumoniae pneumonia in adults admitted to an intensive care unit

2007 ◽  
Vol 56 (12) ◽  
pp. 1625-1629 ◽  
Author(s):  
Naoyuki Miyashita ◽  
Yasushi Obase ◽  
Kazunobu Ouchi ◽  
Kozo Kawasaki ◽  
Yasuhiro Kawai ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Severe Pneumonia ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
Life Threatening ◽  
Mycoplasma Pneumoniae Pneumonia

Community-acquired pneumonia (CAP) due to Mycoplasma pneumoniae is usually mild, but some cases develop a severe life-threatening pneumonia. To investigate the clinical features of severe M. pneumoniae pneumonia in adults admitted to an intensive care unit, a multi-centre CAP surveillance study was performed. Among all hospitalized CAP cases between January 2000 and December 2004, there were 227 cases with M. pneumoniae pneumonia without the complication of other pathogens. A total of 13 of the cases required admission to an intensive care unit because of acute respiratory failure (ARF), and the remaining 214 cases (non-ARF) were low to moderately severe. The clinical features of ARF cases were compared with those of non-ARF cases. The underlying conditions in both types of case were identical, whereas clinical findings on admission clearly differed between the two groups. A regimen of an antibiotic effective against M. pneumoniae was begun on average at 9.3 days after the onset of symptoms in ARF cases, which was significantly later than for non-ARF cases (P<0.0001). However, two of the ARF cases progressed to respiratory failure despite the fact that adequate antibiotics were initially administered within 3 days after the onset of symptoms. All ARF cases received corticosteroids with adequate antibiotics, and their condition improved promptly. These results indicate that the clinical features, excluding underlying conditions, clearly differed between severe M. pneumoniae pneumonia and low to moderately severe pneumonia. The delayed administration of adequate antibiotics may contribute to the severity of M. pneumoniae pneumonia. Early corticosteroid therapy with adequate antibiotics should be considered.

Community-Acquired Pneumonia Due to Virus and Mycoplasma pneumoniae Infection in Children Younger than 5 Years

2019 ◽  
Vol 14 (04) ◽  
pp. 155-160
Author(s):  
Huiming Sun ◽  
Wenqing Zhu ◽  
Zhengrong Chen ◽  
Wei Ji ◽  
Chuangli Hao ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Viral Infections ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Direct Immunofluorescence ◽  
Symptom Duration ◽  
Viral Pathogens ◽  
Duration Of Symptoms ◽  
Viral Coinfection

AbstractThe purpose of this study was to determine the clinical features of viral pathogens and Mycoplasma pneumoniae in children hospitalized with community-acquired pneumonia (CAP). M. pneumoniae infection was diagnosed by both serology and polymerase chain reaction (PCR). Respiratory viruses were detected by direct immunofluorescence or PCR. Medical records of children younger than 5 years diagnosed with 5-day-old CAP were reviewed. Viral pathogens and/or M. pneumoniae were detected in 388 (15.59%) children in the following three groups: viral monoinfection (n = 321), M. pneumoniae with viral coinfection (n = 17), and M. pneumoniae monoinfection (n = 50). M. pneumoniae monoinfection was characterized by older age, fever, higher neutrophil count, and chest X-ray showing lobar consolidation. Wheezing was more common in children with viral infections. Elevated alanine aminotransferase and aspartate aminotransferase were commonly seen in children with Mycoplasma infections. The median symptom duration in children with viral coinfection was shorter than in the other two groups (both p < 0.05). M. pneumoniae and respiratory viruses are important etiologic agents for CAP in children younger than 5 years, with characteristic clinical features. M. pneumoniae and viral coinfection are associated with shorter duration of symptoms before admission.

Clinical Features of Superficially Located Brain Arteriovenous Malformations with Transdural Arterial Communication

2016 ◽  
Vol 41 (3-4) ◽  
pp. 204-210 ◽  
Author(s):  
Hae-Won Koo ◽  
Kyung-Il Jo ◽  
Je-Young Yeon ◽  
Keon Ha Kim ◽  
Pyoung Jeon ◽  
...  
Keyword(s):  
Clinical Features ◽  
Arteriovenous Malformations ◽  
Chronic Headache ◽  
Prognostic Significance ◽  
Clinical Findings ◽  
Older Age ◽  
Brain Arteriovenous Malformations ◽  
Radiologic Findings ◽  
Brain Avm ◽  
Brain Avms

Background: Contrary to deeply located brain arteriovenous malformations (AVMs), superficially located AVMs are more likely to have transdural arterial communications (TACs). However, the clinical and radiologic characteristics of patients presenting with AVMs and TACs are poorly understood. The purpose of this study is to determine whether clinicoradiological features of cerebral AVMs differ according to TAC. Methods: Between 2002 and 2012, 438 consecutive patients with a brain AVM were treated in our hospital. Among them were 124 patients with superficially located brain AVMs who met the inclusion and exclusion criteria of our study. We retrospectively reviewed the clinicoradiological features of their TACs to explore the variation in characteristics. Results: Thirty-two of the 124 patients with a superficially located AVM (25.8%) had TAC. Radiologic findings of brain AVM images with TAC showed that TAC occurred significantly more frequently among larger AVMs (with vs. without TAC, 11.2 vs. 4.0 ml) and among diffuse AVMs (56.3 vs. 28.3%, p = 0.004). Clinical findings indicate that TAC was associated with chronic headache (43.8 vs. 12.0%, p < 0.001) and older age (43.1 vs. 36.6 years, p = 0.037). Conclusions: Brain AVM with TAC seems to be accompanied by distinctive clinical features, such as chronic headache and older age. Larger size and diffuseness of the AVM were also associated with TAC. Findings from this study and the prognostic significance of TAC should be further explored in a large prospective study.

scholarly journals Clinical and radiological findings of adult hospitalized patients with community-acquired pneumonia from SARS-CoV-2 and endemic human coronaviruses

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245547 ◽  
Author(s):  
Moon Seong Baek ◽  
Min Jae Cha ◽  
Min-Chul Kim ◽  
Jin-Won Chung ◽  
Won-Young Kim ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
The Novel ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
The Republic ◽  
Human Coronaviruses

Endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are members of the family Coronaviridae. Comparing the findings of the infections caused by these viruses would help reveal the novel characteristics of SARS-CoV-2 and provide insight into the unique pathogenesis of SARS-CoV-2 infection. This study aimed to compare the clinical and radiological characteristics of SARS-CoV-2 and endemic HCoVs infection in adult hospitalized patients with community-acquired pneumonia (CAP). This study was performed at a university-affiliated tertiary hospital in the Republic of Korea, between January 1, 2015, and July 31, 2020. A total of 109 consecutive patients who were over 18 years of age with confirmed SARS-CoV-2 and endemic HCoVs were enrolled. Finally, 19 patients with SARS-CoV-2 CAP were compared to 40 patients with endemic HCoV CAP. Flu-like symptoms such as cough, sore throat, headache, myalgia, and prolonged fever were more common in SARS-CoV-2 CAP, whereas clinical findings suggestive of bacterial pneumonia such as dyspnea, leukocytosis with left shift, and increased C-reactive protein were more common in endemic HCoV CAP. Bilateral peripherally distributed ground-glass opacities (GGOs) were typical radiologic findings in SARS-CoV-2 CAP, whereas mixed patterns of GGOs, consolidations, micronodules, and pleural effusion were observed in endemic HCoV CAP. Coinfection was not observed in patients with SARS-CoV-2 CAP, but was observed in more than half of the patients with endemic HCoV CAP. There were distinctive differences in the clinical and radiologic findings between SARS-CoV-2 and endemic HCoV CAP. Further investigations are required to elucidate the mechanism underlying this difference. Follow-up observations are needed to determine if the presentation of SARS-CoV-2 CAP changes with repeated infection.

scholarly journals Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

Preoperative prediction for lauren type of gastric cancer: A radiomics nomogram analysis based on CT images and clinical features

2021 ◽  
pp. 1-12
Author(s):  
Zongqiong Sun ◽  
Linfang Jin ◽  
Shuai Zhang ◽  
Shaofeng Duan ◽  
Wei Xing ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Features ◽  
Calibration Curve ◽  
Prediction Models ◽  
Ct Images ◽  
Clinical Findings ◽  
Training Set ◽  
Prediction Probability ◽  
Radiomics Signature ◽  
Testing Set

PURPOSE: To investigate feasibility of predicting Lauren type of gastric cancer based on CT radiomics nomogram before operation. MATERIALS AND METHODS: The clinical data and pre-treatment CT images of 300 gastric cancer patients with Lauren intestinal or diffuse type confirmed by postoperative pathology were retrospectively analyzed, who were randomly divided into training set and testing set with a ratio of 2:1. Clinical features were compared between the two Lauren types in the training set and testing set, respectively. Gastric tumors on CT images were manually segmented using ITK-SNAP software, and radiomic features of the segmented tumors were extracted, filtered and minimized using the least absolute shrinkage and selection operator (LASSO) regression to select optimal features and develop radiomics signature. A nomogram was constructed with radiomic features and clinical characteristics to predict Lauren type of gastric cancer. Clinical model, radiomics signature model, and the nomogram model were compared using the receiver operating characteristic (ROC) curve analysis with area under the curve (AUC). The calibration curve was used to test the agreement between prediction probability and actual clinical findings, and the decision curve was performed to assess the clinical usage of the nomogram model. RESULTS: In clinical features, Lauren type of gastric cancer relate to age and CT-N stage of patients (all p <  0.05). Radiomics signature was developed with the retained 10 radiomic features. The nomogram was constructed with the 2 clinical features and radiomics signature. Among 3 prediction models, performance of the nomogram was the best in predicting Lauren type of gastric cancer, with the respective AUC, accuracy, sensitivity and specificity of 0.864, 78.0%, 90.0%, 70.0%in the testing set. In addition, the calibration curve showed a good agreement between prediction probability and actual clinical findings (p >  0.05). CONCLUSION: The nomogram combining radiomics signature and clinical features is a useful tool with the increased value to predict Lauren type of gastric cancer.

Clinical features of adults with seven-valent-conjugated-vaccine-serotype pneumococcal pneumonia

Vaccine ◽  
2014 ◽  
Vol 32 (13) ◽  
pp. 1460-1465 ◽  
Author(s):  
Chamira Rodrigo ◽  
Thomas Bewick ◽  
Carmen Sheppard ◽  
Sonia Greenwood ◽  
Caroline Trotter ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pneumococcal Pneumonia

scholarly journals Viruses in community-acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection

2008 ◽  
Vol 80 (10) ◽  
pp. 1843-1849 ◽  
Author(s):  
Gustavo Cilla ◽  
Eider Oñate ◽  
Eduardo G. Perez-Yarza ◽  
Milagrosa Montes ◽  
Diego Vicente ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
High Rate ◽  
Viral Coinfection

scholarly journals Evaluation of Incidence and Clinical Features of Antibody-Associated Autoimmune Encephalitis Mimicking Dementia

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Arzu Çoban ◽  
Cem İsmail Küçükali ◽  
Başar Bilgiç ◽  
Nazlı Yalçınkaya ◽  
Hazal Haytural ◽  
...  
Keyword(s):  
Clinical Features ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Autoimmune Encephalitis ◽  
Clinical Findings ◽  
Acid Decarboxylase ◽  
Sleep Behavior ◽  
Clinical Criteria ◽  
Dementia Patients

Background. Anti-neuronal autoimmunity may cause cognitive impairment that meets the criteria for dementia.Objective. Our aim was to detect the incidence and clinical features of autoimmune encephalitis imitating clinical findings of primary dementia disorders and to delineate the validity of anti-neuronal antibody screening in dementia patients.Methods. Fifty consecutive patients fulfilling the clinical criteria for primary dementia, 130 control patients, and 50 healthy controls were included. Their sera were investigated for several ion channel and glutamic acid decarboxylase (GAD) antibodies by a cell-based assay, radioimmunoassay, and ELISA, as required.Results. Sixteen patients satisfying dementia criteria had atypical findings or findings suggestive of autoimmune encephalitis. N-methyl-D-aspartate receptor (NMDAR) antibody was detected in a patient with dementia, Parkinsonism, and REM sleep behavior disorder (RBD) fulfilling the criteria for dementia with Lewy bodies (DLB). One control patient with bipolar disease displayed low anti-GAD antibody levels.Conclusions. Our study showed for the first time the presence of parkinsonism and RBD in an anti-NMDAR encephalitis patient mimicking DLB. Although autoimmune encephalitis patients may occasionally present with cognitive decline, most dementia patients do not exhibit anti-neuronal antibodies, suggesting that routine analysis of these antibodies in dementia is not mandatory, even though they display atypical features.

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