Chest CT Features of Community-acquired Respiratory Viral Infections in Adult Inpatients With Lower Respiratory Tract Infections

Objective: to study the clinical features of metapneumovirus infection in children of different ages in a hospital. Materials and methods. A retrospective analysis of medical records of 142 patients aged 1 month to 14 years inclusive who were hospitalized in the period from January 2012 to April 2019. Metapneumovirus infection was confirmed by hMPV nucleic acid isolation by PCR in nasopharyngeal smears. Results. Metapneumovirus infection is detected among hospitalized children with acute respiratory viral infections in 4,4% of cases. In the age structure, 72,2% are children under 4 years old, and the maximum incidence rate is among children aged 3 years of life. The leading clinical symptoms are cough in 93,0% of cases and rhinitis in 96,5% of cases.In 88,2% of children, the disease proceeds with an increase in temperature 38 C, including in 34,6% 39,5 C and above. Symptoms of gastrointestinal dysfunction in the form of vomiting and diarrhea develop in 26,1% and 22,5% of children, respectively. 78,2% of patients requiring hospitalization suffer hMPV infection with damage to the lower respiratory tract, including in the form of bronchitis in 85,6% of cases and pneumonia in 14,4% of cases. The disease is complicated by the development of bronchial obstructive syndrome in 38,7% and acute respiratory failure in 22,3% of cases. ARF and BOS are significantly more likely to develop in children of the first 3 years of life 71,0% versus 29,0% in children of the older age group (p = 0.038) and 69,8% against 30,2% (p = 0.007), respectively. In a clinical blood test for hMPV infection, leukopenia and leukocytosis are detected only in 3,5% and 12,7% of cases, respectively, as well as an increase in ESR in 23,9% of children. The level of CRP in the 93,0% of children was less than 20 mg/l. Conclusions. Virological confirmation of metapneumovirus infection in hospitalized children with lower respiratory tract infections contributes to the formation of an adequate therapeutic tactic.

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Brief report. Simultaneous multiple viral infections in childhood acute lower respiratory tract infections in Southern Taiwan

Journal of Tropical Pediatrics ◽

10.1093/tropej/44.5.308 ◽

1998 ◽

Vol 44 (5) ◽

pp. 308-311 ◽

Cited By ~ 10

Author(s):

J-J Huang

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Viral Infections ◽

Lower Respiratory Tract Infections ◽

Southern Taiwan ◽

Tract Infections

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A Collaborative Approach to Improve Consistent Use of Procalcitonin in Lower Respiratory Tract Infections

Annals of Pharmacotherapy ◽

10.1177/1060028017753411 ◽

2018 ◽

Vol 52 (6) ◽

pp. 538-545 ◽

Cited By ~ 1

Author(s):

Alexander R. Levine ◽

Robyn Riggott ◽

Kristela Vulaj ◽

Tera R. Falcetti ◽

Syed Ali ◽

...

Keyword(s):

Quality Improvement ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Viral Infections ◽

Intervention Group ◽

Quality Improvement Initiative ◽

Lower Respiratory Tract Infections ◽

Improvement Project ◽

Tract Infections

Background: Procalcitonin (PCT) is a biomarker that can help differentiate bacterial from viral infections and has been extensively studied in patients with sepsis and pneumonia to guide antibiotic therapy. However, there is poor adherence to prescribed algorithms when used to discontinue antibiotics in the real world. A quality improvement project was implemented to increase consistent use of PCT. Objective: To evaluate use of PCT and impact on antibiotic length of therapy (LOT) preimplementation and postimplementation of a quality improvement initiative. Methods: This was a single-center retrospective cohort study in patients with lower respiratory tract infections (LRTIs). Results: In all, 330 patients were included in this study. Following implementation of the quality improvement initiative, ordering PCT in the first 24 hours increased from 59.6% to 75.5% ( P = 0.011). Documentation to discontinue antibiotics in patients with low initial PCT values increased from 13.2% to 28.6% ( P = 0.100). Increased PCT use correlated with an overall mean reduction of 1.05 antibiotic days between cohorts (6.82 ± 3.88 vs 5.77 ± 3.43, P = 0.028). There was no difference in incidence of antibiotic-associated adverse effects or 30-day hospital readmission rates attributed to pneumonia. Conclusions: Consistent use of PCT was achieved through a collaborative effort with the clinical pharmacy and hospitalist staff. Increased use of PCT was associated with a significant reduction in antibiotic LOT among patients with LRTIs. When controlling for other factors, low initial PCT values had the strongest influence on discontinuing antibiotics within 72 hours in the intervention group.

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An analysis of the clinical picture of respiratory tract infections in primary care patients

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2020.0069 ◽

2020 ◽

Vol 16 (4) ◽

pp. 382-388

Author(s):

Aneta Rzepka ◽

◽

Anna Mania ◽

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Viral Infections ◽

Upper Respiratory Tract ◽

Lower Respiratory Tract Infections ◽

Upper Respiratory ◽

Tract Infections

Aim: The aim of this study was to analyse the clinical picture of respiratory tract infections among adult patients visiting their general practitioners. Materials and methods: The analysis included 301 adult patients who reported to their general practitioners due to respiratory tract infection. W assessed clinical symptoms, age, final diagnosis, probable aetiology, additional tests, including Actim® Influenza A&B rapid test to confirm influenza infection, radiographic and laboratory findings, as well as comorbidities, treatment used, vaccinations against influenza, and smoking habits. Results: Upper respiratory tract infections accounted for the vast majority of cases (74%), and these primarily included viral infections (62%), some of which required a change of therapy (23%) due to suspected secondary bacterial infection; lower respiratory tract infections accounted for 26% of cases. The main symptoms reported by the patients included cough, pharyngeal pain, fever, rhinitis, general malaise, nasal obstruction, headache, muscle pain and dysphonia. Acute pharyngitis was the dominant diagnosis (27%), followed by acute upper respiratory tract infection of multiple sites (13.6%), acute nasopharyngitis (known as common cold) (10%), purulent tonsillitis (11.6%), acute bronchitis (11%) and influenza (11%). Antibiotic therapy was used in 60% of patients with upper respiratory tract infection and 68% of patients with lower respiratory tract infection. Conclusions: The majority of patients were diagnosed with viral infections. The highest incidence of respiratory tract infections was observed in elderly individuals and patients with chronic cardiovascular diseases, lung diseases, diabetes mellitus and cancer. Smokers are more likely to develop lower respiratory tract infections (confirmed by additional tests) compared to other groups of patients. Individuals vaccinated against influenza account for a small proportion of patients.

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