scholarly journals Post-Streptococcus mitis infection polyserositis

2021 ◽  
Vol 14 (1) ◽  
pp. e236704
Author(s):  
Paula Grech ◽  
Jessica Mangion ◽  
Sandro Vella
Keyword(s):  
Pleural Fluid ◽  
Spontaneous Recovery ◽  
Pericardial Fluid ◽  
Exertional Dyspnoea ◽  
Pleural Effusions ◽  
Streptococcus Mitis ◽  
Serological Tests ◽  
Source Of Infection ◽  
Large Pericardial Effusion

We report a case of a 42-year-old man who presented with acute epigastric and retrosternal chest pain and exertional dyspnoea, and was subsequently diagnosed with polyserositis secondary to post-Streptococcal mitis infection. A CT scan showed a large pericardial effusion requiring pericardiocentesis, small bilateral pleural effusions and small amount of ascites. Several serological tests were done, which were all found to be normal. Pericardial and pleural fluid aspirates revealed an exudate. Culture of the pleural fluid yielded growth of S.  mitis and this was deemed the cause of the polyserositis, which is rare. The patient made a spontaneous recovery. He was started on colchicine by the cardiologists to help prevent pericardial fluid recurrence and this was continued for 3 months. A dental review confirmed the presence of dental caries, the possible source of infection. On follow-up, the patient remained well with no further relapses.

scholarly journals The Use of a Novel Quantitative Marker of Echogenicity of Pleural Fluid in Parapneumonic Pleural Effusions

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Charalampos Varsamas ◽  
Alexandros Kalkanis ◽  
Konstantinos I. Gourgoulianis ◽  
Foteini Malli
Keyword(s):  
Pleural Fluid ◽  
Clinical Care ◽  
Cell Number ◽  
Total Cell ◽  
Tube Placement ◽  
Laboratory Measurements ◽  
Pleural Effusions ◽  
Total Cell Number ◽  
Thoracic Ultrasound

Background. Thoracic ultrasound is an essential tool in the daily clinical care of pleural effusions and especially parapneumonic pleural effusions (PPEs), in terms of diagnosis, management, and follow-up. Hypoechogenicity index (HI) is a quantitative marker of pleural fluid echogenicity. We aimed to examine associations of HI with pleural inflammation in patients with PPE. Methods. All patients included underwent a thoracic ultrasound with HI determination at the first day of their admission for a PPE. Thoracentesis was performed in all patients. Demographics, laboratory measurements, and clinical data were collected prospectively and recorded in all subjects. Results. Twenty-four patients with PPE were included in the study. HI was statistically significantly correlated with intensity of inflammation as suggested by pleural fluid LDH ( p < 0.001 , r = −0.831), pleural fluid glucose ( p = 0.022 , r = 0.474), and pleural fluid pH ( p < 0.001 , r = 0.811). HI was correlated with ADA levels ( p = 0.005 , r = −0.552). We observed a statistically significant correlation of HI with pleural fluid total cell number ( p < 0.001 , r = −0.657) and polymorphonuclears percentage ( p = 0.02 , r = −0.590), as well as days to afebrile ( p = 0.046 , r = −0.411), duration of chest tube placement ( p < 0.001 , r = −0.806), and days of hospitalization ( p = 0.013 , r = −0.501). Discussion. HI presents a fast, easily applicable, objective, and quantitative marker of pleural inflammation that reliably reflects the intensity of pleural inflammation and could potentially guide therapeutic management of PPE.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

The role of pleural fluid thiol/disulphide homoeostasis in the differentiation between transudative and exudative pleural effusions

2021 ◽  
Author(s):  
Nazli Gormeli Kurt ◽  
Servan Gokhan ◽  
Ozcan Erel ◽  
Celal Gunes ◽  
Ahmet Fatih Kahraman ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Pleural Effusions

Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
L.A. Vaira ◽  
C. Hopkins ◽  
M. Petrocelli ◽  
J.R. Lechien ◽  
S. Cutrupi ◽  
...  
Keyword(s):  
Treatment Group ◽  
Case Control Study ◽  
Spontaneous Recovery ◽  
Olfactory Function ◽  
Control Group ◽  
Initial Control ◽  
Group A ◽  
Control Study

BACKGROUND: The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify effective treatments that enhance the spontaneous recovery of olfactory function. METHODS: Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS: In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS: Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.

scholarly journals Diving into the Pleural Fluid: Liquid Biopsy for Metastatic Malignant Pleural Effusions

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2798
Author(s):  
Maria Alba Sorolla ◽  
Anabel Sorolla ◽  
Eva Parisi ◽  
Antonieta Salud ◽  
José M. Porcel
Keyword(s):  
Pleural Fluid ◽  
Liquid Biopsy ◽  
Cell Types ◽  
Circulating Tumor Dna ◽  
Therapeutic Interventions ◽  
Driver Mutations ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Micro Rnas ◽  
Low Sensitivity

Liquid biopsy is emerging as a promising non-invasive diagnostic tool for malignant pleural effusions (MPE) due to the low sensitivity of conventional pleural fluid (PF) cytological examination and the difficulty to obtain tissue biopsies, which are invasive and require procedural skills. Currently, liquid biopsy is increasingly being used for the detection of driver mutations in circulating tumor DNA (ctDNA) from plasma specimens to guide therapeutic interventions. Notably, malignant PF are richer than plasma in tumor-derived products with potential clinical usefulness, such as ctDNA, micro RNAs (miRNAs) and long non-coding RNAs (lncRNAs), and circulating tumor cells (CTC). Tumor-educated cell types, such as platelets and macrophages, have also been added to this diagnostic armamentarium. Herein, we will present an overview of the role of the preceding biomarkers, collectively known as liquid biopsy, in PF samples, as well as the main technical approaches used for their detection and quantitation, including a proper sample processing. Technical limitations of current platforms and future perspectives in the field will also be addressed. Using PF as liquid biopsy shows promise for use in current practice to facilitate the diagnosis and management of metastatic MPE.

scholarly journals Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis

2021 ◽  
Author(s):  
Ayah Megahed ◽  
Rahul Hegde ◽  
Pranav Sharma ◽  
Rahmat Ali ◽  
Anas Bamashmos
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Pleural Fluid ◽  
Rare Complication ◽  
Delayed Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pleural Effusions ◽  
Diagnostic Challenge ◽  
Abdominal Symptoms ◽  
Pancreatic Duct Stenting

AbstractPancreaticopleural fistula is a rare complication of chronic pancreatitis caused by disruption of the pancreatic duct and fistulous communication with the pleural cavity. It usually presents with respiratory symptoms from recurrent large volume pleural effusions. Paucity of abdominal symptoms makes it a diagnostic challenge, leading often to delayed diagnosis. Marked elevation of pleural fluid amylase, which is not a commonly performed test, is a sensitive marker in its detection. Imaging with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography can help delineate the fistula. In this report, we present the clinical features, imaging, and management of a 59-year-old male patient with pancreaticopleural fistula, wherein the diagnosis was suspected only after repeated pleural fluid drainages were performed for re-accumulating pleural effusions and it was eventually successfully treated with pancreatic duct stenting. We review the literature with regards to the incidence, presentation, diagnosis, and management of this rare entity.

Pleural fluid characteristics of tuberculous pleural effusions

Heart & Lung ◽  
2010 ◽  
Vol 39 (6) ◽  
pp. 540-543 ◽  
Author(s):  
Emmet E. McGrath ◽  
David Warriner ◽  
Paul B. Anderson
Keyword(s):  
Pleural Fluid ◽  
Pleural Effusions ◽  
Fluid Characteristics

scholarly journals Hyaluronic acid levels are increased in complicated parapneumonic pleural effusions

2015 ◽  
Vol 75 (3) ◽  
Author(s):  
T. Zaga ◽  
D. Makris ◽  
I. Tsilioni ◽  
T. Kiropoulos ◽  
S. Oikonomidi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Extracellular Matrix ◽  
Congestive Heart Failure ◽  
Hyaluronic Acid ◽  
Pleural Fluid ◽  
Inflammatory Process ◽  
Serum Levels ◽  
Pleural Effusions ◽  
Tnf Α ◽  
Malignant Effusions

Background and Aim. Hyaluronic acid (HA) is a component of extracellular matrix and may play a role in the pleural inflammation which is implicated in parapneumonic effusions.The aim of the current study was to investigate HA levels in serum and pleura in patients with parapneumonic effusions. Methods. We prospectively studied pleural and serum levels of HA in 58 patients with pleural effusions due to infection (complicated and uncomplicated parapneumonic effusions), malignant effusions and transudative effusions due to congestive heart failure. In addition to HA, TNF-α and IL-1β levels were determined in pleural fluid and serum by ELISA. Results. The median±SD HA levels (pg/ml) in pleural fluid of patients with complicated effusions (39.058±11.208) were significantly increased (p&lt;0.005), compared to those with uncomplicated parapneumonic effusions (11.230±1.969), malignant effusions (10.837±4.803) or congestive heart failure (5.392±3.133). There was no correlation between pleural fluid and serum HA values. Pleural fluid TNF-α levels (146±127 pg/mL) and IL-1β levels (133.4±156 pg/mL) were significantly higher in patients with complicated parapneumonic effusions compared to patients with other types of effusion (p&lt;0.05). No significant association between HA and TNF-α or IL-1β was found. Conclusions. HA may play a significant role in the inflammatory process which characterises exudative infectious pleuritis. Further investigation might reveal whether HA is a useful marker in the management of parapneumonic effusions.

scholarly journals S115 Pleural Fluid Adenosine Deaminase (ada) In The Diagnosis Of Tuberculous Pleural Effusions In A Low Incidence Population

Thorax ◽  
2014 ◽  
Vol 69 (Suppl 2) ◽  
pp. A62-A62 ◽  
Author(s):  
D. Arnold ◽  
R. Bhatnagar ◽  
L. Fairbanks ◽  
N. Zahan-Evans ◽  
A. Clive ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Pleural Effusions ◽  
Low Incidence

scholarly journals Etiological treatment of young women infected with Trypanosoma cruzi, and prevention of congenital transmission

2009 ◽  
Vol 42 (5) ◽  
pp. 484-487 ◽  
Author(s):  
Sergio Sosa-Estani ◽  
Estela Cura ◽  
Elsa Velazquez ◽  
Cristina Yampotis ◽  
Elsa Leonor Segura
Keyword(s):  
Trypanosoma Cruzi ◽  
Young Women ◽  
Serological Tests ◽  
Congenital Transmission ◽  
Cruzi Infection ◽  
Efficacy Of Treatment

The objective was to detect Trypanosoma cruzi infection in 32 children in Salta, Argentina, born to 16 chronically infected young women who were treated with benznidazole. Tests were performed to assess the efficacy of treatment after 14 years. At the end of the follow up, 87.5% of the women were non-reactive to EIA tests, 62.5% to IHA and 43.8% to IFA. 62.5% of the women were non-reactive according to two or three serological tests. No infected children were detected among the newborns of mothers treated before their pregnancy.

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