scholarly journals Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia

2021 ◽  
Author(s):  
Chiagozie O. Pickens ◽  
Catherine A. Gao ◽  
Michael J. Cuttica ◽  
Sean B Smith ◽  
Lorenzo L. Pesce ◽  
...  
Keyword(s):  
Mechanically Ventilated ◽  
Bacterial Superinfection

scholarly journals Bronchoscopy in COVID19 ARDS patients on mechanical ventilation – a prospective study

2021 ◽  
Author(s):  
Ravindra Mehta ◽  
Sameer Bansal ◽  
Ashwin Kumar ◽  
Anmol Thorbole ◽  
L Chakravarthi ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Laboratory Findings ◽  
Pneumocystis Jiroveci ◽  
Mechanically Ventilated ◽  
Aerosol Generation ◽  
Culture Positivity ◽  
Co Morbidity ◽  
A Prospective Study ◽  
Viral Inclusions ◽  
Bacterial Superinfection

AbstractBackgroundBronchoscopy has been done sparingly in COVID19 patients due to the risk of aerosol generation, with few reports describing its clinical utility. We describe a study on bronchoscopy in mechanically ventilated (MV) COVID-19 patients outlining the procedural, clinical, utilitarian and safety aspects.MethodsBedside bronchoscopy was performed in suspected or confirmed COVID-19 cases on MV; only positive cases were included in the study. Demographic, clinical, bronchoscopic and laboratory findings were noted and analysed.Results98 procedures were performed on 61 patients, mean age of 62.1 years, 51 (83.6%) males. 42 patients (69%) had at least 1 co-morbidity. Major indications for bronchoscopy were new radiographic infiltrates with clinical deterioration, increased endotracheal tube (ETT) secretions and haemorrhagic secretions/hemoptysis. Common findings were copious secretions in 87 (88.8%), purulent in 61%, mucoid in 18%, haemorrhagic in 7% and frothy in 14% cases. Morphologically, hyperaemic airways were seen in 85 (86.7%) cases, ranging from mild (61%) to moderate-severe (39%). On the management front, antibiotics were changed in 31 (31.6%) cases based on bronchoscopic findings. Other significant changes included reduction or stopping of steroids and anticoagulation, fluid, and diuretic adjustment and ETT repositioning. The incidence of bacterial superinfection was also high (54% culture positivity for various bacteria), a significant number (94%) with multi-drug resistant organisms. Fungi were seen in 7 cases (7.1%). Pneumocystis jiroveci was not seen and cytology did not show any viral inclusions. Therapeutic mucus plug removal was done in 30 cases (30.6%), and hemoptysis control in 4% cases. The procedures were safe with no complications, and none of the HCW developed any COVID19 infection.ConclusionBronchoscopy in critically ill MV COVID-19 patients contributes on both diagnostic and therapeutic fronts and can significantly influence management decisions. With adequate precautions and standard protocols, it is safe for both HCW and patients.

CHICKENPOX AND ITS COMMON COMPLICATIONS

2017 ◽  
pp. 7-14
Author(s):  
Dinh Binh Tran ◽  
Thi Ai Liên Dinh
Keyword(s):  
Infectious Disease ◽  
Radiation Therapy ◽  
Emergency Care ◽  
Benign Disease ◽  
Severe Malnutrition ◽  
Child Transmission ◽  
Chicken Pox ◽  
The Family ◽  
Mother To Child ◽  
Bacterial Superinfection

Chickenpox is an infectious disease caused by the Varicella-Zostervirus (VZV), this is a virus in the family of Herpesviridae. It’s characterized by fever, skin rash and mucocutaneous rash. Chickenpox is widely distributed disease with varying in age, seasons, climate, and resident of people . Mother-to-child transmission of the virus can occur during pregnancy, during delivery and after birth. In people who have had chickenpox, after the cure, a few viruses exist in the nerves sensing the spine in the form of latent, silent. When conditions are favorable (triggers) such as immunodeficiency, stress, radiation therapy, cancer, HIV infection ... the virus reacts, multiplies and spreads, causing inflammation and necrosis of the nerve in shingles (Zona). Chickenpox is a benign disease but it can also cause many complications in severe cases and which is not properly treated. Complications of dermatitis due to bacterial superinfection, the peanut note to pus, when cured can leave scar. In patients with severe malnutrition, nodules may be necrotic. The most severe complication is encephalitis, meningitis that are very dangerous, which can cause dead if delayed to hospital and emergency care is not timely. The disease can spread rapidly in the community, but there are active measures to prevent chicken pox, which is vaccination. Key words: Chickenpox, Varicella-Zostervirus (VZV)

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