scholarly journals Pyopneumothorax from coinfection by Trichomonas tenax and Geotrichum capitatum in a child from China: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuhui Wu ◽  
Yuanzhen Ye ◽  
Yanlan Yang ◽  
Weiguo Yang ◽  
Jiayin Lin ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Respiratory Tract Infections ◽  
Bronchoalveolar Lavage Fluid ◽  
Clinical Symptoms ◽  
Lavage Fluid ◽  
Lower Respiratory Tract Infections ◽  
Case Presentation ◽  
Geotrichum Capitatum ◽  
Tract Infections ◽  
Generation Sequencing

Abstract Background Trichomonas tenax may appear in the oral cavity of humans due to poor dentition or oral hygiene. Pyopneumothorax is a serious complication of lower respiratory tract infections that very rarely can be caused by a trichomonad species in predisposed individuals. We report a rare case of pleurisy due to T. tenax with coinfection by a fungus. Case presentation We describe a 16-year-old patient with cerebral palsy who presented with severe pyopneumothorax. T. tenax was identified by microscopic examination of the pleural effusion and next-generation sequencing. We also identified Geotrichum capitatum in the pleural effusion and bronchoalveolar lavage fluid cultures. Treatment with voriconazole and metronidazole successfully eliminated these pathogens and relieved the clinical symptoms. A literature review indicated this is the first reported case of pleurisy due to T. tenax with coinfection by a fungus. Conclusion The rarity of pyopneumothorax caused by T. tenax coinfection with a fungus should not be overlooked in the clinic. These patients should be and treated in a timely manner.

scholarly journals Severe pneumonia caused by Parvimonas micra: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yu ◽  
Lingling Sun ◽  
Zuqing Xu ◽  
Lumei Fan ◽  
Yunbo Du
Keyword(s):  
Bronchoalveolar Lavage Fluid ◽  
Case Reports ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Due Date ◽  
Case Presentation ◽  
Abdominal Abscesses ◽  
Parvimonas Micra ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Abstract Background Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset. Case presentation A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient’s bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved. Conclusion In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.

scholarly journals Metapneumovirus infection in children

2020 ◽  
Vol 11 (5) ◽  
pp. 13-19
Author(s):  
Elena V. Sharipova ◽  
Irina V. Babachenko ◽  
Elizaveta D. Orlova
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Hospitalized Children ◽  
Lower Respiratory Tract Infections ◽  
Nucleic Acid Isolation ◽  
Hmpv Infection ◽  
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.

Clinical Utility of In-house Metagenomic Next-generation Sequencing for the Diagnosis of Lower Respiratory Tract Infections and Analysis of the Host Immune Response

2020 ◽  
Vol 71 (Supplement_4) ◽  
pp. S416-S426
Author(s):  
Hongbin Chen ◽  
Yuyao Yin ◽  
Hua Gao ◽  
Yifan Guo ◽  
Zhao Dong ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Respiratory Tract ◽  
Predictive Value ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Next Generation ◽  
Lower Respiratory Tract Infections ◽  
Dna And Rna ◽  
Tract Infections ◽  
Generation Sequencing

Abstract Background Only few pathogens that cause lower respiratory tract infections (LRTIs) can be identified due to limitations of traditional microbiological methods and the complexity of the oropharyngeal normal flora. Metagenomic next-generation sequencing (mNGS) has the potential to solve this problem. Methods This prospective observational study sequentially enrolled 93 patients with LRTI and 69 patients without LRTI who visited Peking University People’s Hospital in 2019. Pathogens in bronchoalveolar lavage fluid (BALF) specimens were detected using mNGS (DNA and RNA) and traditional microbiological assays. Human transcriptomes were compared between LRTI and non-LRTI, bacterial and viral LRTI, and tuberculosis and nontuberculosis groups. Results Among 93 patients with LRTI, 20%, 35%, and 65% of cases were detected as definite or probable pathogens by culture, all microbiological tests, and mNGS, respectively. Our in-house BALF mNGS platform had an approximately 2-working-day turnaround time and detected more viruses and fungi than the other methods. Taking the composite reference standard as a gold standard, it had a sensitivity of 66.7%, specificity of 75.4%, positive-predictive value of 78.5%, and negative-predictive value of 62.7%. LRTI-, viral LRTI–, and tuberculosis-related differentially expressed genes were respectively related to immunity responses to infection, viral transcription and response to interferon-γ pathways, and perforin 1 and T-cell receptor B variable 9. Conclusions Metagenomic DNA and RNA-seq can identify a wide range of LRTI pathogens, with improved sensitivity for viruses and fungi. Our in-host platform is likely feasible in the clinic. Host transcriptome data are expected to be useful for the diagnosis of LRTIs.

scholarly journals Combined nanopore adaptive sequencing and enzyme-based host depletion efficiently enriched microbial sequences and identified missing respiratory pathogens

BMC Genomics ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mingyu Gan ◽  
Bingbing Wu ◽  
Gangfeng Yan ◽  
Gang Li ◽  
Li Sun ◽  
...  
Keyword(s):  
Standard Method ◽  
Respiratory Tract Infections ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Interquartile Range ◽  
Clinical Samples ◽  
Respiratory Pathogens ◽  
Combined Method ◽  
Tract Infections ◽  
Enrichment Efficiency

Abstract Background Enzyme-based host depletion significantly improves the sensitivity of clinical metagenomics. Recent studies found that real-time adaptive sequencing of DNA molecules was achieved using a nanopore sequencing machine, which enabled effective enrichment of microbial sequences. However, few studies have compared the enzyme-based host depletion and nanopore adaptive sequencing for microbial enrichment efficiency. Results To compare the host depletion and microbial enrichment efficiency of enzyme-based and adaptive sequencing methods, the present study collected clinical samples from eight children with respiratory tract infections. The same respiratory samples were subjected to standard methods, adaptive sequencing methods, enzyme-based host depletion methods, and the combination of adaptive sequencing and enzyme-based host depletion methods. We compared the host depletion efficiency, microbial enrichment efficiency, and pathogenic microorganisms detected between the four methods. We found that adaptive sequencing, enzyme-based host depletion and the combined methods significantly enriched the microbial sequences and significantly increased the diversity of microorganisms (p value < 0.001 for each method compared to standard). The highest microbial enrichment efficiency was achieved using the combined method. Compared to the standard method, the combined method increased the microbial reads by a median of 113.41-fold (interquartile range 23.32–327.72, maximum 1812), and the number of genera by a median of 70-fold (interquartile range 56.75–86.75, maximum 164). The combined method detected 6 pathogens in 4 samples with a median read of 547, compared to 5 pathogens in 4 samples with a median read of 4 using the standard method. Conclusion The combined method is an effective, easy-to-run method for enriching microbial sequences in clinical metagenomics from sputum and bronchoalveolar lavage fluid samples and may improve the sensitivity of clinical metagenomics for other host-derived clinical samples.

scholarly journals Ablation of the leptin receptor in myeloid cells impairs pulmonary clearance ofStreptococcus pneumoniaeand alveolar macrophage bactericidal function

2018 ◽  
Vol 315 (1) ◽  
pp. L78-L86 ◽  
Author(s):  
Peter Mancuso ◽  
Jeffrey L. Curtis ◽  
Christine M. Freeman ◽  
Marc Peters-Golden ◽  
Jason B. Weinberg ◽  
...  
Keyword(s):  
Pneumococcal Pneumonia ◽  
Respiratory Tract Infections ◽  
Bronchoalveolar Lavage Fluid ◽  
Leptin Receptor ◽  
Lavage Fluid ◽  
Bacterial Killing ◽  
Leptin Deficiency ◽  
Tract Infections ◽  
Bactericidal Function

Leptin is a pleiotropic hormone produced by white adipose tissue that regulates appetite and many physiological functions, including the immune response to infection. Genetic leptin deficiency in humans and mice impairs host defenses against respiratory tract infections. Since leptin deficiency is associated with obesity and other metabolic abnormalities, we generated mice that lack the leptin receptor (LepRb) in cells of the myeloid linage (LysM-LepRb-KO) to evaluate its impact in lean metabolically normal mice in a murine model of pneumococcal pneumonia. We observed higher lung and spleen bacterial burdens in LysM-LepRb-KO mice following an intratracheal challenge with Streptococcus pneumoniae. Although numbers of leukocytes recovered from bronchoalveolar lavage fluid did not differ between groups, we did observe higher levels of pulmonary IL-13 and TNFα in LysM-LepRb-KO mice 48 h post infection. Phagocytosis and killing of ingested S. pneumoniae were also impaired in alveolar macrophages (AMs) from LysM-LepRb-KO mice in vitro and were associated with reduced LTB4and enhanced PGE2synthesis in vitro. Pretreatment of AMs with LTB4and the cyclooxygenase inhibitor, indomethacin, restored phagocytosis but not bacterial killing in vitro. These results confirm our previous observations in leptin-deficient ( ob/ob) and fasted mice and demonstrate that decreased leptin action, as opposed to metabolic irregularities associated with obesity or starvation, is responsible for the defective host defense against pneumococcal pneumonia. They also provide novel targets for therapeutic intervention in humans with bacterial pneumonia.

scholarly journals Epidemiology of Human Respiratory Viruses in Children with Acute Respiratory Tract Infections in Jinan, China

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yanqin Lu ◽  
Shifu Wang ◽  
Lehai Zhang ◽  
Chao Xu ◽  
Cuirong Bian ◽  
...  
Keyword(s):  
Respiratory Tract Infections ◽  
Bronchoalveolar Lavage Fluid ◽  
Respiratory Virus ◽  
Lavage Fluid ◽  
Virus Infections ◽  
Rt Pcr ◽  
Viral Pathogens ◽  
Tract Infections ◽  
Respiratory Virus Infections ◽  
Viral Etiologies

The viral etiologies of UTRIs and LTRIs in children in Jinan city were investigated between July 2009 and June 2010. Nasal and throat swabs were collected from 397 children with URTIs and bronchoalveolar lavage fluid specimens were collected from 323 children with LRTIs. RT-PCR/PCR was used to examine all samples for IFV, PIV, RSV, RV, hMPV, HBoV, CoV, ADV, RSV, and EV. Viral pathogens were detected in 47.10% of URTI samples and 66.57% samples, and the incidence of viral coinfection was 5.29% and 21.05%, respectively. IFV was the most common virus in URTIs, with a detection rate of 19.40%, followed by PIV (10.83%), RV (10.58%), and EV (6.30%). For LRTIs, PIV and RV were both detected in 27% of samples, followed by RSV (9.91%), HBoV (8.36%), IFV (5.57%), and hMPV (5.57%). RSV and HBoV were more prevalent in the youngest children of no more than six months. Meanwhile, RV, PIV, and RSV were the most frequent viruses combined with bacterial pathogens in LRTIs. In conclusion, the spectrum of respiratory virus infections in URTIs and LRTIs differed in terms of the most common pathogens, seasonal distribution, and coinfection rate.

Broncho-alveolar lavage in chronic upper respiratory tract infections

1995 ◽  
Vol 109 (9) ◽  
pp. 859-862
Author(s):  
H. Zeitoun ◽  
W. El-Husseiny ◽  
M. El-Sawi ◽  
M. A. Mandour
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lavage Fluid ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Dye Reduction ◽  
Upper Respiratory ◽  
Tract Infections ◽  
The Relationship

AbstractThe relationship between upper and lower respiratory tract infections has been demonstrated previously, although the effect of chronic infection of One tract on the other has not been well studied. This work analyses the broncho-alveolar lavage fluid of patients with chronic purulent rhino-sinusitis and reveals and increase in the neutrophil nitro-blue tetrazolium dye reduction test positivity provides evidence for increased phagocutosis to compensate for the increased contamination of the lower respiratory tract.

scholarly journals Pneumonia caused by Lichtheimia ramosa during the COVID-19 pandemic in Hubei Province, China：mNGS assists diagnosis

2021 ◽  
Author(s):  
Jiangqin Song ◽  
Hui Li ◽  
Fuying Hu ◽  
Huashun Li ◽  
Youping Chen ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Bronchoalveolar Lavage Fluid ◽  
Fungal Infections ◽  
Lavage Fluid ◽  
Hubei Province ◽  
Lung Imaging ◽  
Case Presentation ◽  
Invasive Fungal Diseases ◽  
Lichtheimia Ramosa ◽  
Generation Sequencing

Abstract BackgroundRecently, COVID-19 is still pandemic in worldwide. India has reported multiple cases of COVID-19 combined with mucormycosis(MM)(1). This paper reports a case during the COVID-19 pandemic in Hubei Province, China. Case PresentationA anesthesiology doctor was initially diagnosed as COVID-19 due to changes in lung imaging. Later Lichtheimia ramose was found by Metagenomic next generation sequencing (mNGS) in the Bronchoalveolar lavage fluid (BALF).After adjusting amphotericin B for anti-infective treatment, the patient's infection lesions were shranked and the symptoms were significantly relieved.ConclusionThe diagnosis of invasive fungal infections is very difficult, mNGS can make an accurate pathogenic diagnosis of invasive fungal diseases for the clinic and provide a basis for clinical treatment.

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