Association of Mycoplasma pneumoniae coinfection with  adenovirus pneumonia severity in children

Between the winter of 2018 and the end of 2019, there has been an epidemic of adenovirus infection in southern China, including Zhejiang Province. The number of children suffering from adenovirus pneumonia (AP) has significantly increased. AP can be accompanied by Mycoplasma pneumoniae in children. This study aimed to investigate the association of M. pneumoniae and identify the risk factors for coinfection on hospitalized patients with AP. The patients were classified into two groups by etiologic analysis (single AP and AP with M. pneumoniae coinfection groups). The clinical manifestations, clinical medication, and laboratory and imaging findings of the two groups were compared and analyzed. The coinfection group (n = 125) had a significantly longer duration of fever than the single AP group (n = 171; P = 0.03). Shortness of breath (P = 0.023) and pulmonary imaging findings, such as pulmonary consolidation, atelectasis, pleural effusion, and multilobe lesions (P < 0.05), were more common in the coinfection group. The patients with coinfection had more severe symptoms, significantly longer hospitalization time and an increased proportion of using glucocorticoids and/or immunoglobulin needing oxygen inhalation (P < 0.05). The incidence of AP with M. pneumoniae coinfection is high. The prolonged fever duration and pulmonary imaging findings could be used as prediction factors to predict M. pneumoniae coinfection in children with AP. Patients with AP coinfected with MP may easily develop severe illness. Hence, a reasonable change in the treatment is necessary.

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Impact of Mycoplasma pneumoniae coinfection in children with adenovirus pneumonia

10.21203/rs.3.rs-207614/v1 ◽

2021 ◽

Author(s):

Jin-feng Wei ◽

Shan-shan Pan ◽

Su-ling Wu ◽

Xue-feng Jin ◽

Jie Zhang

Keyword(s):

Mycoplasma Pneumoniae ◽

Southern China ◽

Clinical Manifestations ◽

Community Acquired Pneumonia ◽

Severe Illness ◽

Number Of Children ◽

Oxygen Inhalation ◽

Pulmonary Imaging ◽

Adenovirus Pneumonia ◽

The Impact

Abstract Background Since the winter of 2018 to the end of 2019, there has been an epidemic of Adenovirus infection in southern China, including Zhejiang province, and the number of children suffering from adenovirus pneumonia has increased significantly. Adenovirus pneumonia is often accompanied by other infections in children[3,4], but the effect of other Pathogenic coinfection on the AP has been reported few. Mycoplasma pneumoniae is also an important pathogen of community-acquired pneumonia, accounting for 20-40% of children's CAP[5]. As we know the Impact of Mycoplasma pneumoniae coinfection in children with adenovirus pneumonia, which has drawn the attention of the society and the Paediatrician now has not been reported before. This study aimed to investigate the impacts of MP coinfection on hospitalized AP patients, to identify the risk factors for those patients. Methods Nasopharyngeal swabs (NPSs) or sputum specimens for Culturing were collected from patients once they were admitted to our hospital. ADV-Ag, MP-IgM and MP nucleic acid was tested at the same time, then we classify under two groups(single AP groups and AP groups coinfected with MP) . The clinical manifestations, laboratory and imaging findings and clinical medication of the two groups were compared and analyzed.Results A total of 171 patients diagnosed with single AP and 125 patients diagnosed with AP coinfected with MP. Coinfection group lead to a significantly longer duration of fever than single AP group(p=0.03). Shortness of breath was more commonly found in the coinfection group(P = 0.023).there was no statistical difference in pulmonary signs and blood tests between the two groups (P > 0.05). pulmonary imaging, such as pulmonary consolidation, atelectasis, pleural effusion and multi lobe lesions were more common in the coinfection group (P < 0.05). The patients with coinfection had a more severe symptom, leading to a significantly longer hospitalization time, and increasing the proportion of patients using glucocorticoids and / or gamma globulin, needing oxygen inhalation(P < 0.05). Conclusions The occurrence of adenovirus pneumonia coinfected MP is high. prediction factors of prolonged fever duration and pulmonary imaging can be used to predict MP coinfection in children with adenovirus pneumonia. AP patients coinfected MP may easily turn into severe illness, and a reasonable change in treatment is necessary.

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Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

BMC Infectious Diseases ◽

10.1186/s12879-021-05903-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruimu Zhang ◽

Hongmei Wang ◽

Shufeng Tian ◽

Jikui Deng

Keyword(s):

Risk Factors ◽

Viral Load ◽

Disease Severity ◽

Mycoplasma Pneumoniae ◽

Quantitative Polymerase Chain Reaction ◽

Univariate Analysis ◽

Clinical Manifestations ◽

Pneumonia Severity ◽

Adenovirus Pneumonia ◽

Blood Viral Load

Abstract Background Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia. Results A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P < 0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia. Conclusions Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.

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Adenovirus Viremia Predicts Adenovirus Pneumonia Severity in Immunocompetent Children

10.21203/rs.3.rs-66081/v2 ◽

2020 ◽

Author(s):

Ruimu Zhang ◽

Hongmei Wang ◽

Shufeng Tian ◽

Jikui Deng

Keyword(s):

Risk Factors ◽

Viral Load ◽

Disease Severity ◽

Mycoplasma Pneumoniae ◽

Quantitative Polymerase Chain Reaction ◽

Univariate Analysis ◽

Clinical Manifestations ◽

Pneumonia Severity ◽

Adenovirus Pneumonia ◽

Blood Viral Load

Abstract Background: Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies focused on the use of this approach in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods: We did a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted in Shenzhen Children’s hospital in Shenzhen, China. Pneumonia was classified as severe or mild, based on the Chinese guideline of pneumonia severity classification. The serum of all the children in the study was tested for adenovirus DNA with quantitative polymerase chain reaction (PCR). Clinical manifestations, laboratory examinations, and disease severity were compared between these two groups. Results: A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months and 64 patients were male. Five patients were admitted to intensive care unit and two were endotracheal intubated. All the patients were discharged with recovery or improvement. Univariate analysis and binary logistic regression analysis showed leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection of mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P < 0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) were risk factors for severe adenovirus pneumonia. Conclusions: Leukocytosis, co-infection of mycoplasma pneumoniae, and high blood viral load are risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load predicts pneumonia severity.

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Adenovirus Viremia Predicts Adenovirus Pneumonia Severity in Immunocompetent Children

10.21203/rs.3.rs-66081/v1 ◽

2020 ◽

Author(s):

Ruimu Zhang ◽

Hongmei Wang ◽

Shufeng Tian ◽

Jikui Deng

Keyword(s):

Risk Factors ◽

Viral Load ◽

Disease Severity ◽

Mycoplasma Pneumoniae ◽

Quantitative Polymerase Chain Reaction ◽

Univariate Analysis ◽

Clinical Manifestations ◽

Pneumonia Severity ◽

Adenovirus Pneumonia ◽

Blood Viral Load

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Juxtaneural ganglia arising from the hip joint: focus on magnetic resonance imaging findings and clinical manifestations

Skeletal Radiology ◽

10.1007/s00256-022-03989-8 ◽

2022 ◽

Author(s):

Nari Shin ◽

Hyun Su Kim ◽

Ji Hyun Lee ◽

So Yeon Cha ◽

Min Jae Cha

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Hip Joint ◽

Clinical Manifestations ◽

Imaging Findings ◽

Resonance Imaging

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Clinical Manifestations and Spinal Cord Magnetic Resonance Imaging Findings in Chinese Neuromyelitis Optica Patients

European Neurology ◽

10.1159/000353983 ◽

2013 ◽

Vol 71 (1-2) ◽

pp. 35-41 ◽

Cited By ~ 7

Author(s):

Aiyu Lin ◽

Jiting Zhu ◽

Xiaoping Yao ◽

Shifang Lin ◽

Shenxing Murong ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Neuromyelitis Optica ◽

Clinical Manifestations ◽

Imaging Findings ◽

Resonance Imaging

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Prognostic implication of hypocalcaemia in COVID-19: a systematic review

African Journal of Clinical and Experimental Microbiology ◽

10.4314/ajcem.v22i2.4 ◽

2021 ◽

Vol 22 (2) ◽

pp. 124-132

Author(s):

T.A. Azeez ◽

S. Lakoh ◽

O.T. Bamidele ◽

E. Ekhaiyeme ◽

S.A. Nwosu

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Prognostic Factor ◽

Clinical Manifestations ◽

Severe Illness ◽

Prognostic Implication ◽

Poor Prognostic Factor ◽

Medical Databases ◽

Reactive Protein ◽

Prognostic Implications

Coronavirus disease-2019 (COVID-19) has been declared as a pandemic affecting several millions of people worldwide. It has varied clinical manifestations ranging from asymptomatic to critical illness. It has led to the mortality of several affected individuals. However, the prognosis seems to vary from one person to the other and efforts are being made to identify the prognostic factors. Hypocalcaemia has been identified as a poor prognostic factor with a high frequency among individuals affected with COVID-19. This review aims to estimate the prevalence of hypocalcaemia among COVID-19 patients and identify the poor prognostic factors associated with the presence of hypocalcaemia in COVID-19 patients. Electronic medical databases were searched for publications on the prognostic implications of hypocalcaemia in COVID-19 infection, and relevant articles were selected for systematic review following PRISMA algorithm. The prevalence of hypocalcaemia among patients with COVID-19 was 40.0-74.4%. There was a significant association between the rate of hospital admission, intensive care unit (ICU) admission as well as septic shock and hypocalcaemia in patients with COVID-19. Hypocalcaemia is also associated with a higher mortality rate in these patients. COVID-19 patients with hypocalcaemia tend to have elevated C-reactive protein, interleukin6, alanine transaminase, procalcitonin, serum creatinine and low albumin. Hypocalcaemia is common in COVID-19 patients and is a poor prognostic factor in these patients. Presence of hypocalcaemia is associated with a severe illness and even death. Keywords: COVID-19; hypocalcaemia; prognosis; systematic review

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Discrepancy Between the Degree of Cognitive Impairment and Brain Imaging Abnormalities in Alzheimer’s Disease Patients Is Associated with Cognitive Reserve

Journal of Alzheimer s Disease ◽

10.3233/jad-210728 ◽

2021 ◽

pp. 1-9

Author(s):

Tomohiko Sato ◽

Haruo Hanyu ◽

Yumi Koyama ◽

Haruka Horita ◽

Toshinori Aoki ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Brain Imaging ◽

Cognitive Reserve ◽

Photon Emission ◽

Clinical Manifestations ◽

Leisure Activity ◽

Emission Computed Tomography ◽

Imaging Findings

Background: In Alzheimer’s disease (AD) patients, the severity of cognitive impairment is thought to correlate with the degree of brain imaging abnormalities. However, some patients show only mild cognitive deficit, despite severe brain atrophy on magnetic resonance imaging (MRI) or marked hypoperfusion in the cerebral cortices on single-photon emission computed tomography (SPECT). This suggests that cognitive reserve (CR) can compensate for the clinical manifestations of AD in patients with extensive brain pathology. Objective: We aimed to determine whether this discrepancy between cognitive and imaging findings is associated with CR. Methods: Factors associated with the discrepancy between the degree of cognitive impairment and MRI (medial temporal lobe atrophy) and SPECT (posterior cerebral hypoperfusion) findings were analyzed in 135 patients with probable AD. Factors as proxies for CR included education, occupation, leisure activity, comorbidities, frailty, and other demographics. The discrepancy index (DI) was calculated as the difference between the degree of imaging abnormalities and the degree of cognitive dysfunction. Results: Multiple regression analysis showed that leisure activity and education were significantly associated with the discrepancy between cognitive and imaging findings. When the level of CR was determined based on leisure activity and education, the high-CR group showed a significantly larger DI than the moderate- and low-CR groups. Conclusion: The discrepancy between cognitive and imaging findings in patients with AD is associated with CR, measured using a combination of two indicators, i.e., leisure activity and education. Therefore, lifestyle interventions may delay the appearance of clinical symptoms resulting from underlying AD pathology, by increasing CR.

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Intensity of Nematode Infection in Children Aged 3 to 5 Years Living in Mukuru Kwa Njenga Slum Settlement, Nairobi, Kenya

Journal of Tropical Medicine ◽

10.1155/2020/4124808 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Lynda Allan ◽

Fiona N. Mbai ◽

Dorcas S. Yole ◽

Moses Owino

Keyword(s):

Health Workers ◽

Clinical Manifestations ◽

Infection Intensity ◽

Nematode Infection ◽

Intensity Of Infection ◽

Mean Intensity ◽

Number Of Children ◽

The Status ◽

Severe Infections ◽

Stool Samples

Background. The burden of nematode infections is high mostly in children below 5 years old, with clinical manifestations ranging from mild to painful symptoms due to severe infections that end up suppressing the immune system of the infected children. The occurrence of these infections is highest in areas of extreme poverty. This study evaluated the intensity of nematode infections and assessed the status of deworming in children aged 3 to 5 years living in Mukuru slum settlement, Nairobi County, Kenya. Methodology. A total of 172 children aged between 3 and 5 years were sampled across the 5 major villages of Mukuru Slum settlement: Kwa Njenga, Vietnum, Wapewape, Kwa Reuben, and Motomoto. Community health workers administered questionnaires on the deworming history of children. Stool samples were collected, macroscopically examined, and microscopically analysed using Kato-Katz technique to assess the intensity of infection. The intensities of nematode infections were expressed as eggs per gram (epg) of faeces. Results. The point prevalence of nematode infection among the 98 children in the 1st sampling was 25.5% with a mean infection intensity of 5424 epg, whereas among the 74 children sampled in 2nd sampling, 47.3% had nematode infection with a mean infection intensity of 12384 epg. The average nematode infection for the 172 participants was 34.9% with a mean intensity of 17808 epg. The highest number of children infected with nematodes was in the village of Wapewape where 34 participants were examined and 36.3% were infected with a mean intensity of 3216 epg. Kwa Reuben and Vietnum villages had the same prevalence values of 32.4% where 34 participants in each village had a mean intensity of 3624 epg and 4512 epg, respectively. In both samplings, more than 80% of children had been dewormed more than 6 months prior to the study. Ascaris lumbricoides was the only species of intestinal nematodes identified to be present in the stool samples of children in this study, whereas Trichuris trichiura and hookworm infections were found to be absent. The intensity of infection was not dependent on age or gender.

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