Clinical, Microbiological and Radiological Characterises of Lower Respiratory tract Infection in Children with Established Congenital Heart Diseases.

Introduction: Acute Lower Respiratory Tract Infection (ALRTI) is the most common cause of deathin children under five. Various demographic, socio-economic and environmental factors have beenassociated with ALRTI, with conflicting results. Children with congenital heart diseases are morevulnerable to lower respiratory tract infections following the fact that they had an anatomical defectthat causes hemodynamic disturbance of lung circulation and mucosal oedema finally leads todecreased lung compliance and recurrent lower respiratory tract infections. Methods: Children agedbetween1 month and 18 years with clinically established congenital heart disease confirmed byechocardiography and presenting with signs and symptoms suggestive of lower respiratory tractinfection were enrolled in the study. A detailed history was taken and routine blood investigationswere done in all cases. Chest X-Ray was done to confirm the clinical diagnosis. Results: Mean ageof the study subjects was 2 years. VSD was seen in 64.9% of cases while 10.5% of cases had VSDand ASD. The most common presenting symptoms were: cough (98.2%), reduced feeding (97.4%),fever (89.5%), running nose (67.5%) and wheeze (49.1%). Leucocytosis and raised ESR were seenin 66.7% and 64.9% cases respectively. In Throat swab Commensals were seen in 36% of caseswhile gram-positive cocci were seen in 3.5% cases respectively. In blood culture Streptococcuspneumoniae being the commonest organism isolated. Bilateral and unilateral opacities on chest x-ray were seen in 16.7% and 12.3% cases respectively. Conclusion: Bronchopneumonia was thecommonest LRTI in children with the predominance of VSD.

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Chest Ultrasound versus Chest X-Ray in Children with Lower Respiratory Tract Infections

Open Journal of Pediatrics ◽

10.4236/ojped.2021.114055 ◽

2021 ◽

Vol 11 (04) ◽

pp. 597-607

Author(s):

Elham Saad Ellithey Elkhazragy ◽

Saneya Abdel Halim Fahmy ◽

Mona Sayed Mohammad Attaya ◽

Ashraf Mohammad Abd Elrahman

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

X Ray ◽

Chest Ultrasound ◽

Chest X Ray ◽

Tract Infections

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Treatment of Lower Respiratory Tract Infections with Amoxycillin/Clavulanic Acid in Adults

Journal of International Medical Research ◽

10.1177/030006059302100205 ◽

1993 ◽

Vol 21 (2) ◽

pp. 98-101 ◽

Cited By ~ 2

Author(s):

G Tatsis ◽

M Veslemes ◽

C Hadjistavrou ◽

A Votsiou ◽

J Jordanoglou

Keyword(s):

Respiratory Tract ◽

Clavulanic Acid ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Adverse Side Effect ◽

Lower Respiratory Tract Infections ◽

Acute Exacerbations ◽

Sputum Volume ◽

Chest X Ray ◽

Tract Infections

Patients with lower respiratory tract infections [pneumonia ( n = 16), bronchiectasis ( n = 5) and acute exacerbations of chronic bronchitis ( n = 44)] were treated daily with amoxycillin/clavulanic acid given either 1.2 g intravenously three times daily or 625 mg orally three times daily for 7–15 days. Symptoms, signs and sputum volume and colour were monitored daily. Chest X-ray, sputum culture and Gram-stain examinations were also carried out on days 1 and 5, and immediately after the end of the treatment. There was a clinical improvement, as indicated by the incidence of cough, dyspnoea and rales, and by sputum volume and colour in 90.8% of the patients. Microbiological improvement, as indicated by the complete elimination of sputum pathogens and pus cells, was achieved in the same proportion of patients (90.8%). In one patient, an adverse side-effect, diffuse exanthema, was noted. Amoxycillin/clavulanic acid possesses a high clinical and microbiological efficacy for lower respiratory tract infections.

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“A STUDY OF CLINICO RADIOLOGICALAND BRONCHOALVEOLAR LAVAGE FLUID PROFILE OF PEOPLE LIVING WITH ACQUIRED IMMUNO DEFICIENCY SYNDROME WITH LOWER RESPIRATORY TRACT INFECTIONS (LRTI).”

10.36106/ijsr/3628117 ◽

2020 ◽

pp. 63-65

Author(s):

Aneri Parekh ◽

Jigna Dave

Keyword(s):

Lower Respiratory Tract ◽

Bacterial Pneumonia ◽

Respiratory Tract Infections ◽

Cd4 Count ◽

Lower Respiratory Tract Infections ◽

Exclusion Criteria ◽

X Ray ◽

Common Etiology ◽

Chest X Ray ◽

Tract Infections

BACKGROUND AND SIGNIFICANCE: Infection with HIV results in progressive immunodeficiency and renders the infected person become increasingly vulnerable to wide range of pathogens, referred to as Opportunistic Infections. Expert clinical assessment with early diagnosis and aggressive treatment are required for a positive outcome. Hence this study was planned. AIMS AND OBJECTIVES: • To study the clinical, radiological, BAL fluid profile and common organisms responsible for lower respiratory tract infections (LRTI) in PLHIV/AIDS who are sputum CBNAAT negative and have LRTI. MATERIALS AND METHODS: • Patients admitted to Respiratory Medicine Department, Sir T Hospital, Bhavnagar, from August 2019 to July 2020, were recruited based on the inclusion and exclusion criteria.  Inclusion criteria:  Sputum CBNAAT negative PLHA patients aged >18 years with 4S symptoms positive (cough, fever, weight loss, night sweats) with abnormal chest X- ray.  Exclusion criteria:  Drowsy or comatose patients, pregnant females, severely hypoxic patients, patients requiring ICU admissions for cardiac, hepatic or renal disease. Detailed history taking, general and clinical examination was carried out and routine laboratory investigations were sent. Chest X-ray, CT Thorax and bronchoscopy were done. BAL fluid was sent for staining, CBNAAT, bacterial and fungal culture. RESULTS: Male preponderance is seen with cough (92%) as the most common presenting complaint, tachypnea (69%) and crepitations (77%) as most consistent signs. Most common X-ray and CT finding was consolidation (65%) with bilateral lower lobe preponderance (35%). Most common etiology was bacterial pneumonia (23%) and most common organism was pseudomonas (23%). Bacterial pneumonia and tuberculosis were more prevalent when CD4 count >350 cells/ cumm; Fungal pneumonia and PCP when CD4 count <350 cells/ cumm. CONCLUSION: Bacterial pneumonia is most common etiology with Pseudomonas aeruginosa being the most common etiological agent. The susceptibility for LRTI increases when CD4 count falls below 500 cells/ cumm.

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Palivizumab compliance in congenital heart disease patients: factors related to compliance and altered lower respiratory tract infection viruses after palivizumab prophylaxis

Cardiology in the Young ◽

10.1017/s1047951120001092 ◽

2020 ◽

Vol 30 (6) ◽

pp. 818-821

Author(s):

Kutay Sel ◽

Ebru Aypar ◽

Yasemin Nuran Dönmez ◽

Emil Aliyev ◽

Hakan Hayrettin Aykan ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Congenital Heart ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Syncytial Virus ◽

Tract Infections

AbstractBackground:Lower respiratory tract infections caused by respiratory syncytial virus can be severe during infancy, which requires admission to the hospital. These infections may be more severe especially in patients with congenital heart disease. Passive immunisation with palivizumab, a monoclonal antibody, is recommended in high-risk infants. We tried to determine the compliance rates, factors affecting compliance, and also other microorganisms responsible for lower respiratory tract infections after palivizumab prophylaxis in these patients.Methods:We evaluated patients’ compliance to prophylaxis with palivizumab in two consecutive respiratory syncytial virus seasons from pharmacy records. We also investigated factors affecting compliance and the frequency of hospitalisations for lower respiratory tract infections. We investigated the causative microorganisms detected in hospitalised patients.Results:In this study, 86.7% of the desired number of injections was achieved in 176 patients in two seasons. Out of these, 117 patients (66.4%) received all the doses they were prescribed. Although not statistically significant, compliance to prophylaxis was higher in male patients, cyanotic patients, those who started under 1 year old, and who lived in the city centre. Human metapneumovirus, parainfluenza type 3, and bocavirus were detected in the hospitalised patients.Conclusion:Patients with congenital heart disease can survive the period of infancy with less problem by making palivizumab prophylaxis more effective, and awareness about non- respiratory syncytial virus factors may be a guide for the development of new treatments.

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