scholarly journals Risk factors of acute respiratory distress syndrome in Scrub typhus

2017 ◽  
Vol 5 (9) ◽  
pp. 3912 ◽  
Author(s):  
Karunya Jayasimha ◽  
Muralidhar Varma ◽  
Asha Kamath ◽  
Indira Bairy ◽  
Rahul Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
High Mortality ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Early Recognition ◽  
Febrile Illness

Background: Scrub typhus is a common tropical infection presenting as acute febrile illness. Acute Respiratory Distress Syndrome (ARDS) is a serious complication of scrub typhus and is often associated with high mortality. This study was aimed to analyse risk factors of ARDS in Scrub typhus patients.Methods: This study was a prospective observational case control study conducted from June 2012 to June 2015 in Kasturba Hospital, Manipal, Karnataka, India. ARDS was diagnosed as per Berlin criteria.Results: During the study period, a total of 320 patients were diagnosed to have scrub typhus as per our criteria. All the patients were from state of Karnataka except for 1 patient, who was from state of Kerala. A total of 20 (6.25%) patients (cases) were diagnosed to have ARDS and 300 (93.75%) patients (controls) did not have ARDS. After multivariate analysis of the risk factors only two risk factors had significant association with development of ARDS: sepsis (OR 4.34,95% CI 0.51,36.76) and septic shock (OR 16.57 95% CI 1.64,166.76).Conclusions: ARDS is a common and serious complication of scrub typhus. It often occurs along with other complications. Presence of dyspnoea, sepsis, septic shock, hypoalbuminemia should alert clinicians about ARDS. ARDS due to scrub typhus is associated with high mortality. Early recognition and prompt therapy can reduce mortality.

Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome

2021 ◽  
Vol 14 (4) ◽  
pp. e242870
Author(s):  
Meenupriya Arasu ◽  
Nagalakshmi Swaminathan ◽  
Anusha Cherian ◽  
Magesh Parthiban
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Pregnant Patient ◽  
Lung Compliance ◽  
Pcr Assay ◽  
Oxygenation Indices

A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.

scholarly journals A case of scrub typhus presenting as ARDS

2019 ◽  
Vol 10 (3) ◽  
pp. 2014-2016
Author(s):  
Ahmed Siddique A ◽  
Jagadeesan M ◽  
Mariraj I ◽  
Ramkumar M ◽  
Prasanna Karthik S1 ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Central Nervous System Involvement ◽  
Febrile Illness ◽  
Interesting Case ◽  
Systemic Spread

Acute respiratory distress syndrome (ARDS) is a disease, mainly occurring in critically ill patients. The systemic spread of infections mainly causes ARDS due to the seepage of fluid in the spaces of the lung . Scrub typhus is a infection caused by . The bite of mite transmits it. Scrub typhus is frequently due to its non-specific clinical presentation and relatively low level of suspicion in treating physicians. The clinical presentation of scrub typhus is varied from fever, , rashes, headache, to pneumonia, acute respiratory distress syndrome, sepsis, central nervous system involvement. The disease is usually indistinguishable from other febrile illness like enteric fever, disease, malaria and certain viral hemorrhagic fevers. Identification of an points to the diagnosis without which the diagnosis is based on a high index of clinical suspicion. We report an interesting case of scrub typhus presenting as acute respiratory distress syndrome.

scholarly journals Active Cytomegalovirus Infection in Acute Respiratory Distress Syndrome Patients: Incidence, Risk Factors, and Clinical Outcomes

2021 ◽  
Author(s):  
Zhihui Zhang ◽  
Rujian Li ◽  
Yongxin Zheng ◽  
Qianyi Zhan ◽  
Qing Zang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Outcomes ◽  
Distress Syndrome ◽  
Cmv Infection ◽  
Hospitalization Period ◽  
Incidence Risk

Abstract Background: Acute respiratory distress syndrome (ARDS) patients have been reported to have a high seroprevalence of cytomegalovirus (CMV). However, the role of active CMV infection in ARDS patients has not been clearly established.Objective: This study aimed at determining the incidence, risk factors, and clinical outcomes of active cytomegalovirus (CMV) infection in acute respiratory distress syndrome (ARDS) patients.Methods: We retrospectively reviewed medical records for ARDS patients who had been admitted to the intensive care unit (ICU) from January 1st, 2018 to December 31st, 2020 at a national teaching hospital in China. Study participants were divided into active CMV infection and non-active infection groups based on CMV DNAemia within a 28-day hospitalization period in ICU. Clinical features, laboratory findings, treatment measures, and clinical outcomes were compared between the two groups.Results: Among 168 ARDS patients, 31 (18.5%) exhibited active CMV infection within the 28-day hospitalization period in ICU. In multivariate logistic regression analysis, monocyte counts, hemoglobin levels, blood transfusion, and septic shock were significantly independently associated with active CMV infection (p < 0.05). Oxygenation (PaO2/FiO2) of active CMV infection patients was worse than for non-active CMV infection (p < 0.05). Duration of invasive mechanical ventilation, 28-day ventilator-free days, length of ICU stay, and 28-day all-cause mortality rates in active CMV infection patients were significantly higher than in those without active CMV infection (p < 0.05).Conclusions: Active CMV infection is common among critically ill ARDS patients. Monocytes, hemoglobin, blood transfusion, and septic shock are risk factors for active CMV infection, which has a negative effect on oxygenation. Moreover, active CMV infection is associated with several adverse prognoses. Prospective studies should be performed to evaluate the impact of prophylactic antiviral therapy for prognoses among ARDS patients.

scholarly journals Does reactivation of cytomegalovirus contribute to severe COVID-19 disease?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Cecilia Söderberg-Nauclér
Keyword(s):  
Septic Shock ◽  
Acute Respiratory Distress Syndrome ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
High Mortality ◽  
Hospital Care ◽  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Severe Pneumonia

AbstractThe majority of people infected with SARS-CoV-2 are asymptomatic or have mild to moderate symptoms. However, for unknown reasons, about 15 % have severe pneumonia requiring hospital care and oxygen support, and about 5 % develop acute respiratory distress syndrome, septic shock, and multiorgan failure that result in a high mortality rate. The risk of severe COVID-19 is highest among those who are over 70 years of age. Why severe COVID-19 develops in some people but not others is not understood. Could some cases involve reactivation of latent cytomegalovirus (CMV)?

Prognostic factors for development of acute respiratory distress syndrome following traumatic injury – a systematic review and meta-analysis

2021 ◽  
pp. 2100857
Author(s):  
Alexandre Tran ◽  
Shannon M. Fernando ◽  
Laurent J. Brochard ◽  
Eddy Fan ◽  
Kenji Inaba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Respiratory Distress Syndrome ◽  
Prognostic Factors ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Traumatic Injury ◽  
Clinical Risk Factors ◽  
Factors Associated ◽  
Post Traumatic

PurposeTo summarise the prognostic associations between various clinical risk factors and the development of the acute respiratory distress syndrome (ARDS) following traumatic injury.MethodsWe conducted this review in accordance with the PRISMA and CHARMS guidelines. We searched six databases from inception through December 2020. We included English language studies describing the clinical risk factors associated with the development of post-traumatic ARDS, as defined by either the American-European Consensus Conference or the Berlin definition. We pooled adjusted odds ratios for prognostic factors using the random effects method. We assessed risk of bias using the QUIPS tool and certainty of findings using GRADE methodology.ResultsWe included 39 studies involving 5 350 927 patients. We identified the amount of crystalloid resuscitation as a potentially modifiable prognostic factor associated with the development of post-traumatic ARDS (adjusted odds ratio [aOR] 1.19 for each additional liter of crystalloid administered within first 6 h after injury, 95% CI 1.15 to 1.24, high certainty). Non-modifiable prognostic factors with a moderate or high certainty of association with post-traumatic ARDS included increasing age, non-Hispanic white race, blunt mechanism of injury, presence of head injury, pulmonary contusion, or rib fracture; and increasing chest injury severity.ConclusionWe identified one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS. This information should support the judicious use of crystalloid resuscitation in trauma patients and may inform the development of a risk-stratification tools.

scholarly journals Acute respiratory distress syndrome in a case of diabetic ketoacidosis requiring ECMO support

2021 ◽  
Vol 2021 ◽  
Author(s):  
Milad Darrat ◽  
Brian Gilmartin ◽  
Carmel Kennedy ◽  
Diarmuid Smith
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Diabetic Ketoacidosis ◽  
Distress Syndrome ◽  
Early Recognition ◽  
Ecmo Support ◽  
List Type ◽  
Life Threatening ◽  
Life Threatening Complication

Summary Acute respiratory distress syndrome (ARDS) is a rare but life-threatening complication of diabetic ketoacidosis (DKA). We present the case of a young female, with no previous diagnosis of diabetes, presenting in DKA complicated by ARDS requiring extra corporeal membrane oxygenation (ECMO) ventilator support. This case report highlights the importance of early recognition of respiratory complications of severe DKA and their appropriate management. Learning points ARDS is a very rare but life-threatening complication in DKA. The incidence of ARDS remains unknown but less frequent than cerebral oedema in DKA. The mechanism of ARDS in DKA has multifactorial aetiology, including genetic predisposition. Early recognition and consideration of rare pulmonary complication of DKA can increase survival rate and provide very satisfactory outcomes. DKA patients who present with refractory ARDS can be successfully rescued by ECMO support.

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