scholarly journals Radiographic aspects of acute community-acquired bacterial pneumonia and pulmonary tuberculosis in children

Author(s):  
Rivo Lova Herilanto Rakotomalala ◽  
Harimino Mireille Rakotondravelo ◽  
Andrianina Harivelo Ranivoson ◽  
Annick Lalaina Robinson

Background: The etiological diagnosis of pneumonia is often difficult because of the impossibility of microbiological confirmation most of the time. Therefore, chest X-ray is still essential for a positive diagnosis and etiological orientation. The main objective of our study was to describe the radiographic aspects of acute community-acquired pneumonia and tubercular pneumonia in children.Methods: This was a descriptive retrospective study conducted at the university hospital mother and child of Tsaralalana from January 1st to July 31st, 2017.Results: Sixty-nine cases of pneumonia were included, including 13 cases of TB pneumonia and 46 cases of acute community-acquired pneumonia. The average age was 36.68 months with a male predominance. Clinically, respiratory functional signs predominated in both cases. Alteration in general condition was mainly observed in tubercular pneumonia (26.08%). Alveolar syndromes were present in 43.47% of TB pneumonias and 36.94% of acute community-acquired pneumonia. With regard to the radiographic images, alveolar involvement was common to both types of pneumonia; the nodular image was present in 8.69% of the tubercular pneumonias and 2.17% of the acute community-acquired pneumonia; the cavity image was present only in the tubercular pneumonia (p=0.04); the right-sided location predominated in both cases.Conclusions: X-ray images were common to both TB pneumonia and acute community-acquired pneumonia; some images were specific to TB pneumonia. However, the etiologic orientation of pneumonia is based on a combination of epidemiologic, clinical, and radiographic evidence.

2021 ◽  
Vol 4 (2) ◽  
pp. 01-03
Author(s):  
Gbenou A.S

Introduction: The Currarino syndrome (CS) is one of the rare syndromic forms of anorectal malformations (ARM). Observation: This is the clinical case of a 3 days male newborn admitted for high ARM in the pediatric surgery Department of the Lagune Mother and Child University Hospital of Cotonou. An emergency colostomy was performed. At the age of 7 months as a prelude to anorectoplasty, the distal colography revealed a semilunar pelvic opacity in front of the sacrum. The posterior sagittal approach according to Peña could not reveal the distal end of the intestine. The reconstruction of the sphincter-muscular complex was done on a tracheal tube. The abdominal approach allowed the discovery and resection of a presacral mass. The rectal pouch end found was then lowered. Post-operative follows up was uneventful. The standard postoperative X-ray revealed a partial agenesis of the sacrum. The histology of the operative specimen found a cystic lipoma. The diagnosis of CS was done. The search of a HLXB9 mutation was not possible. Conclusion: The clinical observation associated with standard radiological investigations highlighted the triad: anorectal malformation, presacral tumor, and partial agenesis of the sacrum, which upheld the diagnosis of CS; but the search for an indispensable HLXB9 mutation was lacking for the genetic link.


2021 ◽  
Vol 10 (1-2) ◽  
pp. 51-56
Author(s):  
Muhammad Shakhawath Hossain ◽  
Salma Islam ◽  
Israt Zerin Eva ◽  
SK Md Abu Zafar ◽  
Dilruba Yeasmin ◽  
...  

Background & Objective: The purpose of the study was to evaluate the clinical presentation and severity of community acquired pneumonia in adults. Methods: The present cross-sectional study was conducted in Sir Salimullah Medical College & Mitford Hospital, Dhaka over a period of 1 year. Patients admitted with the symptoms and signs suspected of pneumonia and confirmed by clinical examination and necessary investigations were the study population. The baseline characteristics, patients’ behavioural factors, presenting complaints, co-morbidities, examination findings and investigations were recorded. Data were processed and analyzed using software SPSS (Statistical Package for Social Sciences), version 11.5. The test statistics used to analyze the data were descriptive statistics. Result: In the present study, a large proportion of patients were 50 years or more than 50 years with mean age of the patients being 46.4 ± 13.3 years. A male predominance (58%) was observed in the series. Over half (56%) of the patients was smoker and 8% were alcoholic. Fever (90%) and purulent sputum (70%) were the common complaints. The second most common complaints were chest pain and haemoptysis (each of 44%). Thirty eight percent of the patients had dyspnoea and a very few had other symptoms. Eighteen percent of the patients had COPD, another 18% had diabetes and 4% had cardiac insufficiency. About one-quarter (24%) of the patients had agitation stupor, 88% bronchial breathing and 68% crackles. Right lower lobe (31%) and right middle lobe (26%) were commonly affected by pneumonia of the patients detected with a chest X-ray. Assessment of severity pneumonia by CURB-65 score shows that 83% of the patients had mild (score 0 – 1) CAP, 12% had moderate (score 2) and 5% had severe CAP (score 3 or more).Over two-thirds (68.5%) of the patients exhibited positive sputum for Gram’s stain. Conclusion: The study concluded that CAP is more likely to occur in older males with preexisting comorbidities like diabetes and COPD. Fever and purulent cough are the predominant presentation of CAP followed by chest pain and haemoptysis. Pneumonic consolidation on chest X-ray and +ve gram stain are diagnostic of CAP, while raised total count of WBC with neutrophilic leucocytosis are supportive to it. Assessing pneumonia severity by CURB-65 scoring system revealed that severe pneumonia (score 3 or more) is now a rarity. Patient evaluation should focus on severity of illness, patient age, comorbidities, clinical presentation, epidemiologic setting, and previous exposure. The majority of patients with CAP are treated empirically based on the most common pathogen(s) associated with the condition. Ibrahim Card Med J 2020; 10 (1&2): 51-56


Author(s):  
Joana Ricardo Pires ◽  
Maria José Moreira ◽  
Margarida Martins ◽  
Clarinda Neves

Disease in atypical organ locations can mimic other pathologies, hampering the right diagnosis. Such conditions may even be emergencies, like appendicitis. Subhepatic appendix is a very rare entity which may be caused by caecum dehiscence failure. The authors present the case of a 55-year-old immunocompetent man admitted to the Emergency Department with sepsis and severe hypoxaemia. Chest x-ray showed right lower lobe infiltrate, and community-acquired pneumonia was diagnosed. The patient was started on broad-spectrum antibiotics, but he continued to deteriorate and after 3 days developed abdominal complaints. Exploratory laparoscopy revealed an abscess caused by perforated subhepatic appendicitis. Subhepatic appendicitis presents a diagnostic challenge and its clinical presentation may mimic that of other entities. This case highlights an atypical presentation, where the early development of inflammatory lung injury mimicked common pneumonia. Maintenance of a high index of suspicion and knowledge of these atypical locations is crucial.


Author(s):  
S. Edith Taylor ◽  
Patrick Echlin ◽  
May McKoon ◽  
Thomas L. Hayes

Low temperature x-ray microanalysis (LTXM) of solid biological materials has been documented for Lemna minor L. root tips. This discussion will be limited to a demonstration of LTXM for measuring relative elemental distributions of P,S,Cl and K species within whole cells of tobacco leaves.Mature Wisconsin-38 tobacco was grown in the greenhouse at the University of California, Berkeley and picked daily from the mid-stalk position (leaf #9). The tissue was excised from the right of the mid rib and rapidly frozen in liquid nitrogen slush. It was then placed into an Amray biochamber and maintained at 103K. Fracture faces of the tissue were prepared and carbon-coated in the biochamber. The prepared sample was transferred from the biochamber to the Amray 1000A SEM equipped with a cold stage to maintain low temperatures at 103K. Analyses were performed using a tungsten source with accelerating voltages of 17.5 to 20 KV and beam currents from 1-2nA.


2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.


Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.


2011 ◽  
Vol 51 (183) ◽  
Author(s):  
A Shrestha ◽  
S Acharya

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice. Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.


2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Fombotioh Ndifor ◽  
Abakar Idriss Lawane ◽  
Nadjioroum Ngam-Asra ◽  
Mouktar Abaya Adoum ◽  
Brahim Boy Otchom ◽  
...  

Acute diarrhea is one of the leading causes of morbidity and mortality in children from 0-5 months old, especially in Africa and many developing countries. Rotavirus and Adenovirus have been recognized as the common pathogens for this public health problem. However, little or no investigation has been carried out on the two viruses in Chad. In view of this fact, we decided to study the prevalence of Rotavirus and Adenovirus in children suffering from acute diarrhea at the University Hospital Center of Mother and Child (UHC-MC). Fresh stool samples were collected from 440 children ages 0-5 years (225 females and 2015 males). They were brought for medical consultation from March 2019- September 2019 at the pediatric department. Specimens were analyzed and Rotavirus and Adenovirus were detected using Rapid Immunochromatographic Test kit (Vikia BioMerieux, France). Out of the 440 children examined, 228 had viral infection with a prevalence of 51.81%. Based on gender infection, females 140 (62.22%) were significantly more infected than males 88(40.93%). Prevalence of mono infection of Rotavirus in children 110 (48.24%) was higher than that of Adenovirus 74(32.45%). More males had Rotavirus infection 60(68.18%) than girls 50 (37.71%). Co-infection was found to be 44 (19.29%). Distribution of viral infection indicated that children between 6-11 months had the highest viral burden 101(77.69%). Among clinical symptoms recorded, dehydration was the highest in children 84(61.76%). Due to the high prevalence of Rotavirus and Adenovirus discovered, we suggest that vaccines for the two viruses should be included in the national immunization program.


2021 ◽  
Vol 14 (1) ◽  
pp. e239356
Author(s):  
Holly P Morgan ◽  
Muram El-Nayir ◽  
Christopher Jenkins ◽  
Philip G Campbell

A previously well 48-year-old man presented with presyncope and was found to be in complete heart block. Blood tests, echocardiography and coronary angiography were reported as normal, and a dual chamber permanent pacemaker was inserted. Six months later he re-presented with breathlessness. His chest X-ray showed cardiomegaly and echocardiography revealed a 4.4 cm pericardial effusion. A CT thorax revealed a mass originating from the intra-atrial septum, extending into the right atrium and ventricle. There were multiple pulmonary lesions suspected to be metastases. Histology demonstrated high-grade B-cell lymphoma. He was treated with eight cycles of R-CHOP chemotherapy and showed good radiological and clinical improvement. Post-treatment echocardiography found severe left ventricular dysfunction with an ejection fraction of <20%. Heart failure medical therapy was optimised and the pacemaker was upgraded to a resynchronisation device. A repeat scan 6 months post device upgrade showed an improvement in ejection fraction to 45%–50%.


ESC CardioMed ◽  
2018 ◽  
pp. 1582-1584
Author(s):  
Angelos G. Rigopoulos ◽  
Hubert Seggewiss

Pericardial masses include cysts, pericardial tumours, and pericardial haematomas. Pericardial cysts are benign lesions commonly located in the right cardiophrenic angle that remain typically asymptomatic and are incidentally found in chest X-ray or chest computed tomography but might cause pressure symptoms or become infected, thus requiring surgical management. Hydatid cysts due to echinococcosis are the most common acquired pericardial cysts, characterized by wall calcification, and indicate surgery.


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