Viral, Fungal, and Atypical Infections

2017 ◽  
Author(s):  
Daniel Caroff ◽  
Chanu Rhee
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Invasive Pulmonary Aspergillosis ◽  
Infectious Agents ◽  
Pulmonary Aspergillosis ◽  
Clinical Syndromes ◽  
Immunosuppressed Patients ◽  
Candida Infections ◽  
Tract Infections ◽  
Immunocompetent Patients

Viral, fungal, and “atypical” bacterial pathogens are important causes of infections in critically ill patients. Many of these pathogens predominantly cause disease in immunosuppressed patients, but immunocompetent patients can also face serious illness or death. Understanding the risk factors and clinical syndromes caused by these pathogens is necessary to quickly identify patients who may need specialized diagnostics and treatment and is an essential component of training for any provider who practices in the intensive care unit. In this review, we discuss the most relevant aspects of clinical presentation, epidemiology, diagnosis, and management of these infectious agents, with a particular focus on respiratory tract infections. New advances in the diagnosis and treatment of influenza, invasive Candida infections, aspergillosis, and Legionella are highlighted. This review contains 3 figures, 5 tables, and 94 references. Key words: Candida, influenza, invasive pulmonary aspergillosis, Legionella pneumophilia, viral pneumonia

scholarly journals Prognosis and treatment of 46 Chinese pediatric cystic fibrosis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qionghua Chen ◽  
Yuelin Shen ◽  
Hui Xu ◽  
Xiaolei Tang ◽  
Haiming Yang ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Respiratory Tract Infections ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Public Awareness ◽  
Sputum Production ◽  
Tract Infections ◽  
Lost To Follow Up

Abstract Background Since public awareness of cystic fibrosis (CF) has increased, more children have been diagnosed with CF in China. This study aimed to investigate medical and other challenges faced by pediatric CF patients in China. Method Treatments and treatment outcomes were retrospectively analyzed for 46 pediatric CF patients diagnosed from August 2009 to June 2019. Pre- and post-treatment results were compared using independent samples t-test. Results Of 46 pediatric CF study patients, four died and five were lost to follow-up. Thirty-seven patients were monitored for 0.03 to 9.21 years; patients exhibited fewer attacks of respiratory tract infections after diagnosis (4.49 ± 2.13 episodes/year before diagnosis vs 1.97 ± 1.87 times/year after 1-year treatment, p < 0.05), significantly reduced sputum production and experienced 1.62 ± 1.71 exacerbations/year. Patient mean body mass index was 16.87 ± 3.53 and pancreatic malfunction persisted in 15 patients. For 17 children, no significant differences in lung function were found at follow-up as compared to lung function at diagnosis (FEV1: 82.45% ± 16.56% vs 75.26% ± 22.34%, FVC: 87.18% ± 13.64% vs 86.99% ± 19.95%, FEF75%: 46.51% ± 28.78% vs 36.63% ± 24.30%, P = 0.27, 0.97, 0.20, respectively). Pseudomonas aeruginosa (17/27) and bronchiectasis (22/22) were found during follow-up evaluation. Twenty-four patients (64.8%) maintained good adherence to therapies. Overall, azithromycin and tobramycin treatments were administered for 0.5–62 months and 0.5–48 months, respectively, and triggered no obvious adverse reactions. Conclusion No obvious declines in clinical presentation or lung function were found in Chinese pediatric CF patients after receiving standard therapeutic and active treatments, although malnutrition and low compliance were persistent challenges.

Invasive pulmonary aspergillosis in immunocompetent patients acquired during renovation in a chest institute

2017 ◽  
Author(s):  
Kshitij Agarwal ◽  
Aradhana Masih ◽  
Mujeeb ur Rahman ◽  
SN Gaur ◽  
Ferry Hagen ◽  
...  
Keyword(s):  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Immunocompetent Patients

Invasive Pulmonary Aspergillosis in Critically Ill Apparently Immunocompetent Patients

2016 ◽  
Vol 23 (4) ◽  
pp. 184-187
Author(s):  
Abdul Rishi ◽  
Imran Sethi ◽  
Michael Jesinger ◽  
Yazen Beddawi ◽  
Scott Morehead ◽  
...  
Keyword(s):  
Critically Ill ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Immunocompetent Patients

scholarly journals Assessment of changes in blood urea and creatinine levels in patients with coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Hassan Mahmoudi ◽  
Mohammad Yousef Alikhani ◽  
Narges Mofrad Taheri ◽  
Alireza Behzadi
Keyword(s):  
Viral Infection ◽  
Biochemical Parameters ◽  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Plasma Creatinine ◽  
Serum Urea ◽  
Creatinine Concentration ◽  
Urea Level ◽  
The Mean ◽  
Tract Infections

Abstract Background Coronavirus disease 2019 (COVID-19) is new respiratory tract infections disease with an evolving understanding of its epidemiology and clinical appearances. Kidney defect seems to be common in patients with Covid-19. Urea and creatinine level often occurs at the beginning or during the infection. This evidence shows that Covid-19 also attacks the kidneys. The aim of this study was to evaluate changes in biochemical parameters associated with kidney function, including urea and creatinine in patients with COVID-19.Methods We conducted a retrospective analysis of the plasma creatinine and urea levels of the 100 COVID-19 patients with normal plasma creatinine and urea at first clinical presentation of COVID-19.Results Among these 100 patients with COVID 19, total of 35 (35%) patients, increased BUN and creatinine levels occurred at duration of 2–4 days after the onset of viral infection. The mean serum urea level in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 34.75 ± 0.10 and 37.64 ± 0.32, 39.81 ± 0.10, 42.56 ± 0.35 mg/dl, respectively. The mean of creatinine concentration in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 1.50 ± 0.026 and 1.51 ± 0.016, 1.99 ± 0.012, 2.58 ± 0.020 mg/dl, respectively.

scholarly journals Case Report: Chronic Cavitatory Pulmonary Aspergillosis after COVID-19

2021 ◽  
Author(s):  
Sheetal Chaurasia ◽  
Manjunath Thimmappa ◽  
Saurav Chowdhury
Keyword(s):  
Fungal Infections ◽  
Initial Response ◽  
Lung Damage ◽  
Response To Treatment ◽  
Pulmonary Aspergillosis ◽  
Clinical Syndromes ◽  
Common Causes ◽  
Chronic Pulmonary Aspergillosis ◽  
The Common ◽  
Immunocompetent Patients

Chronic pulmonary aspergillosis can present in four distinct clinical syndromes, one of which is chronic cavitary pulmonary aspergillosis (CCPA). CCPA is generally associated with a mildly immunosuppressed state or, in immunocompetent patients, with structural lung damage. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with reactivation of previous quiescent infections such as tuberculosis and invasive fungal infections, but CCPA in a patient with COVID-19 is rarely reported. Here we present the case of a 57-year-old man with CCPA associated with COVID-19 infection in whom latent aspergilloma was most likely activated after SARS-CoV-2 infection. The patient presented with severe COVID and, after initial response to treatment, started to deteriorate due to reactivation of latent aspergilloma to a more aggressive CCPA form. After confirmation of the diagnosis, the patient was initiated on treatment with voriconazole. He showed a good response to treatment with clinicoradiological response. This case also depicts one of the common causes of clinical deterioration in otherwise recovering COVID-19 patients.

Invasive pulmonary aspergillosis with Aspergillus vertebral osteomyelitis in an HIV-infected adult: a case report

2019 ◽  
Vol 30 (11) ◽  
pp. 1140-1142 ◽  
Author(s):  
Valeria Senosain-Leon ◽  
Aida Hidalgo-Benites ◽  
Jose Arriola-Montenegro ◽  
Lorenzo D’Angelo-Piaggio ◽  
Renato Beas
Keyword(s):  
Diagnostic Tests ◽  
Fatal Outcome ◽  
Vertebral Osteomyelitis ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Prompt Treatment ◽  
Immunodeficiency Virus ◽  
Amphotericin B Deoxycholate ◽  
Infected Adult ◽  
Immunosuppressed Patients

We report the case of a 29-year-old man with human immunodeficiency virus infection and irregular adherence to antiretroviral therapy who initially presented with pulmonary symptoms and subsequently developed spinal cord compromise symptoms. After many different diagnostic tests, invasive aspergillosis with pleuroparenchymal involvement and vertebral osteomyelitis by Aspergillus spp. was diagnosed. The patient was treated with amphotericin B deoxycholate without improvement and a fatal outcome ensued. Differential diagnoses of vertebral osteomyelitis in immunosuppressed patients should be taken into account for early detection and prompt treatment.

scholarly journals Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
Yanli Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Risk Factors ◽  
Influenza A ◽  
Invasive Pulmonary Aspergillosis ◽  
Neuraminidase Inhibitor ◽  
Teaching Hospitals ◽  
Multivariate Logistic Regression Model ◽  
Pulmonary Aspergillosis ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Immunocompetent Patients

Abstract Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown. Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191–15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048–1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681–76.764, p <  0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028–6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676–73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002–0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

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