Symposium 2. Physiology and pathology of larynx and airway in the aged. C. Lower respiratory tract infection related with bacterial adherence of upper respiratory tract in the aged.

Abstract Data are limited regarding risk factors for lower respiratory tract infection (LRTI) caused by seasonal human coronaviruses (HCoVs) and the significance of virologic documentation by bronchoalveolar lavage (BAL) on outcomes in hematopoietic cell transplant (HCT) recipients. We retrospectively analyzed patients undergoing allogeneic HCT (4/2008-9/2018) with HCoV (OC43/NL63/HKU1/229E) detected by polymerase chain reaction during conditioning or post-HCT. Risk factors for all manifestations of LRTI and progression to LRTI among those presenting with HCoV upper respiratory tract infection (URTI) were analyzed by logistic regression and Cox proportional hazard models, respectively. Mortality rates following HCoV LRTI were compared according to virologic documentation by BAL. A total of 297 patients (61 children and 236 adults) developed HCoV infection as follows: 254 had URTI alone, 18 presented with LRTI, and 25 progressed from URTI to LRTI (median, 16 days; range, 2-62 days). Multivariable logistic regression analyses showed that male sex, higher immunodeficiency scoring index, albumin <3 g/dL, glucose >150 mg/dL, and presence of respiratory copathogens were associated with occurrence of LRTI. Hyperglycemia with steroid use was associated with progression to LRTI (P < .01) in Cox models. LRTI with HCoV detected in BAL was associated with higher mortality than LRTI without documented detection in BAL (P < .01). In conclusion, we identified factors associated with HCoV LRTI, some of which are less commonly appreciated to be risk factors for LRTI with other respiratory viruses in HCT recipients. The association of hyperglycemia with LRTI might provide an intervention opportunity to reduce the risk of LRTI.

Download Full-text

An analysis of the clinical picture of respiratory tract infections in primary care patients

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2020.0069 ◽

2020 ◽

Vol 16 (4) ◽

pp. 382-388

Author(s):

Aneta Rzepka ◽

◽

Anna Mania ◽

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Viral Infections ◽

Upper Respiratory Tract ◽

Lower Respiratory Tract Infections ◽

Upper Respiratory ◽

Tract Infections

Aim: The aim of this study was to analyse the clinical picture of respiratory tract infections among adult patients visiting their general practitioners. Materials and methods: The analysis included 301 adult patients who reported to their general practitioners due to respiratory tract infection. W assessed clinical symptoms, age, final diagnosis, probable aetiology, additional tests, including Actim® Influenza A&B rapid test to confirm influenza infection, radiographic and laboratory findings, as well as comorbidities, treatment used, vaccinations against influenza, and smoking habits. Results: Upper respiratory tract infections accounted for the vast majority of cases (74%), and these primarily included viral infections (62%), some of which required a change of therapy (23%) due to suspected secondary bacterial infection; lower respiratory tract infections accounted for 26% of cases. The main symptoms reported by the patients included cough, pharyngeal pain, fever, rhinitis, general malaise, nasal obstruction, headache, muscle pain and dysphonia. Acute pharyngitis was the dominant diagnosis (27%), followed by acute upper respiratory tract infection of multiple sites (13.6%), acute nasopharyngitis (known as common cold) (10%), purulent tonsillitis (11.6%), acute bronchitis (11%) and influenza (11%). Antibiotic therapy was used in 60% of patients with upper respiratory tract infection and 68% of patients with lower respiratory tract infection. Conclusions: The majority of patients were diagnosed with viral infections. The highest incidence of respiratory tract infections was observed in elderly individuals and patients with chronic cardiovascular diseases, lung diseases, diabetes mellitus and cancer. Smokers are more likely to develop lower respiratory tract infections (confirmed by additional tests) compared to other groups of patients. Individuals vaccinated against influenza account for a small proportion of patients.

Download Full-text

A CASE OF CLINICAL ITP IN A PATIENT WITH COVID19

10.36106/ijsr/2305358 ◽

2021 ◽

pp. 76-77

Author(s):

Shivani Dalsaniya ◽

Ishan Desai ◽

Janak Khambholja ◽

Paltial Palat ◽

Nehal Shah

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Kidney Injury ◽

Upper Respiratory Tract ◽

Thrombocytopenic Purpura ◽

Rare Association ◽

Upper Respiratory ◽

Multi Organ Dysfunction Syndrome

Since December 2019, China has experienced an outbreak of SARS COV2 known as Coronavirus Disease or COVID19.Subsequently it led to pandemic all across the globe. SARS-COV-2 is known to present with a variety of manifestations ranging from a completely asymptomatic course or a mild URTI (Upper respiratory tract infection) to a full blown LRTI (Lower Respiratory Tract Infection) with ARDS (Acute Respiratory Disease Syndrome) like features, ALIs (Acute Lung Injury), Pulmonary or Pan-endothelitis, overwhelming rapidly escalating Cytokine Storm, Multi-Organ Dysfunction Syndrome (MODS), Stroke, Encephalitis, Myocarditis, Septicemia, Acute Kidney Injury, Septic shock and several other complications(2). Here we report a rare association of SARS-COV2 infection with Immune Thrombocytopenic Purpura.

Download Full-text