CLINICAL AND CHEST X-RAY FEATURES OF PNEUMONIA IN INJECTING-DRUG USERS

Differential Diagnostics ◽

Intravenous Drug Use ◽

X Ray ◽

On an example of a clinical case in a patient with drug addiction, the reviewed clinical and chest X-ray features of community-acquired pneumonia, the diagnostic algorithms and the differential diagnostics are based on the recommendations of the Ukrainian Association of Pulmonology. The treatment strategy of the patient in the conditions of an ambulatory are described. Community-Acquired pneumonia acquired by intravenous drug use is characterized by a severe course, febrile body temperature, severe specific lung disease. On the example of this clinical case, the importance of express diagnostics of pneumonia at the ambulatory stage wasconfirmed to determine the correct tactics of patient management.

COLD AGGLUTININ PADA PENDERITA COMMUNITY ACQUIRED PNEUMONIA

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v18i3.379 ◽

2016 ◽

Vol 18 (3) ◽

pp. 203

Author(s):

Johanis Johanis ◽

Juli Soemarsono

Keyword(s):

Body Temperature ◽

Gamma Globulin ◽

Complete Blood Count ◽

Cold Agglutinins ◽

X Ray ◽

Extended Spectrum Beta Lactamase ◽

Indirect Bilirubin ◽

Chest X Ray ◽

Loss Of Appetite

Cold agglutinins at below physiologic body temperature can cause spontaneous agglutinations of erythrocytes. Cold agglutinins result from a particular antibodies activation on erythrocytes associated with a primary disease, including infection. The generation of antibody activates complement resulting in hemolysis. A 63-year-old man suffered from shortness of breath accompanied with productive cough, fever, right chest pain, loss of appetite, nausea, and occasionally vomiting. Physical examination showed an increase of pulse rate, respiration rate, and body temperature. Lung examination showed right intercostals retraction and rales in both lungs, but no abnormality detected in other organs. Chest X-ray showed pneumonia. EDTA whole blood showed spontaneous agglutinations at room temperature, however this did not occur by maintaining temperature at 37° C. Different complete blood count results were shown between agglutinated blood and absent of agglutination blood samples. As anti-I, anti-i, and/or anti-H was suspected, agglutinations for anti-A and anti-AB occurred by using ABO forward grouping test, whereas reverse grouping showed agglutinations for A, B, and O cells. Protein electrophoresis showed increase of alpha- 1 and gamma globulin; decrease of renal function; slightly increase of indirect bilirubin; and suspected Extended Spectrum Beta-Lactamase (ESBL) Klebsiella pneumoniae. The diagnosis of this case was community acquired pneumonia and suspected ESBL. Cold agglutinins affected CBC evaluations mostly shown in the erithrocyte index, nevertheless this could prevented by maintaining at physiologic body temperature. Infection could induce activation of cold agglutinins.

Childhood Fever: Correlation of Diagnosis With Temperature Response to Acetaminophen

PEDIATRICS ◽

10.1542/peds.80.3.315 ◽

1987 ◽

Vol 80 (3) ◽

pp. 315-318

Author(s):

M. Douglas Baker ◽

Patricia D. Fosarelli ◽

Richard O. Carpenter

Keyword(s):

Patient Management ◽

Temperature Response ◽

Pediatric Emergency ◽

Bacterial Disease ◽

X Ray ◽

Chest X Ray ◽

Antipyretic Treatment ◽

Fever Response ◽

Childhood Fever

Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4°C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children.

GP management of community-acquired pneumonia in Italy: the ISOCAP study

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2005.654 ◽

2005 ◽

Vol 63 (1) ◽

Cited By ~ 3

Author(s):

C.M. Sanguinetti ◽

F. De Benedetto ◽

C.F. Donner

Keyword(s):

Outpatient Treatment ◽

The Elderly ◽

Microbiological Analysis ◽

X Ray ◽

Systemic Arterial Hypertension ◽

Chest X Ray ◽

Socioeconomic Burden ◽

Copd Diagnosis ◽

Observation Period

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.

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211931 ◽

2021 ◽

Author(s):

Rivo Lova Herilanto Rakotomalala ◽

Harimino Mireille Rakotondravelo ◽

Andrianina Harivelo Ranivoson ◽

Annick Lalaina Robinson

Keyword(s):

University Hospital ◽

Radiographic Images ◽

X Ray ◽

Male Predominance ◽

Mother And Child ◽

Chest X Ray ◽

The Right ◽

The University ◽

Tuberculosis In Children

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.

Chest X-ray requests in primary care for suspected community acquired pneumonia

Clinical Radiology ◽

10.1016/j.crad.2017.06.018 ◽

2017 ◽

Vol 72 ◽

pp. S15

Author(s):

Mazen Elfaki ◽

Martina Paetzel ◽

John Nugent

Keyword(s):

Primary Care ◽

X Ray ◽

Reading and interpretation of chest X-ray in adults with community-acquired pneumonia

The Brazilian Journal of Infectious Diseases ◽

10.1590/s1413-86702011000600007 ◽

2011 ◽

Vol 15 (6) ◽

pp. 540-546

Author(s):

Diana Carolina Moncada ◽

Zulma Vanessa Rueda ◽

Antonio Macías ◽

Tatiana Suárez ◽

Héctor Ortega ◽

...

Keyword(s):

X Ray ◽

Effectiveness of Lung Ultrasound in Comparison with Chest X-Ray in Diagnosis of Lung Consolidation

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.669 ◽

2019 ◽

Vol 7 (15) ◽

pp. 2457-2461

Author(s):

Youssef Ibrahim Haggag ◽

Karim Mashhour ◽

Kamal Ahmed ◽

Nael Samir ◽

Waheed Radwan

Keyword(s):

Lung Ultrasound ◽

P Value ◽

Initial Examination ◽

X Ray ◽

Chest Ultrasound ◽

Lung Consolidation ◽

Plain Chest ◽

BACKGROUND: Lung ultrasound (US) is an available and inexpensive tool for the diagnosis of community-acquired pneumonia (CAP); it which has no hazards of radiation and can be easily used. AIM: To evaluate the efficacy of lung ultrasound in the diagnosis and follow-up of CAP. PATIENTS AND METHODS: 100 patients aged from 40 to 63 years with a mean age of 52.3 ± 10 years admitted to the Critical Care Department, Cairo University with pictures of CAP. Lung US was performed for all patients initially, then a plain chest X-ray (CXR) was performed. Another lung ultrasound was performed on the 10th day after admission. RESULTS: Initial chest X-ray was correlated with the initial chest ultrasound examination in CAP diagnosis (R-value = 0.629, P < 0.001). Cohen's κ was run to determine if there is an agreement between the findings of the initial chest X-ray findings and those of the initial chest ultrasound in CAP diagnosis. A moderate agreement was found where κ = .567 (95% CI, 0.422 to 0.712) and P < 0.001. Upon initial examination, the CXR diagnosed CAP in 48.0% of patients, while lung US diagnosed the disease in 70% of patients. Moreover, lung US was more sensitive than CXR (P-value < 0.001). Compared to the accuracy of computed tomography (CT) chest (100%) which is the gold standard for CAP diagnosis, the accuracy of lung US was 95.0%, while the accuracy of CXR was 81.0%. CONCLUSION: This study proved the effectiveness of lung ultrasound in CAP diagnosis.

Klajoklio nervo krūtininės dalies neurilemoma: klinikinis atvejis

Lietuvos chirurgija ◽

10.15388/lietchirur.2014.3892 ◽

2014 ◽

Vol 13 (3) ◽

pp. 200-203

Author(s):

Renatas Aškinis ◽

Arnoldas Krasauskas ◽

Sigitas Zaremba ◽

Saulius Cicėnas

Keyword(s):

Rare Disease ◽

Clinical Case ◽

Clinical Symptoms ◽

Chest Ct ◽

Vagal Nerve ◽

Surgical Removal ◽

Radiological Findings ◽

X Ray ◽

Neurilemoma – periferinių nervų dangalų auglys. Jis auga lėtai ir pradžia dažniausiai būna besimptomė. Pasiekęs kritinį dydį auglys, priklausomai nuo atsiradimo vietos, pasireiškia spaudimo į aplinkinius organus klinika. Neurilemomos dažniausiai atsiranda galūnėse 30–50 gyvenimo metais nepriklausomai nuo lyties. Klajoklio nervo neurilemoma yra nedažna patologija, o krūtininės klajoklio nervo dalies neurilemoma pasitaiko itin retai. Diagnozuojant svarbiausi yra radiologiniai tyrimo metodai. Gydymas – chirurginis auglio pašalinimas. Pateikiame krūtininės klajoklio nervo dalies neurilemomos, nustatytos 39 metų moteriai, klinikinį atvejį. Auglys aptiktas radiologiniais tyrimais (krūtinės rentgeno, kompiuterinės tomografijos ir tarpuplaučio magnetinio branduolių rezonanso), pašalintas naudojant vaizdo torakoskopinę (VATS) metodiką. Diagnozė galutinai patvirtinta histologiniu tyrimu. Aštuntą parą po operacijos ligonė išrašyta į namus.Reikšminiai žodžiai: neurilemoma, klajoklis nervas, operacija Neurilemoma of intrathoracal vagal nerve: clinical caseRenatas Aškinis, Arnoldas Krasauskas, Sigitas Zaremba, Saulius Cicėnas Neurilemoma is a tumour of peripleurical nervous tissues. It grows slowly and has an asymptomatic manifestation. During tumour enlargement, depending on localisation, clinical symptoms appear because of the tumour pressure to the surrounding tissues. Mostly neurilemomas appear in extremities of patients aged 30–50 years. N. vagus neurilemoma is a very rare disease. The diagnosis is made using radiology. The treatment is surgical removal. We present a clinical case of intrathoracal n. vagus neurilemoma in a 39-year-old woman. The diagnosis was made using radiological findings (chest X-ray, chest CT, and the MRI of the mediastinum). The removal of the tumour was made by VATS. The diagnosis was proved morphologically. After 8 days, the patient was discharged from the hospital.Key words: neurilemoma, vagal nerve, operation

TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN: OPTIMIZATION OF ANTIBIOTIC THERAPY

ГРААЛЬ НАУКИ ◽

10.36074/grail-of-science.19.02.2021.094 ◽

2021 ◽

Author(s):

Veronika Dudnyk ◽

Nataliya Sinchuk ◽

Kateryna Khromykh

Keyword(s):

Antibiotic Therapy ◽

Age Groups ◽

Age Group ◽

Case Histories ◽

First Line ◽

X Ray ◽

Comparison Groups ◽

Chest X Ray ◽

Common Infections

Community-acquired pneumonia is one of the most common infections in children with an annual incidence of 34 to 40 cases per 1000 children in Europe and North America. Pneumonia is a common cause of death in children under five years of age worldwide. Thus, about 1,8 million children die from pneumonia annually. According to the statistics of the Ministry of Health of Ukraine, about 80,000 children every year suffer from community-acquired pneumonia in Ukraine. Material and methods: Retrospective analysis of 100 case histories of children aged 3-9 years old with outpatient segmental/polisegmental pneumonia who were in inpatient treatment in the pulmonology department of regional hospital from January 2017 to December 2018. The representativeness of the comparison groups is represented by age and sex. Methods of examination: clinical-anamnestic, laboratory and instrumental (pulse oximetry, chest X-ray). Results: Most of the children (58%) were admitted to the hospital on the first day of the illness. In 33% of children, comorbidity was noted. All children had fever, an unproductive cough, while symptoms of intoxication (76 ± 4.27%) and dyspnea (52 ± 4.49%) were more pronounced in children 3-6 years old. In the general analysis of blood in children of the first age group, in most cases, leukocytosis was more than 12 G / L (56 ± 4.96%), neutrophilic shift of the leukocyte formula to the left of 88 ± 3.25% and elevated ESR (84 ± 3.66%). X-ray in children of the first age group was dominated by polysegmental pneumonia at 54 ± 4.44%, while in children of the second age group segmental pneumonia was more common (64 ± 4.66%). Half of the children of both age groups prescribed antibiotics of the first line - a group of penicillins and cephalosporins. When starting antibiotic therapy with penicillins, the symptoms of pneumonia decreased already in the 2nd day in 16% ± 3.67% in the group of children 3-6 years old and in 18% ± 3.84% of children 7-9 years. Conclusion. Pneumonia is one of the most common diseases in children, and one of those that can cause many complications and even death. Accordingly, the treatment of this disease should be maximally effective and short-lived. The best choice for treating pneumonia is a group of oral aminopenicillins, which were administered in the first days of the disease and showed significantly better results than patients treated with cephalosporins.

The Isambert disease: a very rare revelation of miliary tuberculosis

Revue Malienne d'Infectiologie et de Microbiologie ◽

10.53597/remim.v0i10.952 ◽

2017 ◽

Author(s):

Z Rachadi ◽

M Idalene ◽

L Arsalane ◽

A Raji ◽

N Tassi

Keyword(s):

Clinical Case ◽

Miliary Tuberculosis ◽

Chronic Tonsillitis ◽

Pharyngeal Swab ◽

X Ray ◽

Antituberculous Treatment ◽

Acid Fast Bacilli ◽

The objective of this study was to report a case of miliary tuberculosis revealed by a pharyngeal localization, and study this disease through a literature review.We report the clinical case of a 23 year old patient presented for chronic tonsillitis treated as bacterial but without improvement. Dysphonia and dysphagia were added later with the same signs of tuberculous impregnation. The chest x-ray done before the onset of coughing had objectified miliary. The diagnosis of tuberculosis was selected before the detection of acid-fast bacilli in cytobacteriological examination of the pharyngeal swab and sputum. Specific antituberculous treatment led to a favourable outcomeIn a context of endemic tuberculosis, the diagnosis of miliary tuberculosis of the pharynxshould be considered in all pharyngeal syndrome did not improve with medical treatment.Keywords: Isambert disease; oropharynx ; tuberculosis