scholarly journals Haemorrhagic pneumonia caused by Stenotrophomonas maltophilia in two newborns

2015 ◽  
Vol 9 (05) ◽  
pp. 533-535 ◽  
Author(s):  
Nilufer Guzoglu ◽  
Fatma Nur Demirkol ◽  
Didem Aliefendioglu
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Stenotrophomonas Maltophilia ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Pulmonary Haemorrhage ◽  
Neonatal Intensive Care Units ◽  
Bilateral Pneumothorax ◽  
First Case ◽  
Appropriate Treatment

Invasive procedures and antibiotic treatment increase the risk of nosocomial infections in neonatal intensive care units. Early identification and appropriate treatment is important. Herein we report two cases of massive hemorrhagic pneumonia caused by Stenotrophomonas maltophilia. The first case was diagnosed with congenital pneumonia; a chest tube was inserted because of pneumothorax on the third day of life. The second case had been referred with respiratory distress syndrome, and bilateral pneumothorax was present on admission. Upon follow up, the cases’ clinical condition worsened; acute respiratory distress syndrome and massive pulmonary haemorrhage developed. After Stenotrophomonas maltophilia was isolated in blood cultures, the cases were treated successfully using a combination of trimethoprim/sulfamethoxazole and fluoroquinolone.

scholarly journals Successful treatment of pulmonary haemorrhage and acute respiratory distress syndrome caused by fulminant Stenotrophomonas maltophilia respiratory infection in a patient with acute lymphoblastic leukaemia – case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefan Andrei ◽  
Alexandra Ghiaur ◽  
Lavinia Brezeanu ◽  
Cristina Martac ◽  
Andreea Nicolau ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Acute Lymphoblastic Leukaemia ◽  
Respiratory Distress ◽  
Lymphoblastic Leukaemia ◽  
Stenotrophomonas Maltophilia ◽  
Distress Syndrome ◽  
Pulmonary Haemorrhage ◽  
Empirical Treatment ◽  
Haematological Patients

Abstract Background Stenotrophomonas maltophilia-induced pulmonary haemorrhage is considered a fatal infection among haematological patients. The outcome can be explained by the patients’ immunity status and late diagnosis and treatment. Case presentation We present the rare case of successful outcome in a 61-year-old female who developed alveolar haemorrhage and acute respiratory distress syndrome 8 days after a chemotherapy session for her acute lymphoblastic leukaemia, in the context of secondary bone marrow aplasia. Stenotrophomonas maltophilia was isolated in sputum culture. The patient benefitted from early empirical treatment with colistin followed by trimethoprim/sulfamethoxazole, according to the antibiogram. Despite a severe initial clinical presentation in need of mechanical ventilation, neuromuscular blocking agents infusion, and ventilation in prone position, the patient had a favourable outcome and was discharged from intensive care after 26 days. Conclusions Stenotrophomonas maltophilia severe pneumonia complicated with pulmonary haemorrhage is not always fatal in haematological patients. Empirical treatment of multidrug-resistant Stenotrophomonas maltophilia in an immunocompromised haematological patient presenting with hemoptysis should be taken into consideration.

scholarly journals Health Economics and Outcomes of Surfactant Treatments for Respiratory Distress Syndrome Among Preterm Infants in US Level III/IV Neonatal Intensive Care Units

2019 ◽  
Vol 24 (2) ◽  
pp. 117-127
Author(s):  
Krishnamurthy Sekar ◽  
Daniel Fuentes ◽  
Michelle R. Krukas-Hampel ◽  
Frank R. Ernst
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Hospital Costs ◽  
Neonatal Intensive Care Units ◽  
Multivariable Regression ◽  
Surfactant Administration

OBJECTIVE To compare length of stay (LOS), costs, mechanical ventilation (MV), and mortality in preterm infants treated in the Neonatal Intensive Care Unit (NICU) with beractant (BE), calfactant (CA), and poractant alfa (PA) for Respiratory Distress Syndrome (RDS). METHODS This study evaluated preterm infants born between 2010 and 2013 with RDS diagnosis, gestational age of 25 to 36 weeks, birthweight of ≥500 g, and age of ≤2 days on first surfactant administration. Multivariable regression was used to evaluate all NICU outcomes. RESULTS Of 13,240 infants meeting the study criteria, 4136 (31.2%) received BE, 2502 (18.9%) received CA, and 6602 (49.9%) received PA. Adjusted analyses estimated similar mean LOS (BE 26.7 days, CA 27.8 days, and PA 26.2 days) and hospital costs (BE: $50,929; CA: $50,785; and PA: $50,212). Compared to PA, BE and CA were associated with greater odds of MV use on day 3 (OR = 1.56 and 1.60, respectively) and day 7 (OR = 1.39 and 1.28, respectively; all p < 0.05). Adjusted NICU mortality was significantly higher only with CA vs PA (OR = 1.51; p = 0.015). CONCLUSION Adjusted NICU LOS and costs were similar among BE, CA, and PA. Infants receiving PA were less likely to be on MV at 3 and 7 days, and PA treatment was associated with lower odds of NICU mortality when compared to CA.

Double-Blind, Randomized Trial of a Calf Lung Surfactant Extract Administered at Birth to Very Premature Infants for Prevention of Respiratory Distress Syndrome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 593-599 ◽  
Author(s):  
Donald L. Shapiro ◽  
Robert H. Notter ◽  
Frederick C. Morin ◽  
Karl S. Deluga ◽  
Leonard M. Golub ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Lung Surfactant ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Severe Respiratory Distress

Organic solvent extraction of surfactant obtained by lavage of calf lungs yields a highly surfaceactive material. A double blind, randomized clinical trial to determine the effect of this material on respiratory distress syndrome in premature infants was initiated in the Neonatal Intensive Care Unit at the University of Rochester in December 1983. Infants 25 to 29 weeks gestational age were eligible for entry into the trial. At the time of this interim analysis 32 patients had been randomly selected and entered into the trial, 16 surfactant-treated patients and 16 in a control group who received only saline. At birth, intrapulmonary instillation of the calf lung surfactant extract dispersed in saline or saline alone occurred in the delivery room immediately after intubation and prior to ventilation; infants were then ventilated and treated as usual. At 6, 12, 24, 48, and 72 hours after birth, the severity of respiratory distress was categorized as either minimal, intermediate, or severe based on oxygen and mean airway pressure requirements. Differences observed at six hours after birth were of marginal significance, but at 12 and 24 hours the surfactant-treated group had significantly (P < .01) less severe respiratory distress compared with the control group. Differences between treated and control infants were not statistically significant at 48 and 72 hours after birth. In four surfactant-treated infants the severity of respiratory distress worsened between 24 and 48 hours after birth, suggesting that one dose of surfactant at birth may not be sufficient for some infants.

Treatment Investigational New Drug Experience With Survanta (Beractant)

PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 546-551
Author(s):  
Elizabeth M. Zola ◽  
A. M. Overbach ◽  
J. Harry Gunkel ◽  
Brian R. Mitchell ◽  
Barbara T. Nagle ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Ductus Arteriosus ◽  
Pulmonary Hemorrhage ◽  
The United States ◽  
Controlled Trials ◽  
Randomized Controlled Clinical Trials ◽  
New Drug

From September 1989 through July 1991, before commercial availability, Survanta (beractant intratracheal suspension), a modified bovine-derived surfactant used for prevention and treatment of neonatal respiratory distress syndrome, was made available to 231 neonatal intensive care units in the United States and Canada under a Treatment Investigational New Drug protocol. Results of this open clinical experience are reported. Investigators could give one dose of Survanta soon after birth to neonates weighing 600 to 1250 g (prevention strategy). Neonates weighing 600 to 1750 g who were not treated at birth could begin Survanta therapy if respiratory distress syndrome developed within 8 hours of birth (rescue strategy). All neonates could receive up to three more doses over the first 48 hours of life at minimum intervals of 6 hours if they met retreatment criteria. Qualifications for enrollment closely matched those used in previous randomized controlled clinical trials. This report includes results from 8168 neonates who completed the study. Treatment Investigational New Drug rates for intracranial hemorrhage, patent ductus arteriosus, pulmonary hemorrhage, pulmonary air leaks, bronchopulmonary dysplasia, death or bronchopulmonary dysplasla, pulmonary interstitial emphysema, pretreatment sepsis, and posttreatment sepsis were less than for treated neonates in the controlled trials and survival was equivalent across studies. Problems with treatment administration were reported with 30.4% of doses, while adverse events were reported in 0.5% of neonates. The results of the Treatment Investigational New Drug protocol revealed no new safety concerns associated with the widespread use of Survanta and confirmed the safety profile established in earlier controlled trials.

scholarly journals A Case of Cutaneous Infection Caused by Mycobacterium Szulgai with Progression to Acute Respiratory Distress Syndrome

2011 ◽  
Vol 4 ◽  
pp. CCRep.S7180 ◽  
Author(s):  
Hiromitsu Ohta ◽  
Eisaku Miyauchi ◽  
Masahito Ebina ◽  
Toshihiro Nukiwa
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bronchoalveolar Lavage Fluid ◽  
Distress Syndrome ◽  
Lavage Fluid ◽  
Skin Ulcers ◽  
First Case ◽  
B Virus ◽  
Hepatitis B Virus Carrier

A 59-year-old man presented with a skin eruption and bilateral swelling of the legs. Soon after the initial presentation, he developed acute respiratory distress syndrome (ARDS) with miliary lung nodules. Culture of samples from the skin ulcers, sputum, and bronchoalveolar lavage fluid all revealed Mycobacterium szulgai infection. The patient was successfully treated with antituberculosis drugs. M. szulgai infection is very rarely reported worldwide, and disseminated infection usually occurs in immunocompromised patients. However, the present patient was a non-immunocompromised case, although he was a hepatitis B virus carrier. While the progression to ARDS from M. tuberculosis infection is well known, this is the first case of M. szulgai infection progressing to ARDS.

Acute Respiratory Distress Syndrome After Zinc Chloride Inhalation: Survival After Extracorporeal Life Support and Corticosteroid Treatment

2010 ◽  
Vol 19 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Chih-Feng Chian ◽  
Chin-Pyng Wu ◽  
Chien-Wen Chen ◽  
Wen-Lin Su ◽  
Chin-Bin Yeh ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Corticosteroid Treatment ◽  
High Dose ◽  
Arterial Oxygenation ◽  
Bilateral Pneumothorax

No standard protocol exists for the treatment of acute respiratory distress syndrome induced by inhalation of smoke from a smoke bomb. In this case, a 23-year-old man was exposed to smoke from a smoke grenade for approximately 10 to 15 minutes without protective breathing apparatus. Acute respiratory distress syndrome developed subsequently, complicated by bilateral pneumothorax and pneumomediastinum 48 hours after inhalation. Despite mechanical ventilation and bilateral tube thoracostomy, the patient was severely hypoxemic 4 days after hospitalization. His condition improved upon treatment with high-dose corticosteroids, an additional 500-mg dose of methylprednisolone, and the initiation of extracorporeal life support. Arterial oxygenation decreased gradually after abrupt tapering of the corticosteroid dose and discontinuation of the life support. On day 16 of hospitalization, the patient experienced progressive deterioration of arterial oxygenation despite the intensive treatment. The initial treatment regimen (ie, corticosteroids and extracorporeal life support) was resumed, and the patient’s arterial oxygenation improved. The patient survived.

scholarly journals Fatal acute respiratory distress syndrome in a patient with paracoccidioidomycosis: first case report

2010 ◽  
Vol 48 (3) ◽  
pp. 542-545 ◽  
Author(s):  
Gil Benard ◽  
André Nathan Costa ◽  
Juliana Ravanini ◽  
Silvia Goulart ◽  
Elisabeth Lima Nicodemo ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
First Case
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