scholarly journals Clinical, Laboratory and Radiographic Features of Patients with Pneumonia and Parapneumonic Effusions

2016 ◽  
Vol 4 (3) ◽  
pp. 428-434 ◽  
Author(s):  
Sanja Petrusevska-Marinkovic ◽  
Irena Kondova-Topuzovska ◽  
Zvonko Milenkovic ◽  
Goran Kondov ◽  
Ankica Anastasovska
Keyword(s):  
Clinical Laboratory ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Pleuritic Chest Pain ◽  
Radiographic Features ◽  
Reactive Protein ◽  
Pulmonary Changes ◽  
Male Patients

BACKGROUND: Parapneumonic effusions complicating pneumonia are associated with increased morbidity and mortality.AIM: To determine the role of the clinical, laboratory and radiographic features to the differential diagnosis of patients with community- acquired pneumonia (CAP) without effusion, uncomplicated parapneumonic effusion (UCPPE) and complicated parapneumonic effusion (CPPE).MATERIAL AND METHODS: We analysed 148 patients with CAP without effusion, 50 with UCPPE and 44 with CPPE. In three groups of patients, the majority was male patients (58.11%, 58%, 61.36%) consequently.RESULTS: The chronic heart failure was the most common comorbidity in a group with CAP (28; 18.92%) and UCPPE (7; 14%), alcoholism (12;12.77%) in a group with CPPE. Patients with CPPE had significantly longer fever compared to patients with CAP without effusion (p = 0.003). Pleuritic chest pain (86.36%) and dyspnea (88.64%) were the most common symptoms in CPPE, then to group with UCPPE (60%; 52%), and in CAP without effusion (25.68%; 47,97%). Diffuse pulmonary changes were detected more frequently in the group with CAP without effusion compared with the group with CPPE (64.86 % vs. 27.27 %), while the segment lung changes were more common in patients with CPPE (50% vs. 20.27%). Patients with CPPE were significant with higher erythrocytes sedimentation rate (ESR), white blood cells (WBC) and serum C- reactive protein (CRP) than it the other two groups (p = 0.00090, p = 0.01, p= 0.000065).CONCLUSION:Proper analysis of clinical, laboratory and radiographic features of patients with CAP and parapneumonic effusion can prevent mismanagement in these patients and will reduce morbidity and mortality. 

scholarly journals The Role of Red Blood Cell Distribution Width in the Severity and Prognosis of Community-Acquired Pneumonia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Qiang Ren ◽  
Hebing Liu ◽  
Ying Wang ◽  
Deyu Dai ◽  
Zhennan Tian ◽  
...  
Keyword(s):  
Roc Curve ◽  
Inflammatory Markers ◽  
Operating Characteristic ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Outcomes ◽  
Distribution Width ◽  
Reactive Protein ◽  
The Relationship

Objectives. The objective of this study is to unravel the correlation between RDW and the severity and prognosis of CAP, as well as exploring RDW with the inflammatory markers white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Methods. According to the data characteristics, appropriate statistical methods were selected to analyze the relationship between RDW and the severity and prognosis of CAP patients and to determine whether RDW is associated with the inflammatory markers WBC, CRP, and PCT. Results. The results show that with the increase of PSI and CURB-65 values, the proportion of patients with RDW ≥ 12.987% is significantly higher than that of RDW < 12.987% ( P < 0.01 ). When RDW is combined with PSI or CURB-65 to predict the 90-day mortality of CAP patients, the area under the receiver operating characteristic (ROC) curve increased prominently, and if RDW, PSI, and CURB-65 are combined, the area under the ROC curve is maximized. Conclusions. Our findings suggest that the higher RDW value is associated with short-term adverse outcomes in CAP patients. We also find that when RDW, PSI, and CURB-65 are combined, the best performance is achieved to predict CAP 90-day mortality risk.

EVALUATION OF D-DIMER AND CRP LEVEL IN COVID-19 AND CAP(COMMUNITY ACQUIRED PNEUMONIA) PATIENTS AND THEIR CORRELATION WITH VTE SCORE(VENOUS THROMBOEMBOLISM SCORE)

2021 ◽  
pp. 69-70
Author(s):  
Maitri Bhatt ◽  
Toral Jivani ◽  
Ashwini Shukla
Keyword(s):  
Venous Thromboembolism ◽  
Clinical Laboratory ◽  
Community Acquired Pneumonia ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Dynamic Changes ◽  
Reactive Protein ◽  
Recent Outbreak ◽  
D Dimer

BACKGROUND:In recent outbreak of COVID-19 infection,the risk of thrombosis should be concerned.We observed dynamic changes of D-Dimer level,C-Reactive Protein(CRP) level and Venous Thromboembolism risk assessment score(VTE score) during active disease.We included patients of conrmed covid-19 patients who were RT-PCR positive and patients of community acquired pneumonia(CAP) who were conrmed by CT-SCAN ndings.We observed correlation of D-dimer level with both CRP level & VTE score. METHOD:We examined the clinical laboratory result of 50 patients with conrmed COVID-19 positive patients and 50 patients with community acquired pneumonia(CAP).We analysed D-dimer level of this patients by Automated Coagulometer-STAGO in our hematological laboratory and CRP level by latex method.We use pauda prediction score to identify patients at high risk for venous thrombo embolism.We observed D-dimer level of all patients with their correlation to CRP level & VTE score.S RESULT:On admission,Both COVID-19 and CAP patients,D-dimer level were increased,more increased in COVID-19 patient compare to CAP patient. D-dimer level were related to inammatory marker,mainly with CRP level.There was low correlation between VTE score & Ddimer levels weakened the role of D-dimer in the prediction of thrombosis. CONCLUSION:Elevated baseline D-dimer levels are associated with inammation but not with VTE score in COVID patients,So we can't judge whether anticoagulation is needed only according to D-dimer levels. Abnormal D-dimer level with inammatory factors suggest that anticoagulant therapy might be needed.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

scholarly journals Role of Plasma Presepsin, Procalcitonin and C-reactive Protein Levels in Determining the Severity and Mortality of Community-Acquired Pneumonia in the Emergency Department

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Protein Levels ◽  
Reactive Protein ◽  
Imaging Results ◽  
Severity Scores ◽  
Significant Difference

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.

scholarly journals Features of Parapneumonic Effusions

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 131-141 ◽  
Author(s):  
Sanja Petrusevska Marinkovic ◽  
Irena Kondova Topuzovska ◽  
Milena Stevanovic ◽  
Ankica Anastasovska
Keyword(s):  
Pleural Fluid ◽  
Clinical Problem ◽  
Community Acquired Pneumonia ◽  
Parapneumonic Effusion ◽  
Pleuritic Chest Pain ◽  
Radiological Features ◽  
Significant Difference ◽  
Costophrenic Angle ◽  
The University ◽  
Complicated Parapneumonic Effusion

Abstract Introduction: Parapneumonic effusions, as a complication of community-acquired pneumonia (CAP), usually have a good course, but they sometimes progress into complicated parapneumonic effusion (CPPE) and empyema, thus becoming a significant clinical problem. Aim: To review clinical and radiological features, as well as diagnostic and therapeutic options in parapneumonic effusions. Material and methods: The analysis included 94 patients with parapneumonic effusion hospitalized at the University Infectious Diseases Clinic in Skopje during a 4 year period. Out of 755 patients with CAP, 175 (23.18%), had parapneumonic effusion. Thoracentesis was performed in 94 (53.71%) patients, 50 patients were with uncomplicated parapneumonic effusions (UCPPE) and 44 with complicated parapneumonic effusions (CPPE). Results: More patients (59.57%) were male; the average age was 53.82±17.5 years. The most common symptoms included: fever (91; 96.81%), cough (80; 85.11%), pleuritic chest pain (68; 72.34%), dyspnea (65; 69.15%). Alcoholism was the most common comorbidity registered in 12 (12.77%) patients. Macroscopically, effusion was yellow and clear in most cases (36; 38.29%). Localization of pleural effusion was often in the left costophrenic angle (53; 56.38%) and ultrasonographic non-septated complex. Between the two groups of effusions there was a significant difference between the ERS, WBC and CRP in serum and CRP in pleural fluid. Statistical difference existed in terms of days of hospitalization with a longer hospital stay for patients with CPPE (p <0.0001). Conclusion: Patients with parapneumonic effusion have the symptoms of acute respiratory infection and frequent accompanying diseases. Future diagnostic and therapeutic treatment depends on pleural fluid features and imaging lung findings.

scholarly journals A retrospective observational study to estimate use of biomarkers to predict severity of community acquired pneumonia in children

2021 ◽  
Author(s):  
Anam Bashir ◽  
Raheel Khan ◽  
Stephanie Thompson ◽  
Manuel Caceres
Keyword(s):  
Area Under The Curve ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Minimal Research

Purpose: Multiple studies have investigated the role of biomarkers in predicting pneumonia severity in adults but minimal research exists for children. The aim of this study was to determine if the following biomarkers: white blood cell count (WBC), platelet count, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-lymphocyte ratio, neutrophil count, or band count predict community associated pneumonia (CAP) severity in children. Methods: A retrospective chart review was conducted on pediatric patients (aged 60 days to 18 years) diagnosed with CAP, admitted to a regional, tertiary hospital. Patients were stratified into two severity cohorts, mild (no ICU care), and moderate /severe (required ICU care). Biomarker values were then compared between the severity cohorts and area under the curve (AUC), cut-off values, performance characteristics were calculated. Results: A total of 108 patients met inclusion criteria. Among the biomarkers examined, elevated levels of CRP (51.7 mg/L in mild vs. 104.8 mg/L in moderate/severe, p = 0.003, PCT (0.29 ng/ml in mild vs. 4.02 ng/ml in moderate/severe, p = 0.001) and band counts (8% in mild vs. 15% moderate/severe, p = 0.009) were associated with increased pneumonia severity. In predicting moderate/severe CAP, PCT had the highest AUC of 0.77 (p = 0.001) followed by bands AUC of 0.69 (p = 0.009) and CRP AUC of 0.67 (p = 0.003). The cut-off for PCT of 0.55ng/ml had a sensitivity of 83% and a specificity of 65%. A cut-off level of 53.1 mg/L for CRP had a sensitivity of 79% and specificity of 52%. A cut off level of 12.5% bands had a sensitivity of 61% and specificity of 71%. Conclusion: Biomarkers, in particular PCT, obtained early in hospitalization appear to perform as predictors for CAP severity in children and may be beneficial in guiding CAP management

Sign in / Sign up

Export Citation Format

Share Document