scholarly journals Clinical and Laboratory Findings in Patients With Acute Respiratory Symptoms That Suggest the Necessity of a Chest X-ray for Community-Acquired Pneumonia

2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Azadeh Ebrahimzadeh ◽  
Mahyar Mohammadifard ◽  
Godratallah Naseh ◽  
Alireza Mirgholami
Keyword(s):  
Respiratory Symptoms ◽  
Community Acquired Pneumonia ◽  
Laboratory Findings ◽  
X Ray ◽  
Chest X Ray

scholarly journals Age-specific risk factors of severe pneumonia among pediatric patients hospitalized with community-acquired pneumonia

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Lumin Chen ◽  
Chong Miao ◽  
Yanling Chen ◽  
Xian Han ◽  
Ziying Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Age Groups ◽  
Community Acquired Pneumonia ◽  
Laboratory Findings ◽  
X Ray ◽  
Icu Admission ◽  
Rsv Infection ◽  
History Of ◽  
Chest X Ray

Abstract Background Risk factors that predispose the development of severe community-acquired pneumonia (CAP) among pediatric CAP patients of different age ranges are yet to be identified. Methods We retrospectively analyzed pediatric in-patients (< 6 years old) diagnosed with CAP in our hospital. We subdivided patients into four age groups (< 6 months, 6 months-1 year, 1–2 years, and 2–6 years). Their medical records, including demographic information, clinical features, laboratory findings, and chest radiographic reports, were reviewed and collected for further analysis. Univariate logistic regression analysis and stepwise regression analysis were applied to identify risk factors associated with severe CAP and ICU admission for overall patients and age-stratified subgroups. Results A total of 20,174 cases were initially included. Among them, 3309 (16.40%) cases were identified as severe CAP, and 2824 (14.00%) cases required ICU admission. Potential risk factors for severe CAP and ICU admission identified by univariate analysis included younger age, rural residency, premature birth, low birth weight (LBW), formula feeding, congenital heart disease (CHD), history of pneumonia or neonatal jaundice, patients with other health issues, certain symptoms (manifesting wheezing, dyspnea, cyanosis, but have no cough or fever), abnormal laboratory findings (abnormal levels of white blood cells, albumin, and C-reactive protein and RSV infection), and chest X-ray (odds ratio [OR] > 1 for all). CHD, low albumin, proteinuria, abnormal chest x-ray were independent risks factors across different age groups, whereas birth or feeding history, history of pneumonia, cyanosis or dyspnea on admission, and RSV infection were independent risk factors for only younger kids (< 1 year), and wheezing was an independent risk factor only for older children (2–5 years old). Conclusions Risk factors predicting disease severity among children hospitalized with CAP vary with age. Risk factor stratification of pediatric CAP based on age-specific risk factors can better guide clinical practice. Trial registration This study has been registered in China, with the registration number being ChiCTR2000033019.

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

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
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.

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

2021 ◽  
Author(s):  
Rivo Lova Herilanto Rakotomalala ◽  
Harimino Mireille Rakotondravelo ◽  
Andrianina Harivelo Ranivoson ◽  
Annick Lalaina Robinson
Keyword(s):  
Community Acquired Pneumonia ◽  
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.

scholarly journals Pneumomediastinum and pneumopericardium in an adolescent with asthma attacks. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 63-69
Author(s):  
María Fernanda Ochoa-Ariza ◽  
Jorge Luis Trejos-Caballero ◽  
Cristian Mauricio Parra-Gelves ◽  
Marly Esperanza Camargo-Lozada ◽  
Marlon Adrián Laguado-Nieto
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Subcutaneous Emphysema ◽  
Respiratory Symptoms ◽  
Laboratory Tests ◽  
Young Patients ◽  
Clinical Suspicion ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Introduction: Pneumomediastinum is defined as the presence of air in the mediastinal cavity. This is a rare disease caused by surgical procedures, trauma or spontaneous scape of air from the lungs; asthma is a frequently associated factor. It has extensive differential diagnoses due to its symptoms and clinical signs.Case presentation: A 17-year-old female patient presented with respiratory symptoms for 2 days, dyspnea, chest pain radiated to the neck and shoulders, right supraclavicular subcutaneous emphysema, wheezing in both lung fields, tachycardia and tachypnea. On admission, laboratory tests revealed leukocytosis and neutrophilia, and chest X-ray showed subcutaneous emphysema in the right supraclavicular region. Diagnosis of pneumomediastinum was confirmed through a CT scan of the chest. The patient was admitted for treatment with satisfactory evolution.Discussion: Pneumomediastinum occurs mainly in young patients with asthma, and is associated with its exacerbation. This condition can cause other complications such as pneumopericardium, as in this case. The course of the disease is usually benign and has a good prognosis.Conclusion: Because of its presentation, pneumomediastinum requires clinical suspicion to guide the diagnosis and treatment. In this context, imaging is fundamental.

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

2017 ◽  
Vol 72 ◽  
pp. S15
Author(s):  
Mazen Elfaki ◽  
Martina Paetzel ◽  
John Nugent
Keyword(s):  
Primary Care ◽  
Community Acquired Pneumonia ◽  
X Ray ◽  
Chest X Ray

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

2011 ◽  
Vol 15 (6) ◽  
pp. 540-546
Author(s):  
Diana Carolina Moncada ◽  
Zulma Vanessa Rueda ◽  
Antonio Macías ◽  
Tatiana Suárez ◽  
Héctor Ortega ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
X Ray ◽  
Chest X Ray

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

2019 ◽  
Vol 7 (15) ◽  
pp. 2457-2461
Author(s):  
Youssef Ibrahim Haggag ◽  
Karim Mashhour ◽  
Kamal Ahmed ◽  
Nael Samir ◽  
Waheed Radwan
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Initial Examination ◽  
X Ray ◽  
Chest Ultrasound ◽  
Lung Consolidation ◽  
Plain Chest ◽  
Chest X Ray

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.

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

2021 ◽  
Author(s):  
Veronika Dudnyk ◽  
Nataliya Sinchuk ◽  
Kateryna Khromykh
Keyword(s):  
Antibiotic Therapy ◽  
Age Groups ◽  
Community Acquired Pneumonia ◽  
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.

scholarly journals Therapeutic flexible bronchoscopy in child with cystic fibrosis

2008 ◽  
Vol 5 (2) ◽  
pp. 75-77
Author(s):  
Amina Selimović
Keyword(s):  
Cystic Fibrosis ◽  
Middle Lobe ◽  
Flexible Bronchoscopy ◽  
Sweat Glands ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Laboratory Findings ◽  
X Ray ◽  
Chest X Ray ◽  
Regulator Genes

The report deals with the case of a 10-year-old girl with chronic cystic fibrosis. She has been repeatedly treated at the hospital. She has been hospitalized due to respiratory deterioration. Cystic fibrosis is a rare disease, inherited autosomaly recessively, but is very complex in terms of diagnostic and treatment (2). The diagnosis is confirmed based on a clinical picture of the child, measure of Chloride in the sweat, chest X-ray, CT thorax, laboratory findings--genetic confirmation CFTR ( cystic fibrosis transmembrane conductance regulator) genes (3), which result in the production of hyper-viscous mucus and chloride malabsorption in the sweat glands ducts (5,6). Bronchial thickening and plugging and ring shadows suggesting bronchiectasis, segmental or lobar atelectasis are often. Computer tomography of the chest can be used to detect and localize thickening of bronchial airways walls, mucus plugging, hyperinflation and early bronchieactasiae. Pulmonary therapy: the object is to clear secretions from airways and to control infection (7). The diagnosis is originally set when she was 4 years old. She is now admitted due to a deterioration of the main disease. Day before admission in the hospital had a higher bodily temperature, cough and difficult breathing. She already treated conservatively (Ceftazidim, Ceftriakson, Kloksacillin) Since the girl is a chronic patient with bronchiectasie chronic walls of bronchi changes full of the mucus, who is not responding to conservative treatment (antibiotics), therapeutic and diagnostic flexible bronchoscopy had to be performed, resulting in a gram-negative bacteria pseudomonas aeruginosa--a typical bacteria for chronically sick C. F. PATIENT: A pseudomonas therapy was prescribed according to the sensitive antibiogram, during which bronchoscopy was given locally on changes mucous pulmozyme and garamycin. Flexible bronchoscopy was performed as therapeutic. Local bronchoscopy findings:by aspiration of tracheo-bronchal truncus it was found hyperemia and a lot of mucous sticky secretion inside of tracheobronchal tree, especially middle lobe right side, lingual and basals part of the lungs. It was performed broncho-alveolar lavage and given steroids on the place of changed inflamed mucous membrane of the bronchi. It was also given pulmozyme to destroid mucous and make better spontaneously expectorations. Control chest x ray was performed and it was better.

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