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Latest & greatest articles for pneumonia
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New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study 28613918 2017 12 04 2017 12 13 1535-4970 196 10 2017 Nov 15 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study. 1287-1297 10.1164/rccm.201611-2262OC The Sepsis-3 Task Force updated the clinical criteria (...) for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia. This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals. SIRS, qSOFA, the Confusion
Ceftaroline fosamil (Zinforo) - treatment of complicated skin and soft tissue infections in children from the age of 2 months or community-acquired pneumonia in children from the age of 2 months Published 15 January 2018 Statement of Advice: ceftaroline fosamil 600 mg powder for concentrate for solution for infusion (Zinforo ® ) SMC No 1306/18 Pfizer Limited 8 December 2017 ADVICE: in the absence of a submission from the holder of the marketing authorisation ceftaroline fosamil (Zinforo (...) ® ) is not recommended for use within NHS Scotland. Indication under review: treatment of ? complicated skin and soft tissue infections in children from the age of 2 months ? community-acquired pneumonia in children from the age of 2 months The holder of the marketing authorisation has not made a submission to SMC regarding this product in this setting. As a result we cannot recommend its use within NHSScotland. SMC has previously issued accepted ceftaroline fosamil for restricted use in adults with known
Hospital-acquired pneumonia Hospital-acquired pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Hospital-acquired pneumonia Last reviewed: August 2018 Last updated: June 2018 Summary Most cases are caused by bacteria, especially aerobic gram-negative bacilli, such as Pseudomonas aeruginosa , Escherichia coli , Klebsiella pneumoniae , and Acinetobacter species. Patients with hospital-acquired pneumonia usually (...) . Definition Hospital-acquired pneumonia (HAP) is an acute lower respiratory tract infection that is by definition acquired after at least 48 hours of admission to hospital and is not incubating at the time of admission. Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63:e61-e111. http
Overview of pneumonia Overview of pneumonia - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Overview of pneumonia Last reviewed: August 2018 Last updated: June 2018 Introduction Pneumonia is inflammation of the lungs with consolidation or interstitial lung infiltrates, most often categorised according to the causative organism. Typical symptoms might include fever, cough, dyspnoea, and chest pain. Because each specific (...) type of pneumonia may result from a different aetiology and pathogenic mechanism, each subtype also has its characteristic risk factors, signs, and symptoms. Related conditions Condition Description Community-acquired pneumonia (CAP) is defined as pneumonia acquired outside hospital or healthcare facilities. Older patients in particular are often afebrile and may present with confusion and worsening of underlying diseases. The most common cause is Streptococcus pneumoniae (also known
Chlamydia pneumoniae infection Chlamydia pneumoniae infection - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Chlamydia pneumoniae infection Last reviewed: August 2018 Last updated: January 2018 Summary A bacterial respiratory pathogen that is a frequent cause of community-acquired pneumonia in children and adults. An obligate intracellular parasite that can only be isolated in tissue culture, although culture (...) is not widely available. Pneumonia due to Chlamydia pneumoniae cannot be differentiated clinically from pneumonia due to other atypical organisms, especially Mycoplasma pneumoniae . Serological diagnosis is complicated by the requirement for paired sera and the lack of FDA-approved serological assays. Treatment with macrolides, quinolones, or tetracyclines appears equally effective. Definition Chlamydia pneumoniae (an obligate intracellular bacterium) is a frequent respiratory pathogen in humans that occurs
Bronchiolitis obliterans organising pneumonia Bronchiolitis obliterans organising pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Bronchiolitis obliterans organising pneumonia Last reviewed: August 2018 Last updated: January 2018 Summary An inflammatory disorder involving both the peripheral bronchioles and alveoli simultaneously. It has distinctive radiographic findings, histological features, and response (...) to corticosteroids (unlike usual interstitial pneumonia). Most common type is idiopathic BOOP; other types include focal nodular, post-infection, drug-related, rheumatological, immunological, organ transplantation, radiotherapy, environmental, and miscellaneous BOOP. Accounts for 20% to 30% of all cases of chronic infiltrative lung diseases. It occurs equally among men and women, and is not related to smoking. High-resolution chest CT scan shows bilateral patchy triangular ground glass opacities with air
Aspiration pneumonia Aspiration pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Aspiration pneumonia Last reviewed: August 2018 Last updated: January 2018 Summary Diagnosis is based on clinical signs or symptoms of pneumonia in a person with a history or risk factors for aspiration. Sputum or tracheal Gram stain reveals mixed flora. Infection usually involves the dependent lung lobe. Complications (...) of disease include lung abscess and empyema. Definition Aspiration pneumonia results from inhalation of oropharyngeal contents into the lower airways that leads to lung injury and resultant bacterial infection. It commonly occurs in patients with altered mental status who have an impaired gag or swallowing reflex. The bacteriology and presentation of aspiration pneumonia have changed over the past five decades. Older studies characterised an anaerobic pleuropulmonary syndrome, with necrotising pneumonia
Pneumocystis jirovecii pneumonia Pneumocystis jirovecii pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Pneumocystis jirovecii pneumonia Last reviewed: August 2018 Last updated: January 2018 Summary The organism was known formerly as Pneumocystis carinii . Still the most common AIDS-defining opportunistic infection. Suspicion for Pneumocystis pneumonia (PCP) is based on clinical signs or symptoms (...) of pneumonia in a person with immune suppression, especially when due to HIV infection. Diagnosis is made by detection of the organism in either induced sputum or bronchoalveolar lavage (BAL). The treatment of choice is trimethoprim/sulfamethoxazole (TMP/SMX). The incidence of PCP is declining with the use of combination antiretroviral therapy (ART) and PCP prophylaxis. Definition Pneumocystis pneumonia (PCP) is an infection of the lung caused by the fungal organism Pneumocystis jirovecii (formerly known
Atypical pneumonia Atypical pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Atypical pneumonia Last reviewed: August 2018 Last updated: May 2018 Summary Community-acquired and often seen in young adults living in close proximity. Diagnosis is mostly clinical. Molecular-based diagnosis of throat swabs or sputum can be performed. Serology can be used to confirm the diagnosis. Treatment is often outpatient (...) based with a macrolide antibiotic or doxycycline. Extrapulmonary manifestations may occur, especially in M pneumoniae infections. Definition Atypical bacterial pneumonia is caused by atypical organisms that are not detectable on Gram stain and cannot be cultured using standard methods. The most common organisms are Mycoplasma pneumoniae , Chlamydophila pneumoniae , and Legionella pneumophila . Atypical bacterial pneumonia generally is characterised by a symptom complex that includes headache, low
Community-acquired pneumonia Community-acquired pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Community-acquired pneumonia Last reviewed: August 2018 Last updated: May 2018 Summary Typically characterised by a new lung infiltrate on chest x-ray, together with one or more of the following: fever, chills, cough, sputum production, dyspnoea, myalgia, arthralgia, pleuritic pain. Diagnosis should include (...) a chest x-ray, although this has been challenged by studies using CT scanning. Risk factors relate to environment, lifestyle factors, patient status, and comorbidities. Infection by bacteria or respiratory viruses is the main cause. Initial treatment is empirical with antibiotics, following international guidelines and local epidemiology. Definition Community-acquired pneumonia (CAP) is defined as pneumonia acquired outside hospital or healthcare facilities. Clinical diagnosis is based on a group
Influence of environmental conditions and pollution on the incidence of Streptococcus pneumoniae infections Influence of environmental conditions and pollution on the incidence of Streptococcus pneumoniae infections To the Editor: Streptococcus pneumoniae colonizes a large percentage of the population and while it can cause mild respiratory infections it is also responsible for more severe illnesses, such as invasive pneumococcal disease. Patient co-morbidities, concomitant viral infection, low (...) temperature and environmental pollutants all have a synergistic effect that predisposes to pneumococcal infection, exerting deleterious effects on respiratory epithelium and local immune system, diminishing bacterial clearance and favouring infection . The objective of this study was to analyse the influence of environmental factors on the incidence of pneumococcal infection. For this purpose we designed a retrospective study where data on all cases of S. pneumoniae at the University and Polytechnic
Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study 29796064 2018 11 14 1751-1437 19 2 2018 May Journal of the Intensive Care Society J Intensive Care Soc Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study. 94-100 10.1177/1751143717740804 Ventilator-associated pneumonia is associated with significant (...) morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416
Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia 28890433 2017 09 11 2017 09 11 1399-3003 50 3 2017 Sep The European respiratory journal Eur. Respir. J. Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia. 1602306 10.1183/13993003.02306-2016 International guidelines including those in the UK, Japan, Australia and South Africa recommend the avoidance of macrolides in patients with low-severity community (...) -acquired pneumonia (CAP). We hypothesised that severity scores are poor predictors of atypical pneumonia and response to macrolide therapy, and thus, inadequate tools for guiding antibiotic prescriptions.Secondary analysis of four independent prospective CAP datasets was conducted. The predictive values of the CURB-65 and pneumonia severity index (PSI) for clinically important groups of causative pathogens were evaluated. The effect of macrolide use according to risk class was assessed by multivariable
Short-course versus long-course intravenous therapy with the same antibiotic for severe community-acquired pneumonia in children aged two months to 59 months. BACKGROUND: Pneumonia is a leading cause of childhood mortality from infectious disease, responsible for an estimated 1.3 million deaths annually in children under five years of age, many of which are in low-income countries. The World Health Organization recommends intravenous antibiotics for five days as first-line treatment (...) for children with severe pneumonia. Although controversy exists regarding the specific clinical features used to diagnose pneumonia, the criteria for diagnosis of severe pneumonia are better defined and are widely used to triage children for referral and second-line therapy.In 2011 it was estimated that approximately 120 million new cases of pneumonia occur globally each year in children under five years of age, of which 14 million become severe episodes. Hospitalisation for severe pneumonia in children
Bacteremia Prediction Model for Community-acquired Pneumonia: External Validation in a Multicenter Retrospective Cohort 28714287 2017 07 17 2017 09 29 1553-2712 2017 Jul 16 Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Bacteremia Prediction Model for Community-acquired Pneumonia: External Validation in a Multicenter Retrospective Cohort. 10.1111/acem.13255 Many studies have described constructing a prediction model for bacteremia (...) in community-acquired pneumonia (CAP), but these studies were not validated in external heterogeneous groups. The objective of this study was to test the generalizability of a previous bacteremia prediction model for CAP by external validation. This multicenter retrospective cohort analysis was performed in eight tertiary urban hospital emergency departments (EDs). We reviewed adult patients who were hospitalized after presentation to the ED with CAP. We categorized the enrolled patients into three groups
Nebulized Versus IV Amikacin as Adjunctive Antibiotic for Hospital and Ventilator-Acquired Pneumonia Postcardiac Surgeries: A Randomized Controlled Trial 28857848 2017 08 31 2017 08 31 1530-0293 2017 Aug 28 Critical care medicine Crit. Care Med. Nebulized Versus IV Amikacin as Adjunctive Antibiotic for Hospital and Ventilator-Acquired Pneumonia Postcardiac Surgeries: A Randomized Controlled Trial. 10.1097/CCM.0000000000002695 Nebulized antibiotics offer high efficacy due to significant local (...) concentrations and safety with minimal blood levels. This study evaluates the efficacy and nephrotoxicity of nebulized versus IV amikacin in postcardiothoracic surgical patients with nosocomial pneumonia caused by multidrug-resistant Gram--negative bacilli. Prospective, randomized, controlled study on surgical patients divided into two groups. Postcardiac surgery ICU. The first gtroup was administered IV amikacin 20 mg/kg once daily. The second group was prescribed amikacin nebulizer 400 mg twice daily. Both
Spotlight: Pneumocystis Pneumonia in a Patient Without AIDS, A Clinical Vignette Spotlight: Pneumocystis Pneumonia in a Patient Without AIDS, A Clinical Vignette | Clinical Correlations Spotlight: Pneumocystis Pneumonia in a Patient Without AIDS, A Clinical Vignette September 20, 2017 By Martin Fried, MD Peer reviewed Learning Objectives Why does impaired cellular immunity increase the risk for Pneumocystis jiroveci Pneumonia (PJP)? How do acquired humoral immune deficiencies, such as the use (...) % on ambient air. The physical exam was notable for fine crackles and bronchial breath sounds over the right mid-lower lung field. Initial labs revealed white blood cell count of 21.9 K/uL with 80% neutrophils but was otherwise unremarkable. A rapid HIV test was negative. Chest XR demonstrated right middle and lower lobe consolidations and left basilar hazy opacities consistent with multifocal pneumonia. He was started on antibiotics for community acquired pneumonia and admitted to the hospital
It is possible to replace chest X-rays with pulmonary ultrasound in the diagnose of pneumonia in children? Evidencias en pediatría - ¿Puede la ecografía pulmonar sustituir a la radiografía, para diagnosticar la neumonía en niños? Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar menú Gestión de (...) imagen. Enviar AVC | Artículos Valorados Críticamente Boursiani C, Tsolia M, Koumanidou C, Malagari A, Vakaki M, Karapostolakis G, et al . Lung ultrasound as first-line examination for the diagnosis of community-acquired pneumonia in children. Revisores: Albi Rodríguez M.S 1 , Martínez Rubio M.V 2 . 1 Sección de Neumología y Alergia Infantil. Hospital Universitario 12 de Octubre. Madrid. España. 2 CS Los Fresnos. Torrejón de Ardoz. Madrid. España. Correspondencia: María Salomé Albi Rodríguez. Correo
Can we predict which children with pneumonia will have a severe prognosis? Evidencias en pediatría - ¿Podemos predecir qué niños con neumonía van a tener un pronóstico grave? Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su (...) Williams DJ, Zhu Y, Grijalva CG, Self WH, Harrell FE Jr, Reed C, et al . Predicting Severe Pneumonia Outcomes in Children. Revisores: Orejón de Luna G 1 , Cuestas Montañés E 2 . 1 CS General Ricardos. Madrid. España. 2 Servicio de Pediatría y Neonatología. Hospital Privado. Centro Formador. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Córdoba. Argentina. Correspondencia: Gloria Orejón de Luna. Correo electrónico: Fecha de recepción: 23/03/2017 Fecha de aceptación: 30/03/2017 Fecha de
Advances in the diagnosis of pneumonia in children. Pneumonia remains a major cause of childhood mortality and morbidity globally. Accurate diagnosis and attribution of the causes of pneumonia are important for measuring the burden of disease, implementing appropriate preventive or treatment strategies, and developing more effective interventions. This review summarizes recent diagnostic advances in radiological techniques, specimen collection, and laboratory methods. Although chest ultrasound (...) and chest magnetic resonance imaging are promising modalities for radiological diagnosis, their role in clinical management and their impact on outcomes need further study. Rapid, highly sensitive, multiplex laboratory tests performed on upper respiratory tract samples or induced sputum can detect nucleic acid from potential pathogens in most children with pneumonia. However, it may be difficult to attribute causality because it is often impossible to distinguish between organisms colonizing