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Community Acquired Pneumonia Treatment

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https://www.readbyqxmd.com/read/28728317/mycoplasma-pneumoniae-associated-hepatitis-without-lung-involvement
#1
Han Taek Jeong, Jae Young Oh, Jung Eun Song, Byung Seok Kim, Chang Hyeong Lee
Mycoplasma pneumoniae (M. pneumoniae) is a major cause of community acquired respiratory infections. And it also causes a number of extrapulmonary manifestations including cardiovascular, dermatological, musculoskeletal, and hematological systems. But, acute hepatitis without lung involvement is rare in adults. Here, we report a case of 32-year-old man who presented with fever, chilling, myalgia, and headache. Biochemical analysis showed severely impaired liver function and leukopenia. Laboratory tests and liver biopsy demonstrated a hepatocellular pattern of M...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28723778/thoracic-splenosis-mimicking-a-pleuropneumonia-a-case-report
#2
Aurélie Baldolli, Solène Coeuret, Vincent Le Pennec, Denis Agostini, Renaud Verdon
RATIONALE: Splenosis is the development of one or more heterotopic splenic tissue autoimplants following rupture of the spleen and remains mostly asymptomatic. PATIENT CONCERNS: We report a case of a 50-year old post-traumatic splenectomized man admitted for a left side community acquired pneumonia resistant to antibiotics. DIAGNOSES: The diagnosis of intrathoracic ectopic spleen was suspected because of the history of spleen trauma with diaphragm rupture and the absence of Howell-Jolly bodies...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28711429/-appropriateness-of-antibiotic-prescribing-in-paediatric-patients-in-a-hospital-emergency-department
#3
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28710027/admission-lactate-predicts-poor-prognosis-independently-of-the-crb-curb-65-scores-in-community-acquired-pneumonia
#4
Frederik S Frenzen, Ulrike Kutschan, Nils Meiswinkel, Bernhard Schulte-Hubbert, Santiago Ewig, Martin Kolditz
OBJECTIVES: Community-acquired pneumonia (CAP) is associated with a high risk of respiratory failure or septic organ dysfunction. Lactate is an established early marker of prognosis and sepsis severity, but few data exist in patients with CAP. METHODS: We performed a retrospective cohort study of consecutive adult CAP patients without treatment restrictions or direct ICU admission. Lactate was measured as point of care test within the capillary admission blood gas analysis and its prognostic value was compared to the CRB/CURB-65 criteria by multivariate and ROC curve analysis...
July 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28702467/ceftaroline-for-severe-methicillin-resistant-staphylococcus-aureus-infections-a-systematic-review
#5
REVIEW
Reese A Cosimi, Nahal Beik, David W Kubiak, Jennifer A Johnson
Ceftaroline is approved by the Food and Drug Administration for acute bacterial skin and skin-structure infections and community-acquired bacterial pneumonia, including cases with concurrent bacteremia. Use for serious methicillin-resistant Staphylococcus aureus (MRSA) infections has risen for a multitude of reasons. The aim of this article is to review the literature evaluating clinical outcomes and safety of ceftaroline prescribed for serious MRSA infections. We conducted a literature search in Ovid (Medline) and PubMed for reputable case reports, clinical trials, and reviews focusing on the use of ceftaroline for treatment of MRSA infections...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28701159/bacterial-bloodstream-infections-in-a-tertiary-infectious-diseases-hospital-in-northern-vietnam-aetiology-drug-resistance-and-treatment-outcome
#6
Vu Quoc Dat, Hieu Ngoc Vu, Hung Nguyen The, Hoa Thi Nguyen, Long Bao Hoang, Dung Vu Tien Viet, Chi Linh Bui, Kinh Van Nguyen, Trung Vu Nguyen, Dao Tuyet Trinh, Alessandro Torre, H Rogier van Doorn, Behzad Nadjm, Heiman F L Wertheim
BACKGROUND: Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However their aetiology, antimicrobial susceptibilities and associated outcomes differ between developed and developing countries. Systematic data from Vietnam are scarce. Here we present aetiologic data on BSI in adults admitted to a large tertiary referral hospital for infectious diseases in Hanoi, Vietnam. METHODS: A retrospective study was conducted at the National Hospital for Tropical Diseases between January 2011 and December 2013...
July 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28699429/the-order-of-administration-of-macrolides-and-beta-lactams-may-impact-the-outcomes-of-hospitalized-patients-with-community-acquired-pneumonia-results-from-the-community-acquired-pneumonia-organization
#7
Paula Peyrani, Timothy L Wiemken, Mark L Metersky, Forest W Arnold, William A Mattingly, Charles Feldman, Rodrigo Cavallazzi, Rafael Fernandez-Botran, Jose Bordon, Julio A Ramirez
BACKGROUND: The beneficial effect of macrolides for the treatment of community-acquired pneumonia (CAP) in combination with beta-lactams may be due to their anti-inflammatory activity. In patients with pneumococcal meningitis, the use of steroids improves outcomes only if they are administered before beta-lactams. The objective of this study was to compare outcomes in hospitalized patients with CAP when macrolides were administered before, simultaneously with, or after beta-lactams. METHODS: Secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study database...
July 12, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28698812/treatment-of-community-acquired-pneumonia-a-case-report-and-current-treatment-dilemmas
#8
Glenn Harnett
Resistance to macrolides is rising in the USA and warrants careful consideration when confronted with a patient with suspected pneumonia in the urgent care clinic. This case study exemplifies the potentially serious consequences of treatment failure following prescription of a macrolide for community-acquired bacterial pneumonia. Furthermore, the consequential treatment dilemmas currently faced by physicians are briefly discussed.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28697267/back-to-the-basics-community-acquired-pneumonia-in-children
#9
Kathleen Boyd
Community-acquired pneumonia (CAP) is a common childhood infection and often a reason for inpatient admission, especially when a child is hypoxic or in respiratory distress. Despite advances in technology and diagnostics, it remains difficult to accurately differentiate bacterial CAP from a viral process. Most of the laboratory tests routinely done in inpatient medicine, such as complete blood counts and acute phase reactants, do little to differentiate a viral pneumonia from a bacterial pneumonia. Clinicians must rely heavily on the clinical presentation and decide whether to treat empirically with antibiotics...
July 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#10
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28690980/crh-affects-the-phenotypic-expression-of-sepsis-associated-virulence-factors-by-streptococcus-pneumoniae-serotype-1-in-vitro
#11
Colette G Ngo Ndjom, Lindsay V Kantor, Harlan P Jones
Sepsis is a life-threatening health condition caused by infectious pathogens of the respiratory tract, and accounts for 28-50% of annual deaths in the US alone. Current treatment regimen advocates the use of corticosteroids as adjunct treatment with antibiotics, for their broad inhibitory effect on the activity and production of pro-inflammatory mediators. However, despite their use, corticosteroids have not proven to be able to reverse the death incidence among septic patients. We have previously demonstrated the potential for neuroendocrine factors to directly influence Streptococcus pneumoniae virulence, which may in turn mediate disease outcome leading to sepsis and septic shock...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28690643/mechanism-of-resistance-acquisition-and-treatment-of-macrolide-resistant-mycoplasma-pneumoniae-pneumonia-in-children
#12
REVIEW
Hyeon-Jong Yang, Dae Jin Song, Jung Yeon Shim
Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006-2007, 2011, and 2015-2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%-90%...
June 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28683724/first-report-of-cavitary-pneumonia-due-to-community-acquired-acinetobacter-pittii-study-of-virulence-and-overview-of-pathogenesis-and-treatment
#13
Romaric Larcher, Alix Pantel, Erik Arnaud, Albert Sotto, Jean-Philippe Lavigne
BACKGROUND: Acinetobacter pittii is a nosocomial pathogen rarely involved in community-acquired infections. We report for the first time that A. pittii can be responsible for cavitary community-acquired pneumonia and study its virulence, and discuss its pathogenesis and treatment options. CASE PRESENTATION: A 45-year-old woman with a history of smoking and systemic lupus was admitted to Nimes University Hospital (France) with coughing and sputum lasting for three weeks...
July 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28681941/the-respiratory-threat-posed-by-multidrug-resistant-gram-negative-bacteria
#14
REVIEW
Ana Rodrigo-Troyano, Oriol Sibila
Respiratory infections are a major cause of global mortality and morbidity. In recent years, an increased incidence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) has been described. Microorganisms such as Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae or Acinetobacter baumannii have been identified as causative pathogens of different respiratory tract infections. Several studies have detected MDR-GNB in patients with community-acquired and nosocomial pneumonia. Furthermore, MDR-GNB have also been isolated in patients with chronic obstructive pulmonary disease and bronchiectasis having acute or chronic bronchial infection...
July 6, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28677786/circulating-level-of-high-mobility-group-box%C3%A2-1-predicts-the-severity-of-community%C3%A2-acquired-pneumonia-regulation-of-inflammatory-responses-via-the-c%C3%A2-jun-n%C3%A2-terminal-signaling-pathway-in-macrophages
#15
Hsiang-Ling Wang, Shih-Ming Tsao, Chao-Bin Yeh, Ying-Erh Chou, Shun-Fa Yang
High mobility group box‑1 (HMGB‑1) has been reported to serve significant roles in various inflammatory diseases. However, the correlation between the circulating level of HMGB‑1 and severity of community‑acquired pneumonia (CAP) remains unclear. The present study investigated differential alterations in plasma HMGB‑1 levels of patients with CAP prior to and following antibiotic treatment, and further analyzed the association between CAP severity and HMGB‑1 levels. Furthermore, lipopolysaccharide (LPS)‑induced HMGB‑1 expression in RAW264...
June 30, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28677276/research-on-the-cause-of-death-for-severe-stroke-patients
#16
Mei-Zhen Yuan, Feng Li, Qin Fang, Wei Wang, Jing-Jing Peng, De-Yu Qin, Xue-Feng Wang, Guang-Wei Liu
AIMS AND OBJECTIVES: This study aimed to explore the characteristics of mortality among severe stroke patients, analyze their causes of death, and provide evidence for improving the survival rate of stroke patients. BACKGROUND: Stroke is an important fatal and disabling disease that poses a large burden on its patients, and its high death rates have caused substantial concern to the World Health Organization. DESIGN: A retrospective case-control study...
July 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28672897/adult-community-acquired-pneumonia-with-unusually-enlarged-mediastinal-lymph-nodes-a-case-report
#17
Lanhua Zhang, Shixiong Qiu, Cui Tang, Jinming Xu
Adult community-acquired pneumonia (ACAP) is the most prevalent pulmonary infectious disease that may be asymptomatic or have varying clinical presentations. Patients with ACAP often present with enlarged mediastinal lymph nodes on their chest computed tomography images. However, large irregular swollen lymph nodes are rarely reported in ACAP, and may therefore be confused with enlarged lymph node masses. In the present case report, the patient presented with lymph node masses, which were ameliorated to their normal size following antimicrobial treatment...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28670975/carbapenem-resistant-klebsiella-pneumoniae-isolated-from-bloodstream-infection-indian-experience
#18
Balaji Veeraraghavan, Chaitra Shankar, Susmitha Karunasree, Shantha Kumari, Raji Ravi, Ravikar Ralph
Increased incidence of multidrug resistant (MDR) Gram negative infection has resulted in high rates of morbidity and mortality. Klebsiella pneumoniae is one of the commonest MDR pathogens causing bacteraemia with limited therapeutic options such as colistin and tigecycline. Present study focused on molecular characterisation of MDR K. pneumoniae from bloodstream infection and their clinical outcome. A total of 115 K. pneumoniae from January 2015 to September 2016 were included in the study which comprised of phenotypically identified ESBL and carbapenem resistant (CR) isolates...
July 2, 2017: Pathogens and Global Health
https://www.readbyqxmd.com/read/28669016/co-infection-of-pseudomonas-aeruginosa-and-stenotrophomonas-maltophilia-in-hospitalised-pneumonia-patients-has-a-synergic-and-significant-impact-on-clinical-outcomes
#19
C Yin, W Yang, J Meng, Y Lv, J Wang, B Huang
Ventilator-acquired pneumonia and hospital community-acquired pneumonia are frequently caused by Gram-negative and -positive bacteria. We noted that pneumonia patients with co-infection of Pseudomonas aeruginosa and Stenotrophomonas maltophilia had a poor clinical outcome. To verify this, we retrospectively reviewed pneumonia cases at Hebei General Hospital from 2010 to 2015. These cases were grouped into four categories: (1) co-infection with P. aeruginosa and S. maltophilia, (2) infection with P. aeruginosa, (3) infection with S...
July 1, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28666965/individualizing-duration-of-antibiotic-therapy-in-community-acquired-pneumonia
#20
Stefano Aliberti, Julio Ramirez, Fabio Giuliani, Timothy Wiemken, Giovanni Sotgiu, Sara Tedeschi, Manuela Carugati, Vincenzo Valenti, Marco Marchioni, Marco Camera, Roberto Piro, Manuela Del Forno, Giuseppe Milani, Paola Faverio, Luca Richeldi, Martina Deotto, Massimiliano Villani, Antonio Voza, Eleonora Tobaldini, Mauro Bernardi, Andrea Bellone, Matteo Bassetti, Francesco Blasi
International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration...
June 27, 2017: Pulmonary Pharmacology & Therapeutics
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