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Parapneumonic pleural effusion

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https://www.readbyqxmd.com/read/29901573/acute-scoliosis-as-an-unusual-presentation-of-pneumonia-a-case-report
#1
Rajan Atwal, Charles Stewart
We describe the unique case of a child with pneumonia presenting with acute scoliosis and abdominal pain, without any typical features of the disease.A 10-year-old girl presented to the emergency department on 3 consecutive days with right-sided abdominal pain. There were no associated features, in particular, no fevers or respiratory symptoms. On the first 2 presentations, observation,examination, and blood test findings were unremarkable. Chest x-ray and abdominal ultrasound were also normal. On the third presentation a marked scoliosis was noted and abdominal examination revealed right-sided tenderness with rebound...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29875590/bedside-pleuroscopy-in-the-intensive-care-unit
#2
Hean Ooi
Objectives: It is not always possible to move critically ill patients to the operating or endoscopy room for a pleuroscopy. Bedside pleuroscopy is indicated for these patients. The aim of this study was to investigate the safety and complications of bedside pleuroscopy in an Intensive Care Unit (ICU). Materials and Methods: The patients who had undergone routine examinations for pleural effusion, with no established diagnosis at the previous admission were included in this analysis...
April 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29870025/differentiation-between-malignant-and-non-malignant-pleural-effusion-using-cancer-ratio-and-other-new-parameters
#3
Piotr Korczynski, Michal Mierzejewski, Rafal Krenke, Aleksandra Safianowska, Richard W Light
Introduction In contrast to tuberculous pleurisy (TP), no accurate and commonly accepted biochemical marker of malignant pleural effusion (MPE) has been established. Objectives We aimed to: 1) evaluate the ability of previously reported cancer ratio (CR) to discriminate MPEs and non-MPEs, 2) test whether age may have additional value in differentiating MPEs and non MPEs, and if so, 3) to combine LDH and age with other TP biomarkers in search of an index useful in the identification of MPE. Patients and methods A retrospective analysis of data from 140 patients with malignant (n=74), tuberculous (n=37) and parapneumonic (n=29) pleural effusions was performed...
June 5, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29869427/diagnostic-yield-of-pleural-fluid-cytology-in-malignant-effusions-an-australian-tertiary-centre-experience
#4
Paula Loveland, Micheal Christie, Gary Hammerschlag, Louis Irving, Daniel Steinfort
BACKGROUND: Timely diagnosis of malignant pleural effusions is critical to guide prognosis and management decisions. Cytologic analysis of pleural fluid has been the first-line diagnostic test for many decades, with highly variable reported sensitivities of 40 to 90%. Its diagnostic accuracy in modern practice in Australia needs to be understood. AIMS: To determine the diagnostic yield of pleural fluid cytology for the detection of malignant pleural effusions, and to determine the aetiologies of pleural effusions at our centre...
June 5, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29868142/evolutionary-particularities-in-a-case-of-severe-pneumonia-in-children-case-report
#5
Marcela Daniela Ionescu, Nicoleta Aurelia Popescu, Georgiana Balan, Veronica Marcu, Augustina Enculescu, Lorena Vatra, Marcel Oancea, Mihaela Balgradean
Necrotizing pneumonia remains an uncommon complication of pneumonia in children, but its incidence is increasing. Pneumococcal infection is the predominant cause of severe necrotizing pneumonia in children, but methicillin resistant Staphylococcus aureus (MRSA) and Panton-Valentine leukocidin (PVL) staphylococcal infections are also important. We present the case of a four-year-old girl,with an unremarkable medical history, who was admitted in our hospital with a history of high fever, productive cough and tachypnea lasting for 10 days, progressive worsening despite empirical oral antibiotic...
March 2018: Mædica
https://www.readbyqxmd.com/read/29781330/management-of-pleural-infections
#6
Lucía Ferreiro, José M Porcel, Silvia Bielsa, María Elena Toubes, José Manuel Álvarez-Dobaño, Luis Valdés
The management of infected pleural effusion is complex. Therapeutic resolution requires determining the following: appropriate antibiotic regimen, the need for pleural drainage, the optimal drainage tube size, and the need for intrapleural therapy or surgery. Areas covered: An updating of the latest advances in the management of parapneumonic pleural effusion based on the best evidence available is provided. Expert commentary: The correct management of parapneumonic pleural effusion is based on selecting an antibiotic regimen according to the origin of the pleural infection (community-acquired or nosocomial)...
June 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29660258/pleural-tuberculosis-a-concise-clinical-review
#7
Jane A Shaw, Elvis M Irusen, Andreas H Diacon, Coenraad F Koegelenberg
Tuberculosis (TB) is the leading infectious cause of death worldwide, and the commonest cause of death in people living with HIV. Globally, pleural TB remains one of the most frequent causes of pleural exudates, particularly in TB-endemic areas and in the HIV positive population. Most TB pleural effusions are exudates with high adenosine deaminase (ADA), lymphocyte-rich, straw-coloured and free flowing, with a low yield on mycobacterial culture. TB pleurisy can also present as loculated neutrophil-predominant effusions which mimic parapneumonic effusions...
May 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29538080/emerging-concepts-in-pleural-infection
#8
Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29517587/chest-imaging-for-the-diagnosis-of-complicated-parapneumonic-effusions
#9
José M Porcel
PURPOSE OF REVIEW: To provide an overview of the contribution of thoracic ultrasound (TUS) and computed tomography (CT) in the identification of complicated parapneumonic effusions (CPPE), defined as those which need chest tube drainage for resolution. RECENT FINDINGS: A recent retrospective study found that visualization of complex (nonanechoic) effusions on TUS (likelihood ratio positive = 6.92) outperformed the recognition of loculated/septated effusions on CT (likelihood ratio = 2...
March 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29425674/predictive-variables-for-failure-in-administration-of-intrapleural-tissue-plasminogen-activator-deoxyribonuclease-in-patients-with-complicated-parapneumonic-effusions-empyema
#10
Danai Khemasuwan, Jeffrey Sorensen, David C Griffin
BACKGROUND: Combined intrapleural therapy with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has been shown to reduce the need for surgical intervention for complicated pleural effusion/empyema (CPE/empyema). For patients in whom tPA/DNase is likely to fail, however, receipt of this therapy may simply delay the inevitable. The goal of this study was to identify risk factors for failure of combined intrapleural therapy. METHODS: We performed a retrospective chart review of patients who received intrapleural tPA/DNase for the treatment of CPE/empyema...
February 6, 2018: Chest
https://www.readbyqxmd.com/read/29353318/diagnostic-value-of-vascular-endothelial-growth-factor-transforming-growth-factor-%C3%AE-interleukin-8-and-the-ratio-of-lactate-dehydrogenase-to-adenosine-deaminase-in-pleural-effusion
#11
Takeshi Saraya, Kosuke Ohkuma, Takayasu Watanabe, Sunao Mikura, Fumi Kobayashi, Junpei Aso, Hiroki Nunokawa, Kojiro Honda, Yukari Ogawa, Masaki Tamura, Mitsuru Sada, Miku Oda, Manami Inoue, Takuma Yokoyama, Daisuke Kurai, Haruyuki Ishii, Hirokazu Kimura, Hajime Takizawa
PURPOSE: We studied the diagnostic value of cytokines, including vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and interleukin-8 (IL-8), and the ratio of lactate dehydrogenase (LDH) to adenosine deaminase (ADA) in pleural fluid. METHODS: Prospective analysis of 44 inpatients or outpatients with pleural fluid, from December 2016 to March 2017 was conducted. RESULTS: We enrolled patients with malignant pleural effusion (MPE, N = 15), empyema (N = 11), parapneumonic effusion (PPE, N = 7), chronic renal failure (CRF)/chronic heart failure (CHF) (N = 7), and tuberculous pleural effusion (TBPE, N = 4)...
April 2018: Lung
https://www.readbyqxmd.com/read/29288986/expression-profile-of-three-splicing-factors-in-pleural-cells-based-on-the-underlying-etiology-and-its-clinical-values-in-patients-with-pleural-effusion
#12
A-Lum Han, Hak-Ryul Kim, Keum-Ha Choi, Jae-Won Ryu, Ki-Eun Hwang, Hong-Seob So, Min-Cheol Park, Mengyu Zhu, Yuya Huang, Young-Jin Lee, Do-Sim Park
Splicing factors (SFs) are involved in oncogenesis or immune modulation, the common underlying processes giving rise to pleural effusion (PE). The expression profiles of three SFs (HNRNPA1, SRSF1, and SRSF3) and their clinical values have never been assessed in PE. The three SFs (in pellets of PE) and conventional tumor markers were analyzed using PE samples in patients with PE (N = 336). The sum of higher-molecular weight (Mw) forms of HNRNPA1 (Sum-HMws-HNRNPA1) and SRSF1 (Sum-HMws-SRSF1) and SRSF3 levels were upregulated in malignant PE (MPE) compared to benign PE (BPE); they were highest in cytology-positive MPE, followed by tuberculous PE and parapneumonic PE...
February 2018: Translational Oncology
https://www.readbyqxmd.com/read/29221347/safe-administration-of-intrapleural-alteplase-during-pregnancy
#13
Heather Torbic, Hanine Inaty, Siva Raja, Humberto Choi
Instillation of intrapleural (IP) fibrinolytics has been used in patients with complicated parapneumonic pleural effusions to improve fluid drainage and decrease the need for surgical intervention. However, clinical trials have not included certain special populations such as pregnant females and there are currently no published case reports of this practice in this group. We describe the case of a 35-year-old female, G2P1 at 32 weeks of gestation, with a complicated pleural effusion due to influenza pneumonia with superimposed bacterial pneumonia...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29202740/the-pleural-fluid-lactate-dehydrogenase-adenosine-deaminase-ratio-differentiates-between-tuberculous-and-parapneumonic-pleural-effusions
#14
Jinlin Wang, Jun Liu, Xiaohong Xie, Panxiao Shen, Jianxing He, Yunxiang Zeng
BACKGROUND: Although pleural fluid lactate dehydrogenase (LDH) and adenosine deaminase (ADA) levels are often used to distinguish between tuberculous pleural effusion (TPE) and parapneumonic pleural effusion (PPE), this can be challenging as the LDH level may vary from normal to severely increased in PPE and a significantly elevated ADA is frequently measured in both conditions. In this study, we evaluated use of the pleural fluid LDH/ADA ratio as a new parameter to discriminate TPE from PPE...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29124008/rare-complicated-parapneumonic-effusion-mycoplasma-pneumoniae-with-new-onset-lupus-flare-case-report-and-literature-review
#15
Bharat Bajantri, Shaik Danial, Richard Duncalf, Misbahuddin Khaja
Mycoplasma pneumoniae has been associated with respiratory tract infections. Mycoplasma pneumoniae pneumonia-related pleural effusion is rarely reported. Extra-pulmonary abnormalities such as encephalitis, myocarditis, glomerulonephritis, and myringitis have been reported. However pulmonary manifestations in systemic lupus erythematosus include pneumonitis, pleurisy, interstitial lung disease, and thromboembolic disease. We present the case of a 26-year-old male who came for evaluation of fever, cough, and shortness of breath with right-sided chest pain...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29081644/precision-guided-personalized-intrapleural-fibrinolytic-therapy-for-empyema-and-complicated-parapneumonic-pleural-effusions-the-case-for-the-fibrinolytic-potential
#16
Steven Idell, Galina Florova, Sreerama Shetty, Torry Tucker, Richard Idell, Kathy Koenig, Ali Azghani, Najib M Rahman, Andrey Komissarov
Complicated pleural effusions and empyema with loculation and failed drainage are common clinical problems. In adults, intrapleural fibrinolytic therapy is commonly used with variable results and therapy remains empiric. Despite the intrapleural use of various plasminogen activators; fibrinolysins, for about sixty years, there is no clear consensus about which agent is most effective. Emerging evidence demonstrates that intrapleural administration of plasminogen activators is subject to rapid inhibition by plasminogen activator inhibitor-1 and that processing of fibrinolysins is importantly influenced by other factors including the levels and quality of pleural fluid DNA...
July 2017: Clinical Pulmonary Medicine
https://www.readbyqxmd.com/read/29064169/unexpandable-lung-from-pleural-disease
#17
REVIEW
John T Huggins, Fabien Maldonado, Amit Chopra, Najib Rahman, Richard Light
Unexpandable lung is a common complication of malignant pleural effusions and inflammatory pleural diseases, such as pleural infection (e.g. empyema and complicated parapneumonic effusion) and noninfectious fibrinous pleuritis. Unexpandable lung due to pleural disease may be because of an active pleural process, and is referred to as malignant or inflammatory lung entrapment. An unexpandable lung may also be encountered in the setting of remote pleural inflammation resulting in a mature fibrous membrane overlying the visceral pleura preventing full expansion of the lung...
October 24, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28991771/surgical-treatment-of-pleural-empyema-our-results
#18
Goran Kondov, Zoran Spirovski, Irena Kondova-Topuzovska, Anita Kokareva, Risto Colanceski, M Srceva, Borislav Kondov, I Dzikovski, N Toleska-Dimitrovska, Sanja Petrusevska-Marinkovic
Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce morbidity, mortality and duration of hospital stay. Unfortunately, advanced stages of empyema need to use extensive surgery - decortications or thoracoplasty. Early recognition of the parapneumonic effusion and the adequate treatment with thoracentesis or pleural drainage, which is minimally invasive, is possible not to prograde the process and not to become empyema. AIM: To analyze the results of the surgical treatment in patients with empyema treated at Clinic for thoracic surgery...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28938258/pneumococcal-vaccination-and-pneumonia-associated-with-pleural-effusion-in-a-pediatric-population
#19
Enrique Bernaola, Francisco Gil, Mercedes Herranz, Alberto Gil-Setas, Marcela Guevara, Jesus Castilla
OBJECTIVE: The aim was to assess the effect of the nonsystematic pneumococcal conjugate vaccine (PCV) on incidence of pneumonia associated with parapneumonic pleural effusion (PPE) in vaccinated and unvaccinated children. METHODS: Cases were patients <15 years of age who had been diagnosed with pneumonia associated with PPE in a tertiary hospital in Navarra (Spain) between 1995 and 2014. The population <15 years of age and covered by the public health service was used as reference...
April 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28893806/low-dose-intrapleural-alteplase-without-deoxyribonuclease-in-complicated-parapneumonic-effusion-case-series-and-literature-reviews
#20
Carol Lai, Nurashikin Mohammad, Tidi Maharani Hassan, Mohamed Faisal Abdul Hamid
This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions...
September 11, 2017: BMJ Case Reports
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