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unresolved pneumonia

Oluwatobi Afolayan, Hannah Copeland, Salman Zaheer, Jason M Wallen
A 57 year old man was referred from an outside facility for an unresolving pneumonia. Imaging of the chest demonstrated a right lung mass with a consolidation in the middle lobe, pleural effusion, and mediastinal lymphadenopathy. Cytologic examination of cultures from the bronchoscopy and thoracentesis did not yield a definitive diagnosis. Video-assisted thoracoscopic surgery (VATS) was performed because of a retained hemothorax and a suggestive lesion. Biopsy specimens obtained during VATS were consistent with mucormycosis...
June 2017: Annals of Thoracic Surgery
Christine Robin, Alexandre Alanio, Maud Gits-Muselli, Giulia la Martire, Frédéric Schlemmer, Françoise Botterel, Cécile Angebault, Mathieu Leclerc, Florence Beckerich, Rabah Redjoul, Cécile Pautas, Andrea Toma, Sébastien Maury, Stéphane Bretagne, Catherine Cordonnier
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in hematology. Although occasionally reported, the role of interhuman transmission of P. jirovecii in PCP, compared to that of reactivation, remains an unresolved question; the recommendation to isolate PCP patients in the hematology ward are not well evidence-based. Following an unexpected increase in the number of febrile pneumonia patients with P. jirovecii DNA detected in respiratory samples in our hematology ward, we explored 12 consecutive patients from November 2015 to May 2016...
2017: Frontiers in Microbiology
Amanda N Hyre, Kylie Kavanagh, Nancy D Kock, George L Donati, Sargurunathan Subashchandrabose
Urinary tract infection (UTI) is a major global infectious disease affecting millions of people annually. Human urinary copper (Cu) content is elevated during UTI caused by uropathogenic Escherichia coli (UPEC). UPEC upregulates the expression of Cu efflux genes during clinical UTI in patients as an adaptive response to host-derived Cu. Whether Cu is mobilized to urine as a host response to UTI and its role in protection against UTI remain unresolved. To address these questions, we tested the hypothesis that Cu is a host effector mobilized to urine during UTI to limit bacterial growth...
March 2017: Infection and Immunity
Makoto Hikage, Takashi Kamei, Toru Nakano, Shigeo Abe, Kazunori Katsura, Yusuke Taniyama, Tadashi Sakurai, Jin Teshima, Soichi Ito, Nobuchika Niizuma, Hiroshi Okamoto, Toshiaki Fukutomi, Masato Yamada, Shota Maruyama, Noriaki Ohuchi
BACKGROUND: The problem of recurrent laryngeal nerve (RLN) paralysis (RLNP) after radical esophagectomy remains unresolved. Several studies have confirmed that intraoperative nerve monitoring (IONM) of the RLN during thyroid surgery substantially decreases the incidence of RLN damage. This study tried to determine the feasibility and effectiveness of IONM of the RLN during thoracoscopic esophagectomy in the prone position for esophageal cancer. METHODS: All 108 patients who underwent prone esophagectomy at Tohoku University Hospital between July 2012 and March 2015 were included in this study...
July 2017: Surgical Endoscopy
Yasuo Kohashi, Toru Arai, Chikatoshi Sugimoto, Kazunobu Tachibana, Masanori Akira, Masanori Kitaichi, Seiji Hayashi, Yoshikazu Inoue
BACKGROUND: The prognosis of combined cases of pulmonary fibrosis and emphysema is unresolved partially because radiological differentiation between usual interstitial pneumonia and nonspecific interstitial pneumonia is difficult in coexisting emphysema cases. OBJECTIVE: The purpose of this study was to clarify the clinical impact of emphysema on the survival of patients with idiopathic pulmonary fibrosis (IPF). METHODS: One hundred and seven patients with interstitial lung diseases were diagnosed by surgical lung biopsies between 2006 and 2012, and 47 patients were diagnosed with IPF through multidisciplinary discussion...
2016: Respiration; International Review of Thoracic Diseases
Narin Sriratanaviriyakul, Hanh H La, Timothy E Albertson
BACKGROUND: Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion. CASE PRESENTATION: A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period...
August 12, 2016: Journal of Medical Case Reports
Samantha J Sander, Priscilla H Joyner, Carolyn Cray, David S Rotstein, Copper Aitken-Palmer
Acute phase proteins are sensitive markers of inflammation, which are highly conserved across taxa. Although the utility of these proteins are becoming well defined in human and domestic animal medical fields, their role in nondomestic species remains unclear. In this communication, a 20-yr-old Przewalski's horse was presented for unresolving aspiration pneumonia, which cultured a unique Actinomyces-like bacteria. Despite waxing and waning clinical signs and minimal changes on baseline hematologic analysis, protein electrophoresis, serum amyloid A, and surfactant protein D serum concentrations showed changes that more accurately reflected the clinical severity of this case...
June 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Ken Okumura, Kazuo Matsumoto, Yoshinori Kobayashi, Akihiko Nogami, Robert B Hokanson, Fred Kueffer
BACKGROUND: Outcomes of cryoballoon ablation for paroxysmal atrial fibrillation (PAF) have been reported in the Western countries but not in Japan. The CRYO-Japan PMS study was a single-arm, observational, multicenter, prospective study of the 2nd-generation cryoballoon Arctic Front Advance(TM). We evaluated device- and procedure-related complications and clinical outcomes at 6 months. METHODS AND RESULTS: The 616 patients (male, 72%; mean age, 63±11 years) were enrolled from 33 Japanese hospitals...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Irene Jarana Aparicio, Joyce S Lee
Interstitial lung disease (ILD) complicating connective tissue disorders, such as scleroderma and rheumatoid arthritis, is associated with significant morbidity and mortality. Progress has been made in our understanding of these collective diseases; however, there are still many unanswered questions. In this review, we describe the current views on epidemiology, clinical presentation, treatment, and prognosis in patients with connective tissue disease (CTD)-associated ILD. We also highlight several areas that remain unresolved and in need of further investigation, including interstitial pneumonia with autoimmune features, histopathologic phenotype, and pharmacologic management...
June 2016: Seminars in Respiratory and Critical Care Medicine
Polydoros Tofas, Anna Skiada, Maria Angelopoulou, Nikolaos Sipsas, Ioanna Pavlopoulou, Sofia Tsaousi, Maria Pagoni, Maria Kotsopoulou, Stavroula Perlorentzou, Anastasia Antoniadou, Maria Pirounaki, Athanasios Skoutelis, George L Daikos
Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) are currently among the most important nosocomial pathogens in many geographic regions. A retrospective study was conducted between 2010 and 2014 in four hospitals located in a high-prevalence area (Athens, Greece) to describe the clinical features, treatment and outcomes of neutropenic patients with haematological diseases complicated with CP-Kp bloodstream infections. A total of 50 patients were identified, including 48 with haematological malignancies and 2 with aplastic anaemia...
April 2016: International Journal of Antimicrobial Agents
Melissa M Walker, Lea Novak, Rebecca Widener, James Aaron Grubbs, Janice King, Joanetha Y Hale, Martina M Ochs, Lisa E Myers, David E Briles, Jessy Deshane
We used two different infection models to investigate the kinetics of the PcpA-dependent pneumococcal disease in mice. In a bacteremic pneumonia model, we observed a PcpA-dependent increase in bacterial burden in the lungs, blood, liver, bronchoalveolar lavage, and spleens of mice at 24 h postinfection. This PcpA-dependent effect on bacterial burden appeared earlier (within 12 h) in the focal pneumonia model, which lacks bacteremia or sepsis. Histological changes show that the ability of pneumococci to make PcpA was associated with unresolved inflammation in both models of infection...
March 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Daniela C Rodríguez, Hastings Banda, Ireen Namakhoma
In 2007, Malawi became an early adopter of integrated community case management for childhood illnesses (iCCM), a policy aimed at community-level treatment for malaria, diarrhoea and pneumonia for children below 5 years. Through a retrospective case study, this article explores critical issues in implementation that arose during policy formulation through the lens of the innovation (i.e. iCCM) and of the institutions involved in the policy process. Data analysis is founded on a documentary review and 21 in-depth stakeholder interviews across institutions in Malawi...
December 2015: Health Policy and Planning
A A Zaitsev, A Sinopalnikov
There is a significant number of diseases that occur in the guise of community-acquired pneumonia (CAP), so the progressive course, slowly allowed or unresolved CAP search for an alternative disease becomes crucial. In more than 20% of patients with the syndrome of "protracted" pneumonia alternative diagnosis are established. List of the main pathological processes occurring under the guise of pneumonia include: infiltrative pulmonary tuberculosis, acute interstitial pneumonia, acute eosinophilic pneumonia, thromboembolism, pulmonary artery branches, systemic vasculitis, and a number...
May 2015: Voenno-medit︠s︡inskiĭ Zhurnal
Hiroyuki Tamiya, Hideo Yasunaga, Hiroki Matusi, Kiyohide Fushimi, Masahiro Akishita, Sumito Ogawa
BACKGROUND: Proper artificial nutrition for patients who are unable to eat normally is an ongoing, unresolved concern in geriatric medicine and home medical care. Controversy surrounds prognostic differences between parenteral and enteral nutrition, 2 methods for artificial nutrition. OBJECTIVES: Short-term outcomes of parenteral and enteral nutrition for patients who are unable to eat normally were compared and analyzed. DESIGN: Data were acquired from patients selected from a national inpatient database covering 1057 hospitals in Japan...
November 2015: American Journal of Clinical Nutrition
Kai Wei Kelvin Lee, Joey Kuok Hoong Yam, Manisha Mukherjee, Saravanan Periasamy, Peter D Steinberg, Staffan Kjelleberg, Scott A Rice
Diversity has a key role in the dynamics and resilience of communities and both interspecific (species) and intraspecific (genotypic) diversity can have important effects on community structure and function. However, a critical and unresolved question for understanding the ecology of a community is to what extent these two levels of diversity are functionally substitutable? Here we show, for a mixed-species biofilm community composed of Pseudomonas aeruginosa, P. protegens and Klebsiella pneumoniae, that increased interspecific diversity reduces and functionally substitutes for intraspecific diversity in mediating tolerance to stress...
April 2016: ISME Journal
Kathleen W Wyrwich, Holly Yu, Reiko Sato, John H Powers
BACKGROUND: Millions of older adults who develop community-acquired pneumonia (CAP) each year survive, but there is a large knowledge gap on the burden of CAP and the recovery process in survivors from the patient perspective. METHODS: The newly developed CAP Burden of Illness Questionnaire was administered through a Web survey to a nationwide sample of US adults aged ≥50 years who were recently diagnosed with CAP. Survey respondents with unresolved symptoms or other CAP-related health problems completed a second survey 30 days later; a third survey was completed another 30 days later by respondents with unresolved symptoms or problems...
2015: Patient related Outcome Measures
J S W Prutton, S L Marks, M Aleman
BACKGROUND: Medical treatment of esophageal strictures in horses is limited and the use of balloon dilatation is described in few cases. Long-term follow up after balloon dilatation and the use of intralesional corticosteroids has not been evaluated. OBJECTIVES: To describe the use of endoscopic guided, esophageal balloon dilatation in horses for cervical and thoracic esophageal strictures and administration of intralesional corticosteroids at the time of dilatation...
July 2015: Journal of Veterinary Internal Medicine
Kei Suzuki, Yumiko Sugawara, Takao Sekine, Kazunori Nakase, Naoyuki Katayama
A 69-year-old man, who had been receiving prednisolone for 11 months for treatment of interstitial pneumonia, was diagnosed with acute myeloid leukemia. During induction therapy, he developed severe pneumonia. Although meropenem and micafungin were started, he died of circulatory failure owing to massive gastrointestinal bleeding. Autopsy specimens obtained from the stomach revealed fungal hyphae, which had invaded diffusely into submucosal vessels and caused the massive gastric bleeding. The same hyphae were also observed in both lungs...
November 2014: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Shih-Wen Chiu, Jen-Huo Wang, Kwuang-Han Chang, Ting-Hau Chang, Chia-Min Wang, Chia-Lin Chang, Chen-Ting Tang, Chien-Fu Chen, Chung-Hung Shih, Han-Wen Kuo, Li-Chun Wang, Hsin Chen, Chih-Cheng Hsieh, Meng-Fan Chang, Yi-Wen Liu, Tsan-Jieh Chen, Chia-Hsiang Yang, Herming Chiueh, Juyo-Min Shyu, Kea-Tiong Tang
Ventilator-associated pneumonia (VAP) still lacks a rapid diagnostic strategy. This study proposes installing a nose-on-a-chip at the proximal end of an expiratory circuit of a ventilator to monitor and to detect metabolite of pneumonia in the early stage. The nose-on-a-chip was designed and fabricated in a 90-nm 1P9M CMOS technology in order to downsize the gas detection system. The chip has eight on-chip sensors, an adaptive interface, a successive approximation analog-to-digital converter (SAR ADC), a learning kernel of continuous restricted Boltzmann machine (CRBM), and a RISC-core with low-voltage SRAM...
December 2014: IEEE Transactions on Biomedical Circuits and Systems
Peter A Ricketti, David W Unkle, Katherine A King, Dennis J Cleri, Anthony J Ricketti
Wet cough, wheeze, and sputum in an adolescent with evidence for bronchiectasis is an uncommon presentation. The differential diagnosis includes cystic fibrosis (CF), immunodeficiency disorders, complement deficiency, allergic bronchopulmonary aspergillosis, alpha-1 antitrypsin disease, repeated aspiration pneumonia, foreign body, bronchial carcinoid, unresolved right middle lobe pneumonia, and primary ciliary dyskinesia (PCD). The likely diagnosis proceeds from the more to less common in patients with these symptoms...
January 2015: Allergy and Asthma Proceedings:
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