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Slow resolving pneumonia

Luke C Mullany, Elburg W van Boetzelaer, Julie R Gutman, Laura C Steinhardt, Pascal Ngoy, Yolanda Barbera Lainez, Alison Wittcoff, Steven A Harvey, Lara S Ho
BACKGROUND: The World Health Organization's integrated community case management (iCCM) guidelines recommend that all children presenting with uncomplicated fever and no danger signs return for follow-up on day 3 following the initial consultation on day 1. Such fevers often resolve rapidly, however, and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aimed to determine if a conditional follow-up visit was non-inferior to a universal follow-up visit for these children...
April 2018: PLoS Medicine
Cigdem Isitan, Andrew Ferree, Anna DePold Hohler
Cefepime is a fourth generation cephalosporin which is bactericidal for broad spectrum of organisms. This is a case-series of three patients who presented to our hospital with confusion secondary to cefepime use to treat urinary tract infection (UTI) and health care associated pneumonia (HCAP), after excluding other common etiologies of altered mental status (AMS). Of these three patients, one had progressive expressive aphasia and the other two demonstrated asynchronous myoclonic activity of the limbs. The symptoms were seen within four to five days of initiating the treatment and resolved within three days of discontinuation of cefepime...
September 2017: ENeurologicalSci
Kelli L Hvorecny, Emily Dolben, Sophie Moreau-Marquis, Thomas H Hampton, Tamer B Shabaneh, Becca A Flitter, Christopher D Bahl, Jennifer M Bomberger, Bruce D Levy, Bruce A Stanton, Deborah A Hogan, Dean R Madden
The opportunistic pathogen Pseudomonas aeruginosa colonizes the lungs of susceptible individuals by deploying virulence factors targeting host defenses. The secreted factor Cif (cystic fibrosis transmembrane conductance regulator inhibitory factor) dysregulates the endocytic recycling of CFTR and thus reduces CFTR abundance in host epithelial membranes. We have postulated that the decrease in ion secretion mediated by Cif would slow mucociliary transport and decrease bacterial clearance from the lungs. To test this hypothesis, we explored the effects of Cif in cultured epithelia and in the lungs of mice...
January 1, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
Stephanie Main, Vikas Somani, Angus Molyneux, Milan Bhattacharya, Rabinder Randhawa, Ajikumar Kavidasan
Pulmonary Alveolar Proteinosis (PAP) is a rare condition with an incidence of one in two million and is classified as primary or secondary. This is the first reported case presenting as a slow resolving pneumonia.
2013: Respiratory Medicine Case Reports
Gavin W Hougham, Sandra A Ham, Gregory W Ruhnke, Elizabeth Schulwolf, Andrew D Auerbach, Jeffrey L Schnipper, Peter J Kaboli, Tosha B Wetterneck, David Gonzalez, Vineet M Arora, David O Meltzer
BACKGROUND: In patients hospitalized with community-acquired pneumonia (CAP), indicators of clinical instability at discharge (fever, tachycardia, tachypnea, hypotension, hypoxia, decreased oral intake and altered mental status) are associated with poor outcomes. It is not known whether the order of indicator stabilization is associated with outcomes. OBJECTIVES: To describe variation in the sequences, including whether and in what order, indicators of clinical instability resolve among patients hospitalized with CAP, and to assess associations between patterns of stabilization and patient-level outcomes...
April 2014: Journal of General Internal Medicine
Anneleen Notebaert, Jef Willems, Line Coucke, Rudy Van Coster, Helene Verhelst
We report on a 13-year-old boy who presented with signs suggestive of encephalitis and in whom magnetic resonance imaging revealed lesions in the genu and splenium of the corpus callosum and symmetrical lesions bilaterally in the center semiovale. This clinical-radiologic entity was previously reported in the literature and was given the acronym MERS type 2 (mild encephalitis with reversible splenial) lesion. The clinical, radiologic, and biochemical characteristics of the patient with MERS type 2 lesions presented in this article show some differences with those in previously reported patients...
February 2013: Pediatric Neurology
Damith Rodrigo, Ruwan Perera, Janaka de Silva
INTRODUCTION: Hepatitis C virus has been under-recognized as an etiologic factor for polyarteritis nodosa and the presence of hepatitis C antigenemia in patients with polyarteritis nodosa has been reported as insignificant. In the literature hepatitis C virus-associated polyarteritis nodosa is a rare and controversial entity. CASE PRESENTATION: A 34-year-old Sri Lankan Tamil man presented to our facility with a two-week history of slow-resolving pneumonia of the right mid and lower zones...
2012: Journal of Medical Case Reports
Toshihisa Sugita, Masashi Nakajima, Daisuke Arai, Kohichiro Kuwabara, Mitsuru Kawamura
We report the case of a 58-year-old woman who presented with acutely developed coma characterized by electroencephalographic triphasic waves (TWs) in the absence of metabolic derangement. The patient's coma and TWs were promptly resolved after the administration of glucocorticoids, and thereafter isolated ACTH deficiency was diagnosed. Isolated ACTH deficiency may present with glucocorticoid-responsive acute encephalopathy without hypoglycemia, hyponatremia, or systemic hypotension. Electroencephalographic TWs or bursts of slow waves may be a clue to the diagnosis of this rare condition in patients with coma of unknown origin...
2012: Internal Medicine
Charles Mayaud, Muriel Fartoukh, Jacques Cadranel
The favorable pneumonia outcome with antibiotics according to the recommendations is defined by improving clinical symptoms in 48-72 hours followed by their normalization within less than 10 days. This is different to stop progression of radiological abnormalities that can be delayed for 48-72 hours and moreover to radiological normalization which may require 4 to 8 weeks. The non favorable outcome, 48-72 hours after a first line of antibiotic therapy results in the vast majority of cases, from an infection: the pneumonia is not or poorly treated...
October 2011: La Revue du Praticien
Susana Dimas Alvarez, Maria Del Carmen Fernandez Gonzalez Aragon, Alvaro Moreno, Francisca Palomares-Alonso, Helgi Jung Cook, Graciela Cardenas, Jose Luis Soto-Hernandez
OBJECTIVE: Cefepime neurotoxicity usually occurs in patients with renal impairment. The aim of this study was to evaluate the neurotoxicity of cefepime administered by continuous intravenous infusion during treatment of nosocomial infections in neurological patients with normal renal function. METHODS: This was an open pilot study of neurological patients with infections caused by cefepime sensitive bacteria. Patients had baseline neurological assessment and electroencephalogram (EEG)...
September 1, 2011: Central Nervous System Agents in Medicinal Chemistry
Koustav Ganguly, Swapna Upadhyay, Martin Irmler, Shinji Takenaka, Katrin Pukelsheim, Johannes Beckers, Martin Hrabé De Angelis, Eckard Hamelmann, Tobias Stoeger, Holger Schulz
BACKGROUND: Declined lung function is a risk factor for particulate matter associated respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD). Carbon nanoparticles (CNP) are a prominent component of outdoor air pollution that causes pulmonary toxicity mainly through inflammation. Recently we demonstrated that mice (C3H/HeJ) with higher than normal pulmonary function resolved the elicited pulmonary inflammation following CNP exposure through activation of defense and homeostasis maintenance pathways...
2011: Respiratory Research
Ulrich A Maus, Simeon Janzen, Gerhard Wall, Mrigank Srivastava, Timothy S Blackwell, John W Christman, Werner Seeger, Tobias Welte, Jürgen Lohmeyer
In the acute respiratory distress syndrome, recruitment of peripheral blood monocytes results in expansion of the total pool of resident alveolar macrophages. The fate of resident macrophages, or whether recruited monocytes are selectively eliminated from the alveolar airspace or differentiate into resident alveolar macrophages during the resolving phase of inflammation, has not been determined. Here, we analyzed the kinetics of resident and recruited macrophage turnover within the alveolar airspace of untreated and LPS-challenged mice...
August 2006: American Journal of Respiratory Cell and Molecular Biology
Stephen Brunton
BACKGROUND: Many causes can be proposed for a change in the microbiologic makeup of a specific disease state. However, when viewed through the scope of recent events, only one is likely to be the true cause of a change in the microbiology of acute otitis media (AOM): the release and widespread use of heptavalent pneumococcal conjugate vaccine (PCV-7). OBJECTIVE: The aim of this report was to review the microbiology and prevalence of AOM before and after the release and widespread use of PCV-7...
January 2006: Clinical Therapeutics
Angela Morgan, Elizabeth Ward, Bruce Murdoch
The coexistance of a swallowing impairment can severely impact upon the medical condition and recovery of a child with traumatic brain injury [ref.: Journal of Head Trauma Rehabilitation 9 (1) (1994) 43]. Limited data exist on the progression or outcome of dysphagia in the paediatric population with brainstem injury. The present prospective study documents the resolution of dysphagia in a 14-year-old female post-brainstem injury using clinical, radiological and endoscopic evaluations of swallowing. The subject presented with a pattern of severe oral-motor and oropharyngeal swallowing impairment post-injury that resolved rapidly for the initial 12 weeks, slowed to gradual progress for weeks 12-20, and then plateaued at 20 weeks post-injury...
February 2004: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Stephen W B Fullerton, Simon Daff, David A R Sanders, W John Ingledew, Chris Whitfield, Stephen K Chapman, James H Naismith
UDP-galactopyranose mutase is a flavoprotein which catalyses the interconversion of UDP-galactopyranose and UDP-galactofuranose. The enzyme is of interest because it provides the activated biosynthetic precursor of galactofuranose, a key cell wall component of many bacterial pathogens. The reaction mechanism of this mutase is intriguing because the anomeric oxygen forms a glycosidic bond, which means that the reaction must proceed by a novel mechanism involving ring breakage and closure. The structure of the enzyme is known, but the mechanism, although speculated on, is not resolved...
February 25, 2003: Biochemistry
A Barbato, C Panizzolo, E S D'Amore, M La Rosa, M Saetta
Bronchiolitis obliterans with organizing pneumonia (BOOP) is rarely described in children and little is known about its pathogenesis. This paper reports on an 11-year-old patient suffering from mild-to-moderate asthma. He presented with a retrocardiac density at chest computed tomography scan that was slow to resolve and failed to respond to antibiotic therapy. Open lung biopsy revealed a histological picture with buds of granulation tissue in respiratory bronchioles and alveolar ducts, with organized extensions into the alveoli...
May 2001: Pediatric Pulmonology
C Possamai, U Corbanese
We report a case of slow-resolving pneumonia secondary to bronchiolitis obliterans organizing pneumonia (BOOP) in a 73-year-old woman. Owing to a delayed diagnosis of BOOP, the clinical course was quite long. This syndrome is caused by a nonspecific inflammatory pneumonitis, either idiopathic or associated with infectious or irritant agents (or drugs). It generally presents as a flu-like illness, followed by progressive dyspnea, cough, fever, and bilateral patchy alveolar infiltrates, and lasts several weeks...
July 1999: Acta Anaesthesiologica Scandinavica
H A Cassiere, M S Niederman
Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality in all age groups, especially the elderly, which is a patient population that continues to grow. Recently the spectrum and clinical picture of pneumonia has been changing as a reflection of this aging population; this requires a reassessment of and a new approach to the patient with pneumonia. Currently, pneumonia patients are classified as having either community-acquired or hospital-acquired infection rather than typical versus atypical...
November 1998: Disease-a-month: DM
M X Méndez Piñeiro, B Sopeña, A Rivera, J Carreró, M Freire, C Martínez-Vázquez
No abstract text is available yet for this article.
October 1996: Revista Clínica Española
H Cassiere, J C Rodrigues, A M Fein
Slowly resolving or nonresolving pneumonia is a clinical challenge, but we believe it can be dealt with in a rational and decisive manner. The following risk factors have been established for delayed radiographic resolution of pneumonia and should be considered in patient evaluation: Coexisting medical conditions History of smoking, Advanced age, Multilobar involvement, Persistent fever or leukocytosis. Diabetes, chronic obstructive pulmonary disease, renal failure, and alcohol abuse can impair immune function, which slows normal clearing of infiltrates...
January 1996: Postgraduate Medicine
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