“…Pneumonia is the most frequent presentation, with a mortality rate reaching 21% [52,53], related to shock and bacteremia. Several cases are also reported in travellers returning from endemic areas [54,55].…”
Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11673588. J. Ferreira-Coimbra (
“…Pneumonia is the most frequent presentation, with a mortality rate reaching 21% [52,53], related to shock and bacteremia. Several cases are also reported in travellers returning from endemic areas [54,55].…”
Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11673588. J. Ferreira-Coimbra (
“…27 Despite this, there was a 92% culture positivity, with overall lower mortality (6%). 27 Although the evidence base for the development of guidelines for prevention of melioidosis is limited, it is potentially a preventable disease. So far only cystic fibrosis (CF) patients have been warned about travelling to areas where melioidosis is endemic, no advice is given to tourists in general, despite steadily increasing number of cases in returned travelers, many with underlying comorbidities.…”
Section: Returned Travelersmentioning
confidence: 98%
“…26 Review of articles from PubMed and Web of Science databases found that imported cases of melioidosis into Europe are largely from Thailand (53%), in travelers on holiday who were hospitalized within 1 month following return to Europe. 27 Regardless of the multifaceted nature of presentations, pneumonia remained the most common diagnosis, although misdiagnoses were common at 21%. 27 Despite this, there was a 92% culture positivity, with overall lower mortality (6%).…”
Section: Returned Travelersmentioning
confidence: 99%
“…27 Regardless of the multifaceted nature of presentations, pneumonia remained the most common diagnosis, although misdiagnoses were common at 21%. 27 Despite this, there was a 92% culture positivity, with overall lower mortality (6%). 27 Although the evidence base for the development of guidelines for prevention of melioidosis is limited, it is potentially a preventable disease.…”
AbstractMelioidosis, caused by the facultative intracellular gram-negative pathogen Burkholderia pseudomallei, is an emerging cause of community-acquired pneumonia across the tropics. The majority of patients present with pneumonia with or without sepsis, but localized and asymptomatic infection is also well recognized. Recent modeling and epidemiological studies have demonstrated the widespread presence of B. pseudomallei in otherwise unrecognized regions with a predicted mortality of 90,000 deaths worldwide. Innovative environmental studies are also uncovering how hydrodynamic, pedology, fauna, and weather events influence geographic distribution and incidence of melioidosis cases. Of concern is the changes associated with global warming, which will be conducive to B. pseudomallei in combination with the global diabetes pandemic. In fact, over 80% of patient developing melioidosis have underlying comorbidities. For this great mimicker, culture remains the mainstay of diagnosis and despite availability of other assays, challenges still remain in reducing time to diagnosis and avoiding misdiagnosis. With institution of timely antimicrobials such as ceftazidime and supportive intensive care, overall mortality can be reduced to 10%, although this can still be as high as 50% in poorly resourced areas. Promise is on the horizon with the first human vaccine trials being planned for 2021. Meanwhile new multiomics techniques are giving us a better understanding of the role of virulence and host–pathogen interactions on patient outcomes.
“…Die Übersicht ist erschwert, da keine Meldepflicht Keine Meldepflicht besteht. Der Großteil aller dokumentierten Melioidosen wurde bei Reiserückkehrern aus Thailand Thailand beschrieben [ 15 ].…”
Section: Seltene Bakterielle Erkrankungen Der Lungeunclassified
Es werden Infektionen der Lunge durch Viren, Bakterien, Pilze und Parasiten dargestellt, die in Deutschland nicht endemisch und wenig bekannt sind. Die zoonotische Influenza, das „middle east respiratory syndrome“ (MERS) und die Pest können mit potenziell schweren pulmonalen Komplikationen mit hoher Mortalität und der Gefahr einer nosokomialen Ausbreitung einhergehen, sodass Betroffene isoliert werden müssen. Die Melioidose, Blastomykose, Parakokzidioidomykose und Histoplasmose werden oft zunächst als ambulant erworbene Pneumonie mit typischem Erregerspektrum verkannt. Ein wichtiger Schlüssel zur Diagnose ist die Anamnese mit Abfrage möglicher Expositionen in Endemiegebieten. Die Paragonimiasis manifestiert sich meist wenige Wochen nach dem Verzehr erregerhaltiger roher Meeresfrüchte, typisch ist eine ausgeprägte Eosinophilie. Es werden für die jeweiligen Erreger relevante Aspekte von Epidemiologie, klinischem Verlauf, Therapie und ggf. Prävention beleuchtet, da jederzeit mit Fällen in Deutschland gerechnet werden muss.
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