Acute Pneumonia and Its Complications

Mani, Chitra S.

doi:10.1016/b978-0-323-40181-4.00034-7

Cited by 23 publications

(21 citation statements)

References 189 publications

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“…Community-acquired pneumonia (CAP) is a highly prevalent infection and remains the first cause of early childhood mortality in developing countries (1)(2)(3). Scientific guidelines were established to optimize and standardize medical care yet, several authors reported discrepancies between recommendations and actual management (4)(5)(6)(7)(8), leading to overuse of antibiotics, a higher resistance rate in community-acquired pathogens (9), and longer hospitalizations (7).…”

Section: Introductionmentioning

confidence: 99%

Management of Community-Acquired Pneumonia in Pediatrics: Adherence to Clinical Guidelines

2020

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Objectives: To evaluate adherence to guidelines for inpatient care of pediatric patients with community-acquired pneumonia (CAP). Background: Pediatric CAP is one of the most common acute infections requiring hospital admission. Discrepancies between recommended care and effective management are reported, raising the necessity to evaluate our local clinical practices. Patients and Methods: Retrospective data review of all children hospitalized for CAP at our institution was conducted between 2014 and 2017. Adherence to inpatient care guidelines was evaluated with a focus on indication of hospitalization, initial antibiotic choice, treatment duration, and hospital stay. A bivariate analysis was performed to identify clinical factors influencing adherence rates. Results: A total of 122 children (median age of 3.5 years) were identified. Hospital admission was indicated in 47.5% of patients and was driven by the value of serum CRP as well as prolonged fever. Median hospital stay was 4 days and was justified in 23.8% of patients. The choice of antibiotics was relevant in 91.8% of cases and amoxicillin-clavulanate was the most prescribed drug. The drugs dose, interval, and route of administration were respected in all cases. Antimicrobial therapy lasted for a median of 10 days and was in accordance with recommendations in 58.3% of patients. No clinical parameter was found to be significantly associated with length of stay or choice and duration of treatment. Conclusions: The choice of antibiotics was consistent with guidelines but treatment duration, indication and length of hospitalization still need to be improved.

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Section: Introductionmentioning

confidence: 99%

Management of Community-Acquired Pneumonia in Pediatrics: Adherence to Clinical Guidelines

2020

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“…Although a reliable method of identification, viral isolation is also time-consuming, and is insufficiently sensitive. Performing combinations of these procedures, did not show significantly improved pathogen identification in 34-57% of paediatric patients ( 10 ), and in 13-62% of adult patients with pneumonia ( 11 , 12 ). In the case of respiratory infection, diagnosis of specific microorganisms occurs when they are isolated from sterile materials such as bronchoalveolar lavage fluid (BALF) ( 10 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 91%

“…Performing combinations of these procedures, did not show significantly improved pathogen identification in 34-57% of paediatric patients ( 10 ), and in 13-62% of adult patients with pneumonia ( 11 , 12 ). In the case of respiratory infection, diagnosis of specific microorganisms occurs when they are isolated from sterile materials such as bronchoalveolar lavage fluid (BALF) ( 10 , 13 , 14 ). BALF is more suitable than sputum for identifying pathogens of respiratory infections, as less contamination with oral bacteria is possible during collection from the locus of infection ( 15 ).…”

Section: Introductionmentioning

confidence: 91%

“…The gold standard method is the usage of bacterial and fungal cultures; however, it is time-consuming and not suitable for identification of unculturable bacteria. PCR and antigen tests are commonly used for viral detection; however, only a defined set of microorganisms can be examined ( 10 ). Although a reliable method of identification, viral isolation is also time-consuming, and is insufficiently sensitive.…”

Section: Introductionmentioning

confidence: 99%

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Next-generation sequencing as an advanced supplementary tool for the diagnosis of pathogens in lower respiratory tract infections: An observational trial in Xi'an, China

et al. 2021

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The application of next-generation sequencing (NGS) in routine clinical analysis is still limited. The significance of NGS in the identification of pathogens of lower respiratory tract infection should be assessed as part of routine clinical bacterial examinations and chest imaging results. In the present study, the alveolar lavage fluid samples of 30 patients (25 males and 5 females, aged 19-92 years old, with a median age of 62) were examined by routine bacterial culture and NGS, and the results of pathogen detection and identification were compared. Chest imaging showed consolidation in all 30 patients (100%), and pleural effusion in 13 of the 30 patients (43.33%). The routine bacterial culture of the lavage solution was only positive in 14 of the 30 patients (46.6%), and negative in 16 patients (53.33%). However, the positive rate of NGS test results of the lavage fluid was 100%. A total of 12 cases (40%) were completely consistent with the routine bacterial culture test, with 56 other pathogens of mixed infection detected, accounting for the short comings of the routine bacterial examination. Although NGS cannot distinguish between live and dead bacteria, it is still a useful detection technology for accurate diagnosis of clinical infectious diseases. It is worthy of adaptation in the clinic for more effective clinical management and treatment of the lower respiratory airway infection in addition to the routine bacterial culture testing.

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“…It occurs when pathogenic viruses and bacteria invade the mucosa in the upper respiratory tract and spread to the lower respiratory tract. 3 Viruses are usually responsible for LRTI and respiratory syncytial virus (RSV), rhinoviruses, influenza A and B, parainfluenza virus, and adenoviruses have been identified as the main causative factors. 4 Hypoxemia is the most significant risk factor for all LRTI-related deaths, and hospitalization is shortened 5 and requirement of mechanical ventilator and mortality rates are significantly reduced by detecting hypoxemia via pulse oximetry and providing oxygen therapy.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey

Kar

Akın

Sert

et al. 2020

J Pediatr Infect Dis

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Objective Lower respiratory tract infections (LRTI) are one of the most important causes of morbidity and mortality in childhood. Hypoxemia, pulmonary hypertension (PH) due to pulmonary vasoconstriction, and heart failure due to various causes are the most important risk factors for mortality in LRTI. The aim of this study was to investigate characteristics of the patients with LRTI and the frequency of PH that developed secondary to LRTI. Materials and Methods The study included 70 patients who were diagnosed as having LRTI clinically and radiologically between January 2012 and March 2013 at Department of Pediatrics, Konya Training and Research Hospital. Age, sex, risk factors for LRTI, symptoms and physical examination findings, laboratory tests, and Doppler echocardiography findings of the patients were retrospectively reviewed. Results Of the patients, 44 (62.9%) were male and 26 (37.1%) were female. Thirty-seven (52.9%) patients were younger than 1 year, and the mean age was 2.5 ± 3.11 years. The most common symptoms of the patients were cough and fever. Rhonchus, retraction, and crackles were found to be the most common findings in physical examinations. Heart failure was found in 10% of patients and PH was detected in 8.6% through Doppler echocardiography. Development of heart failure and the presence of bilateral patch infiltration on posteroanterior chest X-rays were significantly more frequent in patients with PH. Some 42.9% of patients had at least one viral agent in their nasopharyngeal swabs. The most common viral agents were respiratory syncytial virus and rhinoviruses. Conclusion PH may develop during the course of LRTI in children. Given that the development of PH can cause life-threatening complications such as heart failure, affected patients should be kept under close follow-up. It should be remembered that PH is more likely to develop in patients with bilateral patch infiltration on chest X-ray.

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Acute Pneumonia and Its Complications

Cited by 23 publications

References 189 publications

Management of Community-Acquired Pneumonia in Pediatrics: Adherence to Clinical Guidelines

Management of Community-Acquired Pneumonia in Pediatrics: Adherence to Clinical Guidelines

Next-generation sequencing as an advanced supplementary tool for the diagnosis of pathogens in lower respiratory tract infections: An observational trial in Xi'an, China

Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey

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