HRCT findings in the lungs of primary care patients with lower respiratory tract infection

Lähde, S; Jartti, Airi; Broas, Markku; Koivisto, Maila; Syrjälä, Hannu

doi:10.1034/j.1600-0455.2002.430211.x

Cited by 8 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Van Gageldonk-Lafeber et al observed no association between detected bacterial and viral pathogens and either diagnosis made by general practitioners or subject's reported symptoms ( 40 ). Moreover, physical examination alone was shown to have a sensitivity of 50–70% and specificity of 60–75% as well as a negative predictive value of 60% and a positive predictive value of 50% ( 41 , 42 ). The difficulty in establishing an etiologic outpatient diagnosis in acute febrile respiratory illness stems from overlap in symptoms and signs, limitations of available diagnostic tests, and the time lag in receiving results from laboratory tests.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of a combined MxA and CRP point-of-care immunoassay to identify viral and/or bacterial immune response in patients with acute febrile respiratory infection

Sambursky¹,

Shapiro

2015

European Clinical Respiratory Journal

View full text Add to dashboard Cite

BackgroundChallenges in the clinical differentiation of viral and/or bacterial respiratory infection lead to the misappropriation of antibiotics and increased healthcare costs. A tool to facilitate rapid and accurate point-of-care (POC) differentiation is needed.Methods and findingsA prospective, single center, blinded, observational clinical trial was conducted at Beth Israel Deaconess Medical Center from December 2012 to August 2013 to determine the accuracy of a POC immunoassay to identify a clinically significant immune response to viral and/or bacterial infection. Sixty patients with acute febrile respiratory infection (19 pharyngitis and 41 lower respiratory tract infection [LRTI]) were enrolled. Participants provided fingerstick blood for immunoassay testing (myxovirus A [MxA] and c-reactive protein [CRP]) and four oropharyngeal samples for viral PCR and routine bacterial cell culture. A venous blood sample was collected. An ELISA was used to measure CRP and MxA. Paired serological testing was used to confirm atypical bacteria. A urine sample was provided for Streptococcus and Legionella antigen testing. Patients with suspected LRTI had sputum and blood cultures, chest X-ray, and WBC count measured. Viral infection was confirmed if oropharyngeal PCR was positive for viral pathogens. Bacterial infection was confirmed in positive throat or sputum cultures. Elevated immunoglobulin M antibodies or twofold increase in IgG antibodies between acute and convalescent phase indicated atypical bacteria. Positive Streptococcus or Legionella urine antigen assays also confirmed bacterial infection. The immunoassay correctly categorized subjects as 92% (22/24) negative, 80% (16/20) with bacterial infection, and 70% (7/10) with viral infection.ConclusionsThe interplay between an MxA value and a semi-quantitative CRP value can aid in the differentiation of infectious etiology. In isolation, neither MxA nor CRP alone is sensitive or specific. However, the pattern of results in a rapid immunoassay provides a sensitive and specific method to differentiate acute febrile respiratory infections. This diagnostic information may help reduce antibiotic misuse and resistance and lower healthcare costs.

show abstract

Section: Discussionmentioning

confidence: 98%

Evaluation of a combined MxA and CRP point-of-care immunoassay to identify viral and/or bacterial immune response in patients with acute febrile respiratory infection

Sambursky¹,

Shapiro

2015

European Clinical Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…We think that the definition of asymptomatic infection should be reserved to the culture or PCR-positive patients without symptoms who have either seroconversion of antibodies or any lung infiltrate at thorax HRCT consistent with pneumonia-since it has been reported that HRCT has greater sensitivity than Chest X-Ray in diagnosing pneumonia [29,30].…”

Section: Discussionmentioning

confidence: 99%

Community-acquired pneumonia by Chlamydophila pneumoniae: a clinical and incidence study in Brazil

Chedid¹,

Chedid²,

Ilha³

et al. 2007

Braz J Infect Dis

View full text Add to dashboard Cite

As there was not any data on Chlamydia pneumoniae (TWAR) infections in Brazil so far, a prospective cohort study of adult patients hospitalized due to CAP was carried out for one year in a Brazilian university general hospital to detect the incidence of CAP by Chlamydophila pneumoniae (TWAR) for one year. During a whole year 645 consecutive patients hospitalized due to an initial presumptive diagnosis of respiratory diseases by ICD-10 (J00-J99), excluding upper respiratory diseases, were screened; 59 consecutive patients with CAP were diagnosed. They had determinations of serum antibodies to C. pneumoniae by microimmunofluorescence at the Infectious Diseases Laboratory of University of Louisville (KY, USA); 37 patients (63.8%) had seroreactivity to TWAR antigens, from which 23 (39.6%) had previous infection; 3 patients (5.2%) were diagnosed with CAP by TWAR and got cured. The incidence of TWAR CAP in our hospital by seroconversion was 5.2%. Our incidence of 5.2% is probably underestimated since TWAR culture was not available; we suggest that Real-Time PCR be used along with other diagnostic methods in future studies to detect the actual incidence of TWAR CAP. We propose that the serological criterion of IgM ≥1:16 alone to the diagnosis of acute infection by TWAR are discontinued due a lack of specificity.

show abstract

“…3 There are several studies that reported the superiority of CT to chest radiography for detecting pneumonia. [4][5][6][7][8][9] Although CT is more sensitive in diagnosing pneumonia and may be more specific for certain pathogens than chest radiography, objective guidelines regarding its indication are lacking. 10 Furthermore, whether CT improves the prognosis of pneumonia patients has not been revealed.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for detection failures of chest radiography in diagnosing pneumonia

Sugishita¹,

Saito²,

Asayama³

et al. 2017

J of Gen and Family Med

View full text Add to dashboard Cite

BackgroundLittle is known about clinical factors associated with undetectable pneumonic shadows on chest radiographs (CRs) for diagnosing pneumonia in the primary care setting.MethodsA retrospective assessment of CRs was conducted to compare chest computed tomography (CT) images of patients admitted to Kesennuma City Motoyoshi Municipal Hospital who were diagnosed with pneumonia from April 2014 to June 2016.ResultsEighty‐three patients were included, and their average age was 83.8 years. Sixty‐eight patients (81.9%) were officially certified as requiring long‐term care or support. Twenty‐nine of the 83 patients (34.9%) had either negative or normal findings on CRs, and positive findings consistent with pneumonia on CT. There were no significant differences in gender, age, cardiothoracic ratio on CR, or severity between the CR‐negative and CR‐positive groups. The proportion of negative CRs was significantly higher in patients with certified care level 5 under the long‐term care system in Japan and tube feeding.ConclusionThe failure rate of CRs for detecting pneumonic shadows was significantly higher in patients with certified care level 5 and tube feeding.

show abstract

HRCT findings in the lungs of primary care patients with lower respiratory tract infection

Cited by 8 publications

References 15 publications

Evaluation of a combined MxA and CRP point-of-care immunoassay to identify viral and/or bacterial immune response in patients with acute febrile respiratory infection

Evaluation of a combined MxA and CRP point-of-care immunoassay to identify viral and/or bacterial immune response in patients with acute febrile respiratory infection

Community-acquired pneumonia by Chlamydophila pneumoniae: a clinical and incidence study in Brazil

Risk factors for detection failures of chest radiography in diagnosing pneumonia

Contact Info

Product

Resources

About