Lobar Pneumonia Presenting as Fever, Headaches, and a Negative Chest Radiograph

Rendon, David R.; Shiau, Jason; Sherman, S

doi:10.1016/j.amjmed.2022.12.022

Cited by 1 publication

(1 citation statement)

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“… 7 , 8 Clinical cases can present with symptoms and signs data that do not permit an accurate diagnosis, and etiological culture of pathogens residing in the lower respiratory tract is hard to succeed. 9 , 10 Compared to the diversity and difficult detection of culprit pathogens, the host response to such infection is relative stable and consistent, and this is increasingly recognized as a feasible target for diagnosis and treatment development. 11–13 Therefore, we aimed to identify biomarkers for CAP by metabolomic analysis of bronchoalveolar lavage fluid (BALF) samples.…”

Section: Introductionmentioning

confidence: 99%

A Nomogram for Early Diagnosis of Community-Acquired Pneumonia Based on Bronchoalveolar Lavage Fluid Metabolomics

Chen¹,

Su²,

Lei³

et al. 2023

IDR

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Purpose There is a high disease burden associated with community-acquired pneumonia (CAP) around the world. A timely and correct diagnosis of CAP can facilitate early treatment and prevent illness progression. The present study aimed to find some novel biomarkers of CAP by metabolic analysis and construct a nomogram model for precise diagnosis and individualized treatment of CAP patients. Patients and Methods 42 CAP patients and 20 controls were enrolled in this study. The metabolic profiles of bronchoalveolar lavage fluid (BALF) samples were identified by untargeted LC-MS/MS analysis. With a VIP score ≥ 1 in OPLS-DA analysis and P < 0.05, the significantly dysregulated metabolites were estimated as potential biomarkers of CAP, which were further included in the construction of the diagnostic prediction model along with laboratory inflammatory indexes via stepwise backward regression analysis. Discrimination, calibration, and clinical applicability of the nomogram were evaluated by the C-index, the calibration curve, and the decision curve analysis (DCA) estimated by bootstrap resampling. Results The metabolic profiles differed obviously between CAP patients and healthy controls, as shown by PCA and OPLS-DA plots. Seven metabolites significantly dysregulated in CAP were established: dimethyl disulfide, oleic acid (d5), N-acetyl-a-neuraminic acid, pyrimidine, choline, LPC (12:0/0:0) and PA (20:4/2:0). Multivariate logistic regression revealed that the expression levels of PA (20:4/2:0), N-acetyl-a-neuraminic acid, and CRP were associated with CAP. After being validated by bootstrap resampling, this model showed satisfactory diagnostic performance. Conclusion A novel nomogram prediction model containing metabolic potential biomarkers in BALF that was developed for the early diagnosis of CAP offers insights into the pathogenesis and host response in CAP.

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