Nonresolving pneumonia in steroid-treated patients with obstructive lung disease

Rodrigues, John; Niederman, Michael S.; Fein, Alan M.; Pai, Praba B.

doi:10.1016/0002-9343(92)90676-3

Cited by 75 publications

(30 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, in COPD patients [2,3,16,17,18,19,20,21,22,23,24,25,26,27,28] recent case reports have focused on IPA as a possible cause of life-threatening pneumonia. Therefore intensivists are increasingly faced with these acutely ill patients requiring life support and mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

“…Conclusions: The poor prognosis of intubated COPD patients with IPA, in spite of antifungal treatment suggests that further studies are required to define the limits and indications for ICU management of these patients. der chronic corticosteroid therapy [2,3,4]. Progressive respiratory failure requiring intensive care unit (ICU) admission for ventilatory support is often necessary in these patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis: benefits of intensive care?

et al. 2000

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis: benefits of intensive care?

et al. 2000

View full text Add to dashboard Cite

show abstract

“…In one large study, 9% of 595 patients with invasive aspergillosis (IA) suffered from pulmonary disease, without distinguishing among respiratory disorders [25]. RODRIGUES et al [26] reported that COPD patients contribute to 1% of all cases of IA in their institution.…”

Section: Epidemiologymentioning

confidence: 99%

“…Therefore, the present authors propose IPA definitions in that population of patients (table 1) in an attempt to standardise definitions, and based on the published information [12,13,34,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54], which are summarised in table 2.…”

Section: Ipa Definitionsmentioning

confidence: 99%

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Bulpa¹,

Dive²,

Sibille³

2007

Eur Respir J

314

200

View full text Add to dashboard Cite

Aspergillus spp. cultured in specimens from the airways of chronic obstructive pulmonary disease (COPD) patients are frequently considered as a contaminant. However, growing evidence suggests that severe COPD patients are at higher risk of developing invasive pulmonary aspergillosis (IPA), although IPA incidence in this population is poorly documented. Some data report that COPD is the underlying disease in 1% of patients with IPA.Definitive diagnosis of IPA in COPD patients is often difficult as tissue samples are rarely obtained before death. Diagnosis is therefore usually based on a combination of clinical features, radiological findings (mostly thoracic computed tomography scans), microbiological results and, sometimes, serological information.Of 56 patients with IPA reported in the literature, 43 (77%) were receiving corticosteroids on admission to hospital. Breathlessness was always a feature of disease and excess wheezing was present in 79% of patients. Fever (.38uC) was present in only 38.5%. Chest pain and haemoptysis were uncommon. Six out of 33 (18%) patients had tracheobronchitis observed during bronchoscopy. The median delay between symptoms and diagnosis was 8.5 days. The mortality rate was high: 53 out of 56 (95%) patients died despite invasive ventilation and antifungal treatment in 43 (77%) of them.In chronic obstructive pulmonary disease patients, invasive pulmonary aspergillosis currently carries a very poor prognosis. Outcome could perhaps be improved by more rapid diagnosis and prompt therapy with voriconazole.

show abstract

“…Infections were also more frequent in patients with severe asthma compared with the milder asthmatics. The higher frequency of infections in patients with severe asthma may be the result of corticosteroid treatment, especially if systemic and prolonged, and its attendant depression of the immune system [18][19][20][21]. Such an influence is usually not found with inhaled or short-term corticosteroid treatment [22,23].…”

Section: Discussionmentioning

confidence: 99%

Influence of Asthma in Pregnancy on Labor and the Newborn

Minerbi-Codish

Fraser²,

Avnun³

et al. 1998

Respiration

View full text Add to dashboard Cite

Asthma in pregnancy has been associated with maternal and fetal morbidity and mortality. This study examines the relations of asthma in pregnancy, its severity and its treatment to the labor process, maternal and fetal parameters. Hundred and one consecutive asthmatic women, who gave birth to single babies between November 1993 and November 1994 at the Soroka Medical Center were studied. A group of 77 nonasthmatic women, matched for age and ethnic origin, who gave birth to single babies during the same period served as controls. A larger percentage of asthmatic women suffered from respiratory and urinary tract infections than in the control group (p < 0.001). Severe asthma was associated with a higher rate of infections than milder asthma (p = 0.01). The incidence of smoking was higher among asthmatic women than among controls (p = 0.037). No association was found between socioeconomic status and smoking or infections. No association was found between maternal asthma or maternal use of corticosteroids and the following: maternal hypertension, maternal diabetes, low birth weight (<2,500 g), preterm delivery (<37 weeks), adequacy of weight to gestational age and Apgar scores. Three infants with congenital heart defects were born to asthmatic mothers. When the presentation of the fetus was not cephalic, all the asthmatic women were delivered by cesarean section, versus only 60% in the control group (p = 0.08). Labor was induced with oxytocin more often in the asthma group than in the control group (p = 0.07). We conclude that the labor and neonatal outcome in pregnant asthmatic women treated medically is good, even when asthma is severe and when the patient is treated with corticosteroids. There is, however, a relation between asthma in pregnancy, especially if severe, and predisposition to infections.

show abstract

Nonresolving pneumonia in steroid-treated patients with obstructive lung disease

Cited by 75 publications

References 14 publications

Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis: benefits of intensive care?

Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis: benefits of intensive care?

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Influence of Asthma in Pregnancy on Labor and the Newborn

Contact Info

Product

Resources

About